Lead poisoning

LEAD POISONING PREVENTION & TREATMENT - Implementing a National Program in Developing Countries: Abraham M. George - Editor; The George Foundation, No. 1155, 6th Main Road, IV Block, First Stage, HBR Layout, Bangalore-560084. Price not mentioned.

LEAD POLLUTION and lead poisoning are basically environmental health hazards. Lead (Pb) is ubiquitous in nature and has been used by human civilisation since at least 6000 B.C.

It is not an instantaneous killer but an insidious, slow and steady killer, through ``plumbism'', in medical terms.

This book documents the proceedings of an International Conference on Lead Poisoning Prevention and Treatment, held at Bangalore, during February 8-10, 1999, organised and sponsored by the George Foundation, in collaboration with the CDC and the EPI of USA, the WHO and the World Bank.

Its chief objective is to evolve a national lead prevention programme in developing countries.

This conference was preceded by the George Foundation-sponsored ``Project Lead-Free'', which tested 21,476 blood samples in seven major cities in India.

Their alarming findings are that nearly 50 per cent of the urban children below 12, in India, showed unacceptable blood lead levels (BLL or PbB) of 10 micrograms per decilitre (10 eg/dL), and 14 per cent have seriously elevated levels of 20 eg/dL. The permissible limits of lead in air are about 0.75 to 1.5 eg/CuM, and in drinking water, it is 0.05 eg/lt.

These alarmingly high levels of lead in our environment, food, water and in human blood, and our total ignorance of it and their consequences are very much regretted, by this conference.

Lead poisoning is known ever since 6000 B.C. The Romans and most Europeans in general, who stored their wine in lead containers were the earliest civilised victims of the metal.

More recently, lead-based painting in the interior of houses in the U.S. was the common pathway for lead poisoning in American children.

However, the galloping lead pollution of air and lead poisoning started globally ever since the use of leaded gasoline (petrol), by adding tetramethyl lead (TEL) to make up ethyl gasoline, for the engine efficiency of automobiles.

Children between six and 72 months are four to five times more vulnerable than adults, in absorbing lead. Even low concentrations of lead in children, manifest as learning disability, as evidenced by the decline in IQs, and by behavioural problems, but higher concentrations result in anaemia, seizures, coma and death.

In adults, lead gets stored up in bones, resulting in its ossification, but in pregnant woman, when calcium is needed from bones, lead also gets released, which can pass through the placenta into the foetus. Lead can show up even in mother's milk.

In adults, lead poisoning manifests clinically as abdominable colics, ending in liver and kidney problems. Various techniques to estimate the lead level in blood and in environment are described in this book, along with the clinical symptoms, treatment of lead poisoning and environmental awareness education which are all so necessary, both for general medical practitioners as well as for the public.

Towards developing a national programme for prevention and treatment of lead poisoning, phasing out leaded petrol, and replacing it with unleaded petrol is recommended as a major global strategy.

Between 1970 and 1999, nearly 29 countries seemed to have phased out leaded gasoline, and India hopes to achieve it by the end of this year.

However, with the spiralling increase of petrol vehicles on our roads, continuing to use leaded petrol, with no stringent rules for emission-checking, with the exposure of children below six to thick clouds of automobile exhausts in our cities, and above all, with limited technicians who can check blood lead levels, this insidious lead poisoning of urban children is a very serious public health negligence.

Several workshops on various related issues were conducted within this conference. Their findings and recommendations also are reported in this book. Also, 10 appendices on topics related to lead poisoning are added, which will broaden and update our knowledge on this complex subject of environmental toxicology in lead poisoning.

P. J. SANJEEVA RAJ

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