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The dangers of lead

  • With a growing number of lead poisoning cases in children, the harmful effects of heavy metal poisoning must be addressed at the policy level and in the public
– Manish Gautam (The Kathmandu Post: PRINT EDITION – 2015-08-01  |  ON SATURDAY)
Last month, a 14-month-old child from Bhaktapur was taken to Siddhi Memorial Hospital, Bhaktapur, for a routine check up when a team of government researchers approached the child’s family. After the researchers counselled the family in detail, the parents agreed to conduct a test on the child. The team carried with them a portable machine that took blood samples from a tiny prick on the child’s fingertip. The blood was processed and, in less than three minutes, the researchers had a verdict.Surprisingly, the child, who had barely started walking, had a lead level of 40.20 micrograms per decilitre in his blood, which is about 10 times higher than the level recommended by the Center for Disease Control (CDC), USA. According to the CDC, a blood lead level (BLL)of more than 5 µg/dl is harmful. The parents, of course, were completely unaware of this situation.
In a similar case at the Tribhuvan University Teaching Hospital, a 17-month-old child from Kathmandu underwent a blood test that showed that the child’s BLL was 40.30 µg/dl.
A recent government report has painted a grim picture of the current situation of BLL in children aged less than three years.The research, undertaken by the Nepal Health Research Council (NHRC), shows that over 90 percent of children in the country are exposed to the toxic heavy metal, which could significantly deter mental growth in children and has other detrimental effects on their health.
The research was conducted among 312 children visiting Tribhuvan University Teaching Hopsital, Patan Hospital and Siddhi Memorial Hospital, Bhaktapur. The researchers, apart from looking into the demographic and income details, conducted on-the-spot blood tests using said portable machine. Each of these tests cost Rs 6,000.
According to Dr Megh Nath Dhimal, chief of the research unit at the NHRC, only 10 percent of the surveyed children had a normal BLL, while the rest exceeded the national and international average. The study found that 26 percent of the children had 0.1-5 µg/dlBLL, while around 65 percent had a BLL above 5 µg/dl. “The Center for Diseases Control recommends that having a BLL of more than 5 micrograms per deciliter is harmful. Our scenario can only be described as ‘the worst case’,” says Dhimal. He says children are exposed to lead through various means such as toys, paints and lead content in the air.
Quite a few reports in the past have already established a high presence of lead in paints and children’s toys. Research in 2013 revealed that over 50 percent of children’s toys sold in the markets here contained toxins. The report stated that in Kathmandu, 54 percent of the toys were found to contain deadly toxins—28 percent contained lead, 40 percent bromine, 14 percent chromium, 9 percent cadmium and 1 percent mercury. The samples of the toys, mostly manufactured in Nepal, India and China, were collected from footpath vendors and shopping malls.
Lead enters the body through children’s inhaling toxic particles, gnawing on toys and so forth. Similarly, old houses whose coats of paint peel off also release lead in the air. Children who play often with dirt were also found to have a high BLL.
“Children belonging to ethnic groups such as Dalits, Janajatis, Tarai caste groups and religious minorities had 3.4 times higher BLL compared to children from upper-caste communities,” says Dhimal.“While this needs further analysis, it can also be assumed that parents take their children to potential sources of lead in unsafe workplaces. As children spend their entire day playing around without any oversight, they face a significant amount of exposure,” he says.
According to the World Health Organisation, at high levels of exposure, lead attacks the brain and the central nervous system, resulting in coma, convulsions and even death. Children who survive severe lead poisoning may be left with mental retardation and behavioural disruption. “Lead affects children’s brain development, resulting in a reduced intelligence quotient (IQ), behavioural changes such as shortening of the attention span, increased antisocial behaviour and reduced educational attainment,” the WHO states.
While there have been some efforts on the government’s part, experts urge a stringent implementation of provisions regarding lead content and an increasing awareness of the dangers of lead poisoning at the policy level and in the public. In December 2014, the government set a standard of 90 parts per million or 90 milligram of lead per litre paint, whether imported or produced in the country.
Dr Krishna Poudel, director of the Child Health Division, says it is past time that the government focused on lead poisoning. “Only children suspected of lead poisoning are tested at hospitals,” says Dr Poudel. “To be honest, the public still doesn’t understand that lead poisoning is a major problem.”
Poudel added that although the CHD is not currently involved with the lead poisoning cases, they will soon ask the Ministry of Health and Population to conduct an extensive follow-up on the issue.
(The Kathmandu Post: PRINT EDITION – 2015-08-01  |  ON SATURDAY)

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