Our Children are at Risk

Lead Poisoning

Presented by: Marcia Thelwell-Reid MPH, B.Sc.Walden University

Purpose of PresentationTo increase knowledge of the risks from

lead poisoning and to decrease childhood blood lead levels in your community.

Learning OutcomesAt the end of the session, participants

should be able to:Define lead poisoningIdentify signs, symptoms and adverse effects

of lead poisoning, especially in childrenIdentify sources of lead in the environmentTake steps to decrease childhood blood lead

levels in your community

StakeholdersParentsHealth care providersCottage industry operators

Scrap metal dealers Battery repairers

Headline NewsJamaica 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.

HistoryLead poisoning is not new, recognized as

early as 2000 BCGout, 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.

StandardsA '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 SituationIN 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 poisoningMost common source - battery repair

shopsMatte ,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 LeadSoil – from gasoline or paint; can last for years,

e.g., Red Pond and Kintyre communitiesWater – lead pipes, brass plumbing fixtures,

copper pipes soldered with leadLead paint – discontinued but older houses still

have lead-based paintsHousehold dust – from paint chips or soil brought

in from outsideImported canned foods – lead solder still used in

some countriesCosmeticsToys and crayons – tested regularly for leadLead-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 spanDecreased hearingSpeech delaysBehavioral problemsLoss of appetiteWeight lossAbdominal painSluggishness and fatigueVomitingConstipationanemia

Symptoms in adultsLead poisoning is also dangerous for adultsSigns and symptoms include:

Pain, numbness or tingling of the extremitiesMuscular weaknessHeadacheAbdominal painMemory lossMood disordersReduced sperm count, abnormal spermMiscarriage or premature birthfatigue

Adverse effects - childrenThe greatest risk to children is brain damage

Even low levels can result in irreversible damageDecreased muscle and bone growthHearing damageLearning disabilitiesNervous system and kidney damagePoor muscle coordinationSpeech, language and behavior problemsAnemia

Source: Mayo Clinic, http://www.mayoclinic.com

Adverse effects - adultsCataractsDamage to reproductive organs in menDigestive problemsHigh blood pressureMemory and concentration problemsMuscle and joint painNerve disordersPregnancy complicationsSchizophrenia

Source: Mayo clinic

Factors Influencing Lead Toxicity in Developing CountriesRisk factors are related to exposure, health

and prevention efforts (Falk, 2003).Exposure

Multiple sourcesIndustrial sites located in residential areasHot climates: more exposure to outdoor

environmentsChild labourInadequate tracking of lead use and

consumptionPoor 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 programsLack of adequate regulations and standardsLack of enforcement where standards existLack of protective devices or safety

equipmentAbsence 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 paintsPeople with lead amalgam in their dental fillings

Treatment for lead poisoningFirst step is to remove the individual from

the source of contaminationFor mild cases, avoiding exposure will

reduce blood lead levelsFor severe cases:

Chelation therapyEDTA therapy

PreventionLead poisoning in children is preventable!Parents

Keep children away from peeling paints (windows)Wash child's hands often, especially if he/she

sucks thumbAvoid food storage in lead glazed potteryFortify the diet with iron and calciumKnow where your kids playKeep your home dust freeIf you have metal pipes, run tap for 1 minute

before usingAvoid using hot tap water for babies’ formulaKeep children away from lead workers

Prevention Workers

Wear protective clothing and equipmentChange clothes and shower before leaving

the jobAvoid washing work clothes with other

clothingDon’t eat or drink where lead may be presentDon’t remove lead paint by sanding (creates

more dust)Avoid backyard battery repairs and smelting

PreventionHealth Care Providers

Be aware of the signs and symptoms of lead poisoning

Refer suspected children for testingEducate parents about lead poisoning and

preventive measures

PreventionGovernmental authorities

Ensure adequate supply of treatment drugsAssess local situation and identify all sources

of lead in the environmentDevelop policies aimed at reducing lead

exposure from the identified sourcesImplement monitoring and surveillance

system for lead poisoning in children

Efforts to reduce lead contamination in JamaicaLeaded gasoline banned in 2000Lead in household paint discontinuedToy imports checked for toxic levels of leadLead recovery plant closedSources of poisoning in Kintyre and other

areas isolated

Existing problemGreatest 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 paintsReduction of lead in:

industrial emissions drinking waterConsumer goodsHazardous 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).

ConclusionLead poisoning is preventableRequires 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 listeningQuestions ? ? ? ?

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