Lead Poisoning Our Children are at Risk Presented by: Marcia Thelwell-Reid MPH, B.Sc. Walden University
Purpose of Presentation • To increase knowledge of the risks from lead poisoning and to decrease childhood blood lead levels in your community.
Learning Outcomes • At the end of the session, participants should be able to: • Define lead poisoning • Identify signs, symptoms and adverse effects of lead poisoning, especially in children • Identify sources of lead in the environment • Take steps to decrease childhood blood lead levels in your community
Stakeholders • Parents • Health care providers • Cottage industry operators • Scrap metal dealers • Battery repairers
Headline News • Jamaica Gleaner – June 22, 2008 • “Lead poisoning linked to crime” (Professor Lalor) • Jamaica Gleaner – April 2004 • “Lead poisoning in Jamaican children is not a new phenomenon”(Dr. Evans-Gilbert) • Could there be a possible link between our unexplainable high crime rate and lead poisoning of our children? (Source: http:www.jamaica-gleaner.com/gleaner/20080622/lead/lead6.html http:www.jamaica-gleaner.com/gleaner/20040414/news/news5.html
What is lead poisoning? • A medical condition that occurs when lead builds up in the body over a period of time. It is also referred to as saturnism, plumbism or painters colic. • Children under the age of 6 are very vulnerable to lead poisoning. • Affects mental and physical development and can be fatal at high levels.
History • Lead poisoning is not new, recognized as early as 2000 BC • Gout, anemia and colic were prevalent in early Rome as a result of ingesting lead from food containers • Famous individuals such as Beethoven and Handel suffered from lead poisoning.
Standards • A 'high' blood level is now defined as more than 10 micrograms (a microgram is one millionth of a gram) of lead per deciliter (1/2 cup) of blood, i.e. (10 mcg/dL). • Studies show that blood lead levels as low as 2 mcg/dL have been linked to deaths from heart attack and stroke. • Conclusion – no level is safe! (Source: Lead in blood: Safe levels too high? Retrieved 17/07/09 from http://www.webmd.com/news/20060918/lead-in-blood-safe-levels-too-high
Jamaican Situation • IN 2004, the National Safety Council reported that approximately 400,000 children under age six had significant levels of lead in their blood (Lalor, 2008). • A Kingston study reveal that 43% of children had blood lead level greater than 70 mcg/dL, and 84% of yards had soil lead levels above 500 ppm (Matte, et al, 1989)
Sources of lead poisoning • Most common source - battery repair shops • Matte ,et al (1989) concluded that battery repair shops create a high risk of lead poisoning for nearby residents. • A previous study concluded that cottage lead smelters are a hazard for nearby residents. • Increasing demand for lead on the world market has resulted in a 120% increase in backyard smelters for used batteries (Lalor, 2008).
Other Sources of Lead • Soil – from gasoline or paint; can last for years, e.g., Red Pond and Kintyre communities • Water – lead pipes, brass plumbing fixtures, copper pipes soldered with lead • Lead paint – discontinued but older houses still have lead-based paints • Household dust – from paint chips or soil brought in from outside • Imported canned foods – lead solder still used in some countries • Cosmetics • Toys and crayons – tested regularly for lead • Lead-glazed food containers
Symptoms of lead poisoning - children • Lead poisoning is difficult to detect early as poisoned individuals may appear healthy. • Signs may include: • Decreased attention span • Decreased hearing • Speech delays • Behavioral problems • Loss of appetite • Weight loss • Abdominal pain • Sluggishness and fatigue • Vomiting • Constipation • anemia
Symptoms in adults • Lead poisoning is also dangerous for adults • Signs and symptoms include: • Pain, numbness or tingling of the extremities • Muscular weakness • Headache • Abdominal pain • Memory loss • Mood disorders • Reduced sperm count, abnormal sperm • Miscarriage or premature birth • fatigue
Adverse effects - children • The greatest risk to children is brain damage • Even low levels can result in irreversible damage • Decreased muscle and bone growth • Hearing damage • Learning disabilities • Nervous system and kidney damage • Poor muscle coordination • Speech, language and behavior problems • Anemia Source: Mayo Clinic, http://www.mayoclinic.com
Adverse effects - adults • Cataracts • Damage to reproductive organs in men • Digestive problems • High blood pressure • Memory and concentration problems • Muscle and joint pain • Nerve disorders • Pregnancy complications • Schizophrenia • Source: Mayo clinic
Factors Influencing Lead Toxicity in Developing Countries • Risk factors are related to exposure, health and prevention efforts (Falk, 2003). • Exposure • Multiple sources • Industrial sites located in residential areas • Hot climates: more exposure to outdoor environments • Child labour • Inadequate tracking of lead use and consumption • Poor environmental monitoring capacity
Factors Influencing Lead Toxicity in Developing Countries (Cont) • Health • Poor nutrition enhances lead toxicity (iron and calcium intake reduces lead accumulation) • Limited knowledge of toxic chemicals among parents/caregivers • Lack of equipment and trained personnel for laboratory monitoring • Lack of or incomplete lead poisoning surveillance • Unavailability of drugs for treatment
Factors Influencing Lead Toxicity in Developing Countries (Cont) • Prevention measures • Limited safety or hygiene programs • Lack of adequate regulations and standards • Lack of enforcement where standards exist • Lack of protective devices or safety equipment • Absence of programmes to remove children from contaminated areas
Who are at risk? • People who live in areas at high risk for lead poisoning (smelters and battery repair shops) • Children who live with adults that are exposed to lead (furniture makers, battery workers, potters and those making stained glass and remodelling homes) • Babies and children under six years (absorb lead more easily than adults) • Children living in older homes with lead paints • People with lead amalgam in their dental fillings
Treatment for lead poisoning • First step is to remove the individual from the source of contamination • For mild cases, avoiding exposure will reduce blood lead levels • For severe cases: • Chelation therapy • EDTA therapy
Prevention • Lead poisoning in children is preventable! • Parents • Keep children away from peeling paints (windows) • Wash child's hands often, especially if he/she sucks thumb • Avoid food storage in lead glazed pottery • Fortify the diet with iron and calcium • Know where your kids play • Keep your home dust free • If you have metal pipes, run tap for 1 minute before using • Avoid using hot tap water for babies’ formula • Keep children away from lead workers
Prevention • Workers • Wear protective clothing and equipment • Change clothes and shower before leaving the job • Avoid washing work clothes with other clothing • Don’t eat or drink where lead may be present • Don’t remove lead paint by sanding (creates more dust) • Avoid backyard battery repairs and smelting
Prevention • Health Care Providers • Be aware of the signs and symptoms of lead poisoning • Refer suspected children for testing • Educate parents about lead poisoning and preventive measures
Prevention • Governmental authorities • Ensure adequate supply of treatment drugs • Assess local situation and identify all sources of lead in the environment • Develop policies aimed at reducing lead exposure from the identified sources • Implement monitoring and surveillance system for lead poisoning in children
Efforts to reduce lead contamination in Jamaica • Leaded gasoline banned in 2000 • Lead in household paint discontinued • Toy imports checked for toxic levels of lead • Lead recovery plant closed • Sources of poisoning in Kintyre and other areas isolated
Existing problem • Greatest source of lead in the Jamaican environment is the improper disposal of lead acid batteries
A Success Story - USA • In 1978 there were about 14.8 million lead poisoned children in the United States. • By the early 1990s, that number had declined to 890,000 children, as a result of: • Phase out of lead from gasoline, food and beverage containers and new house paints • Reduction of lead in: • industrial emissions • drinking water • Consumer goods • Hazardous waste sites • The CDC established a goal to eliminate BLL ≥ 10 µg/dL in children under six years by 2010. • Blood lead levels continue to decline. • Children with BLL ≥ 10 µg/dL have declined from 130,512 in 1997 to 74,887 in 2001 (Meyer, 2003).
Conclusion • Lead poisoning is preventable • Requires the efforts of all stakeholders in saving our children from lead poisoning. • There is also the possibility of reducing our spiralling crime rate by preventing lead poisoning in our children. • We can stop making “fools” of our chiildren.
Thank you for listening • Questions ? ? ? ?
Reference • Evans-Gilbert, T. (2004). Lead poisoning in Jamaican children. Retrieved 18/07/09 from http://www.jamaica-gleaner.com/gleaner/20040414/news/news5.html • Falk, H. (2003). International environmental health for the pediatrician: Case study of lead poisonong. Pediatrics, 112:259 - 264 • Lalor, G. (2008). Lead poisoning linked to crime. Retrieved 18/07/09 from http://www.jamaica-gleaner.com/gleaner/20080622/lead/lead6.html • Lead poisoning. Retrieved 17/07/09 from http://kidshealth.org/parent/ • Matte, T.D., Figueroa, J.P., Ostrowiski, S., Burr, G., Jackson-Hunt, L., Keenlyside, R.A. & Baker, E.L. (1989). Lead poisoning among household members exposed to lead-acid battery repair shops in Kingston, Jamaica. International Journal of Epidemiology, 18:874 – 881. • Matte, T.D., Figueroa, J.P., Ostrowiski, S., Burr, G., Jackson-Hunt, L., & Baker, E.L. (1991). Lead exposure from conventional and cottage lead smelting in Jamaica. Archives of Environmental Contamination and Toxicology, 21:65 – 67. • Mayo Clinic (2009). Lead poisoning. Retrieved 17/07/09 from http://www.mayoclinic.com/health/lead-poisoning/ • Meyer, et al (2003). Surveillance for Elevated Blood Lead Levels Among Children --- United States, 1997—2001. Retrieved 27/06/09 from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5210a1.htm