Estimated Dietary Lead Exposure Through Aquatic Animal Consumption and Health Symptoms in a Lake-Dependent Community: Evidence from Nong Han Lake, Northeast Thailand

Lead (Pb) is a persistent environmental contaminant and a major public health concern. This cross-sectional study investigated self-reported health symptoms and estimated dietary Pb exposure from aquatic animal consumption among residents living around Nong Han Lake, Thailand. Sociodemographic characteristics, dietary behaviors, and health symptoms were collected using a structured questionnaire. Pb concentrations were measured in three commonly consumed aquatic species, and species-specific estimated dietary Pb intake (EDI) was calculated from Pb concentrations and reported consumption patterns. Multivariable logistic regression identified factors associated with symptom reporting. Pb concentrations in all aquatic species were below the permissible limit (0.3 mg/kg wet weight). Median EDI was 0.1004 µg/kg bw/day (IQR: 0.0645–0.1785). Musculoskeletal pain (79.73%) and joint and muscle pain (71.62%) were the most commonly reported symptoms. This study found that female sex (aOR = 2.62; 95% CI: 1.099–6.249; p = 0.030), a lack of lead hazard training (aOR = 3.39; 95% CI: 1.373–8.418; p = 0.008), consumption of more than 300 g of aquatic animals per meal (aOR = 2.47; 95% CI: 1.230–4.960; p = 0.011), and long-term consumption exceeding 30 years (aOR = 2.16; 95% CI: 1.065–4.398; p = 0.033) were each independently associated with symptom reporting. Estimated dietary Pb intake (EDI) was not significantly associated with symptoms after multivariable adjustment (aOR = 1.30; 95% CI: 0.657–2.578; p = 0.450). These findings suggest that consuming large portions of aquatic animals, consuming aquatic animals over prolonged periods, and having limited awareness of lead-related hazards are potential pathways for dietary Pb exposure in this lake-dependent community.