PONE-D-21-33664Blood lead levels and lead toxicity in children aged 1-5 years of Cinangka Village, Bogor RegencyPLOS ONE

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: GENERAL COMMENTS

First, congratulations on the good work! It is particularly a topic that interests me, but it is also a worrying issue that should be highlighted.

In second, the manuscript is well written and tells a reader-friendly story (context). I made some notes that I believe will further improve the quality of your work.

INTRODUCTION

- Lines 62-64: I suggest to say that this number (900,000) is almost equivalent to the number of deaths from HIV/AIDS and is greater than the number of deaths from malaria, war and terrorism and natural disasters. Saying it "is greater than" other causes of death adds more weight to your argument.

- Line 64: First occurrence of "IHME", so use the full name accompanied by the acronym. Even with a list of abbreviations, it's interesting to identify the acronym on its first appearance.

- Line 87: Same for “NHANES”.

- Line 123: Missing an L in the acronym.

MATERIALS AND METHODS

The economic issue is very present in the study. I think it would be interesting to point out, if available, general economic indicators for the region (Gross Domestic Product or Gini Coefficient, for example). In addition, informing the number of inhabitants in the region can also contribute to an understanding of the economic context of the study area.

RESULTS

- Line 166 (and elsewhere): Change g/dl to g/dL.

- Lines 166-168: Is there a limit (lower and/or higher) for hemoglobin levels? If so, it would be interesting to add them to this paragraph. For the reader, it is interesting to know the threshold used to consider the child as having anemia.

- Lines 185-186: Did you mean "50% of PARENTS lived at the ULAB recycling site for more than 23 years"?

DISCUSSION

- Lines 192-193: "Practically" and "only" together doesn't seem to make sense. Also, reiterate which “safe criteria” you are referring to.

- Lines 222-225: What is the value recommended by Management of Hazardous and Toxic Waste? It is important information to incorporate into the manuscript.

- Line 366: Apply the correct tab to the paragraph (here and elsewhere in the manuscript).

Reviewer #2: Line 104: Please include the full the names before each acronyms.

Line 138 - 140: Please, the author must describe in detail anthropometric data. Where the anthropometric measurements were taken? by whom? They are trained to ensure technique standardization? Witch technics and instruments were used to measure height and weight?

line 153: In methods section it is important to describe the currency used to measure family income. Furthermore, I suggest that the authors describe how much 2,000,000 rupiah is equal to the dollar.

Line 141 – 151: Please, in the paragraph of blood sampling and analysis, inform the reference values of all hematological parameter evaluated and how the author determine high/low levels to Hb and BLL.

Line 163 – 166: I suggest include a figure of these BLL data. The authors would include a scatter plot, highlighting the mean value of BLL and WHO reference value (10 µg/dL). This will bring greater emphasis to the outcome of the study.

263 – 264: “in the age range of 1-5 years, the growth of children does not look significant compared to when they were in elementary school.” This is not true. There are several recently studies that point out that the first 2.000 days of child’s life (5 years old) are a crucial period to development (physical, emotional, social, intellectual), than any other time. In this period children are at their developmental peak. Please, review this information in the manuscript.

Major Coments:

# According to a hierarchical model of study variables, the first level would be the sociodemographic factors, then the nutritional status and then the hematological parameters. Therefore, I suggest reverted the describe order of the methodology and results section. First the authors would describe socioeconomic characteristics, then nutritional status and finally the main outcome (hematological parameters/Hb levels). In this way, table 4 and table 1 can be unified, since socioeconomic characteristics can also be considered baseline characteristics.

# In addition to height e weigh, the author must include in Table 1 anthropometric indices as BMI for age, since the systems of classification of the nutritional status of children have been recommended by the World Health Organization and others international organization, based on the BMI for each age. The weight and height alone is of little use and effective for a child's nutritional assessment

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Reviewer #1: Yes: Rodrigo de Lima Brum

Reviewer #2: No

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Blood lead levels and lead toxicity in children aged 1-5 years of Cinangka Village, Bogor Regency

PONE-D-21-33664R1

Dear Dr. Irawati,

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Kind regards,

Flavio Manoel Rodrigues Da Silva Júnior

Academic Editor

PLOS ONE