Childhood lead poisoning a big challenge for healthcare professionals in India

A new report states that around one in three children worldwide has blood lead levels at or above five micrograms per deciliter (µg/dL). There is no safe blood level of lead. However, a level of 5 µg/dL or above is used to indicate a possibly unsafe level for children. Children whose blood tests at those levels should be tested periodically.

Widespread use of lead has resulted in extensive environmental contamination and health problems in many parts of the world, including India. Experts say lead is a cumulative toxicant. That is, its quantity continues to increase in the body over many years and affects multiple body systems. Young children are more susceptible to toxic effects of lead and can suffer with permanent adverse effects on their health.

Out of the 800 million children globally who are suffering from lead poisoning, about half of them are in South Asia and nearly 275 million children are affected by lead exposure in India.

Lead has a more harmful effect on children

Lead exposure occurs when too much of this toxic metal makes its way into our bodies over months or years while we breathe, eat, or drink. Experts say even small quantities of lead can result in critical health problems and children are particularly vulnerable. Lead is a toxic metal that accumulates in our system through our bloodstream and has a more harmful effect on children’s health than on adults.

The report from UNICEF titled 'The Toxic Truth: Children’s exposure to lead pollution undermines a generation of potential', which was released recently says that India has over 275 million children with blood lead levels higher than considered safe. This is also the highest number of lead poisoning cases in children of any country. Some studies find that exposure to lead can make kids lose up to four IQ points.

The report, prepared by UNICEF and an organisation called Pure Earth, states that lead poisoning can cause serious damage to children’s health.

The authors of the report jointly prepared by UNICEF and Pure Earth said their findings were mainly based on data from the Institute of Health Metrics and Evaluation (IHME), University of Washington, which obtained results of blood tests on tens of thousands of children across the world. IHME publishes the research tool, the Global Burden of Disease.

Unborn children and those under 5 at greater risk

The UNICEF report states, "Lead is a powerful neurotoxin. Lead poisoning affects the brain, heart, lungs and kidneys of children. It affects the nerves of the brain. In cases of low exposure, the intellectual development of children is affected leading to low IQ levels, low attention and violent and even criminal behaviour later in life."

"Unborn children and children under the age of 5 may be at greater risk of exposure to lead. Lead poisoning can also damage an unborn child’s brain, kidneys, and nervous system. Lead may cause mental and cognitive problems i.e. lack of understanding and low intelligence, and permanent physical impairment. Lead poisoning may prove fatal for many children," says the report.

Lead poisoning in childhood causes reductions in IQ and attention span, as well as reading and learning disabilities, memory loss, lack of concentration, headaches, irritability, depression, nausea, poor appetite, hyperactivity, impaired growth, and hearing loss. These effects are long-term and may be irreversible.

After India, the countries most affected by lead poisoning in children are Nigeria, Pakistan and Bangladesh.

According to the WHO, lead poisoning can affect virtually every organ system in the body. The principal organs affected are the central and peripheral nervous system and the cardiovascular, gastrointestinal, renal, endocrine, immune and haematological systems.

Unsafe recycling of lead acid batteries

The UNICEF and Pure Earth report says the main cause of lead poisoning is unsafe recycling of lead acid batteries. Exposure to lead can occur by polluted air, water, dust, food, or consumer products. Children can come in contact with lead through a number of sources including lead-glazed utensils and glassware, childcare products made of vinyl and plastic, lead paint of houses and toys, leaded gasoline, and drinking water leaking out of lead pipes etc. Some spices like black pepper and chili powder and herbal medicines may also be other sources of lead in the human body. In India, the irregular handling and disposal of electronic waste (e-waste) can also lead to the risk of lead poisoning. But illegal and uncontrolled re-cycling of lead acid batteries is the main cause of lead poisoning among kids in India, the report points out.

Big increase in number of vehicles in poor countries

Nicholas Rees, the lead author of the report, says, "Since 2000, there has been a tremendous increase in the number of vehicles in poor and low income countries and this has led to a spike in the use as well as recycling of lead acid batteries. Re-cycling is sometimes done in an unsafe way."

According to the report, 85 percent of the total production of lead in the world is used to make lead acid batteries. A large part of this comes from the recycling of lead batteries used in vehicles.

The report says the lead batteries are opened in an unsafe manner during uncontrolled and mostly illegal recycling. This causes acid and lead dust to fall to the ground. The lead is melted in open furnaces and its poisonous smoke spreads in the air and pollutes the entire surrounding areas. Experts say that this is a matter of concern in India.

300 sites contaminated by lead were assessed

"We have assessed 300 sites contaminated by lead throughout India, most of which are informal battery recycling sites and industrial areas with different types of factories," says Promila Sharma of Pure Earth, the report's co-publisher.

The facts gathered were separately assessed by Pure Earth which is a voluntary organisation and works on the impact of environment on humans and earth.

"Our assessment is only a small part of a difficult and gigantic problem," says Promila. "There are many places where the lead acid batteries are illegally recycled, but often this work is done stealthily. Sometimes people do this work in the backyard of their houses and this affects the people living in that area."

Her organisation found that lead-acid battery recycling is done more in states of West Bengal, Bihar and Uttar Pradesh.

"We also found that the work of re-cycling old batteries imported from Bangladesh and Nepal is also increasing in these places," says Promila.

In 2010, five-year-old Amit Pandey suffered from ill-health and persistent and recurrent vomiting. His father Dheeraj Pandey, who hails from northern state of Uttar Pradesh, consulted a doctor, who told him that Amit was suffering from anaemia.

Amit's blood test revealed that the amount of lead in his blood was nearly 50 percent more than safe blood level for this metal.

At that time Dheeraj was making both ends meet by recycling batteries. He used to keep these batteries at his home.

Dheeraj says, "I had no idea that my son's health would suffer due to my work."

After his son's health deteriorated, Dheeraj immediately left this job. Amit's treatment continued for many years, he required blood transfusion on several occasions. Amit's lower body parts were deformed and he needed special shoes to walk.

Ten years have passed since then and now Amit's health has started improving. He is now 15 years old and his studies in school are also going on well.

But his family is worried about him because the amount of lead in his blood is still high.

Dheeraj Pandey says, “He no longer has anaemia but has other health problems like hyperactivity.”

According to the UNICEF and Pure Earth report, the amount of lead in the blood of 275 million children in India is above five micrograms per deciliter. According to the World Health Organisation and the US Centre for Disease Control and Prevention, this level of lead is dangerous and it requires governments to take steps in this matter.

According to some studies, the risk of lead poisoning is higher for infants and children under five years because it starts damaging their brain before it is fully formed. Their body organs can become deformed.