Problem of Lead Poisoning


The National Referral Center for Lead Poisoning Prevention in India (NRCLPI) established by The George Foundation with St. John's National Institute of Health Sciences has now become the nodal referral center in India. Several sub centers are being setup in Andhra Pradesh, Kerala and other states. NRCLPI conducts blood tests, awareness creation efforts and consultation with lead-based industries to reduce lead contamination.

The George Foundation, through NRCLPI, sponsored the evaluation of blood lead levels in lead acid battery industry workers. It has provided reagents and equipment.

OK International (USA) has come forward with an initial grant of US$ 2000 to fund NRCLPI projects on lead in the environment and health. Details of the project are being worked out. NRCLPI has initiated a global networking effort to limit childhood lead poisoning. A nodal centre has been established in Mauritius with the help of its government. The centre will evaluate lead-related health problems in the African subcontinent.

In India, the state governments of Andhra Pradesh, West Bengal and Tamil Nadu are supporting the establishment of state-level referral centres for lead absorption as Chapters of NRCLPI.

A proposal for preparing a lead map of India and a project for a museum of lead-based products both require financial and other support.

Karnataka State PCB has provided NRCLPI Rs.82,800 to screen children below 12 years of age at all district headquarters. Each phase will cover three districts at a time. Three students of Rajiv Gandhi University of Health Sciences and one student of MAHE Manipal have registered for their Ph.D studies on lead-based health topics in the field of Biochemistry.

In Bangalore, the Bangalore Municipal Transport Corporation is meeting the actual expenditure incurred in screening transport employees for blood lead. HICAL Magnetic in Electronic City on the outskirts of Bangalore is covering the cost of evaluation of blood lead in women working in the electronic soldering industry.

Lead poisoning is the number one environmental disease among children in developing countries. The full impact of lead poisoning on the health of children and adults is becoming clearer to most countries, and many governments have begun to take action. Those countries that have developed lead prevention programs have realized significant health and economic benefits.

Until recently, the Government of India did not recognize the seriousness of lead poisoning, and there was very little awareness about it on the part of the population. However, following the blood screening of children in major cities carried out by The George Foundation under "Project Lead Free," this situation began to change. The accomplishments to-date can be summarized as follows:

  • During 1998-99, The George Foundation carried out blood lead tests of over 22,000 children and adults in 7 major cities (Mumbai, Delhi, Calcutta, Chennai, Bangalore, Hyderabad and Vellore) with the participation of 12 hospitals in those areas. This study is the largest ever conducted anywhere in the world to assess the level of lead poisoning in the general population.

  • In February 1999, The George Foundation sponsored and hosted in Bangalore the largest international conference on lead poisoning prevention and treatment ever held, jointly with the World Bank, WHO, CDC, USEPA. At this conference, the results of Project Lead-Free were announced, that revealed that over 51% of the children below the age of 12 living in major urban areas of India had unacceptably elevated levels of blood lead of 10 mcg/dl or more.

  • The results of Project Lead-Free raised the concern of those involved in medical and environmental professions, while for the first time international agencies and the Government of India accepted the seriousness of the problem. At the conference, the 3 major oil refining companies announced that they would offer unleaded petrol within 15 months.

  • In April 2000, all three oil companies announced the introduction of unleaded petrol throughout India. The government regulated that all automobiles use unleaded petrol with immediate effect.

  • The George Foundation published the proceedings of the Bangalore conference, and formed an executive committee consisting of the 5 sponsors and heads of several Indian and international agencies to come up with a joint resolution. This committee issued a "Call for Action" that described what steps should be taken by developing countries to achieve significant progress in their respective nations to reduce lead poisoning within a 5-year timeframe.

  • The Pollution Control Board within the Ministry of Environment formed a Lead Poisoning Prevention Committee that included The George Foundation representative as a member to formulate policy on lead poisoning prevention. This committee accepted the "Call for Action" recommendations with minor modifications, and subsequently issued directives through the Ministry of Environment on battery recycling.

  • The George Foundation and St. Johns Academy of Health, Bangalore, joined together to establish the National Referral Centre for Lead Poisoning in India (NRCLPI). This organization's primary mission is to create public awareness about lead poisoning, assist polluting industries to take remedial measures, and to confirm blood lead cases forwarded by clinics/hospitals throughout the country. NRCLPI is now recognized nationally as the pivotal institution on matters dealing with lead poisoning in India.

  • NRCLPI is currently (April 2002) conducting a major follow up study of blood lead, lead and other additives in petrol, and the level of harmful metals in vegetables, fruits, tap water, bottled water, milk, house dust, play ground soil, and other sources and pathways.

More about Lead Poisoning

Lead occurs naturally in the earth's crust. When ingested, inhaled, or absorbed through skin, lead is highly toxic to humans. Lead's toxicity has been known for thousands of years; Greek physicians made the first clinical description of lead poisoning in the first century B.C.

Lead is not biodegradable. It persists in the soil, in the air, in drinking water, and in homes. It crosses all social, economical and geographical lines. It never disappears, it only accumulates where it is deposited and can poison generations of children and adults unless properly removed.

At high levels, lead poisoning causes coma, convulsions and death. At low levels - levels far below those that present obvious symptoms - lead poisoning in childhood causes reductions in IQ and attention span, reading and learning disabilities, hyperactivity, impaired growth, behavioral problems, and hearing loss. These effects are long-term and may be irreversible.

World-wide, six sources appear to account for most lead exposure:

  1. gasoline additives;
  2. food can soldering;
  3. lead-based paints;
  4. ceramic glazes;
  5. drinking water systems; and
  6. cosmetic and folk remedies.

Other significant exposures result from inadequately controlled industrial emissions from such operations as lead smelters and battery recycling plants, which contaminate environments and people in the surrounding areas. The highest level of environmental contamination is found to be associated with uncontrolled recycling operations and the most highly exposed adults are those who work with lead.

Developed countries like the US, UK and Germany have taken aggressive steps to combat lead poisoning. In developing countries, however, actions have been slower and sporadic. Within the last decade, reports of lead poisoning in humans have poured in particularly from the developing countries faced with environmental and occupational lead exposure.

In India, as in most developing countries, the main source of lead pollution is automobile exhaust. Although India issued in February 1990 its first National Emission Standards for lead and other pollutants, the recommended permissible limits of lead (0.56 g/L) are still very much higher than those of developed countries like the US, UK, and Germany. In the US, the virtual elimination of leaded gasoline resulted in a 77% decrease in the average blood lead level of the population between 1976 and 1991. In the UK, a 50% drop in gasoline lead levels corresponded with a 20% drop in blood lead levels.

The scope and nature of lead poisoning that recent studies have uncovered are alarming. Here are some hard facts:

  • No level of lead in blood is safe or normal. The disturbing fact is that exposure to extremely small amounts can have long-term and measurable effects in children while at the same time causing no distinctive symptoms.
  • Once lead is absorbed into the bloodstream, some of it is filtered out and excreted, but the rest gets distributed to the liver, brain, kidneys and bones.
  • Lead causes anemia in both children and adults by impairing the formation of oxygen-carrying molecules, beginning at exposures of around 40ug/dl. In adults, small but significant increases in blood pressure result from exposures as low as 5 ug/dl, with no evidence of a threshold below which lead does not affect blood pressure.
  • Other adverse effects in adults include kidney disease and impaired fertility.
  • Hypertension caused by lead exposure contributes to thousands of deaths every year, particularly in men between the ages of 35 and 50.
  • Children and pregnant women are particularly susceptible to lead poisoning.
  • Children's digestive system absorbs up to 50% of the lead they ingest. The high retention occurs from birth to age 6 when the brain is developing and lead interferes with its development. By the time physical symptoms are evident - headache, lethargy or hyperactivity, nausea, stomach aches, vomiting, and constipation - significant brain damage has already occurred. Abdominal pain, vomiting and constipation help greatly to differentiate lead from infectious disease that cause similar symptoms and are common, but result in diarrhea.
  • Children pick up lead dust from the floor, from their toys and from pets. They ingest lead when they put their hands in their mouths, when they eat with their hands, when they suck their thumbs, when they ingest soil. Lead compounds used in paint taste sweet, encouraging small children to lick or chew paint chips or chalky paint residue. A single chip of paint of the size of a thumbnail contains 1 gram of lead and a few such chips can raise the intake of lead to 1,000 times the acceptable limit.
  • Blood lead levels in children of around 10 ug/dl are associated with disturbances in early physical and mental growth and in later intellectual functioning and academic achievement. These persist into adulthood and may be irreversible.
  • Progressive elevation of blood lead levels in a child's system can cause a potential genius to drop to an average achievement level and an average child to become learning disabled. Studies have shown as much as a 5.8 decline in IQ (on a scale where 100 is average) for every 10 micrograms increase of lead in blood levels. Long-term consumption of low levels of lead can be more dangerous than a single ingestion of concentrated lead.
  • The fetuses of pregnant women are gravely affected by lead exposure since lead can pass through the placenta directly into the baby. When an expectant mother maintains a poor diet, the problem is compounded since she will start breaking down bone to release calcium and other minerals, thereby releasing lead stored in the bones which passes to the developing baby. High lead exposure probably results in fetal death.
  • Deficiency of iron, calcium and zinc increase absorption and effects of lead.
  • The Centers for Disease Control and Prevention (CDC), USA, has developed various classes of elevated blood lead levels in children. If a child's level is greater than 45 ug/dl, chelation treatment and exposure reduction should start within 48 hours, while levels at or above 70 ug/dl are a medical emergency. Even higher levels cause swelling of the brain or encephalopathy. Children with levels above 120 ug/dl may die unless immediately treated.
  • Childhood lead poisoning is typically more severe in developing countries due to inadequately controlled industrial emissions, unregulated cottage industries, and cultural practices such as folk medicines containing lead.
  • The World Health Organization estimates that 15-18 million children in developing countries are suffering from permanent brain damage due to lead poisoning. Hundreds of millions of children and pregnant women in practically all the developing countries are exposed to elevated levels of lead.

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