The Bhutanese Leading the way.
In Bhutan’s first nationwide survey on blood lead levels, the Ministry of Health (MoH) has uncovered a health risk facing the country’s youngest and most vulnerable population.
Conducted with UNICEF, WHO, IPSAHD, and the Faculty of Nursing and Public Health at KGUMSB, the survey of over 3,000 children, 124 pregnant or breastfeeding women, and 207 children in monastic institutions shows an overwhelming 76 percent of children between ages 1 and 6 have blood lead levels exceeding 3.5 micrograms per deciliter (µg/dL).
Health officials warn that such levels are linked to developmental challenges, cognitive impairment, and anemia in children. Health officials are investigating lead’s contribution to anemia in children, noting that elevated lead levels can impair iron absorption, exacerbating this already prevalent condition.
The survey also presents figures from monastic institutions, where 86 percent of children sampled show similar lead levels in their blood. According to health experts, environmental or lifestyle factors unique to monastic settings may be the cause, though further research is underway to confirm specific sources of exposure.
The findings are no less concerning for women’s health: nearly 60 percent of surveyed pregnant and breastfeeding women also registered elevated blood lead levels, a risk not only to the women themselves but to their unborn or nursing children.
Medical professionals stress that lead exposure during pregnancy can result in developmental issues for the fetus, as lead crosses the placental barrier, potentially impacting the child even before birth.
According to survey data, children and adults with blood lead levels as low as 5 micrograms per deciliter (µg/dL) can experience decreased IQ, impaired cognitive performance, and developmental challenges such as attention-deficit/hyperactivity disorder (ADHD). Lead exposure at this level has also been linked to behavioral issues, reduced kidney function, and anemia, with risks extending to fetal development in pregnant women.
Health officials note that at slightly higher levels, around 10 µg/dL, children may face delayed puberty and developmental delays, while adults can experience heightened blood pressure and increased risk of cardiovascular-related mortality.
Elevated lead levels are also associated with spo ntaneous abortion and preterm birth, adding another layer of concern for maternal health in Bhutan.
The effects worsen as blood lead levels increase: those with levels above 20 µg/dL are at greater risk of anemia, while levels exceeding 30 µg/dL can result in reduced nerve conduction velocity, impacting motor and sensory functions.
Health experts are especially concerned about individuals with blood lead levels above 40 µg/dL, as they face risks of peripheral neuropathy, neurobehavioral effects, and intense abdominal pain.
Lead levels of 50 µg/dL or more bring severe neurological symptoms, while levels approaching 90 µg/dL are linked to encephalopathy (a serious brain condition that can be life-threatening).
The most severe cases, with blood lead levels over 105 µg/dL, are marked by severe neurological impairment, and at 150 µg/dL, the risk becomes fatal.
The survey results show that among the Dzongkhags, Paro (98.7%), Haa (96.9%), and Dagana (98.4%) reported the highest percentages of children aged 1-6 years with blood lead levels at or above 3.5 µg/dL.
To address the risks highlighted in Bhutan’s National Blood Lead Level Survey, health officials recommend several practical steps for families to reduce lead exposure in their daily routines.
One of the most effective preventive measures is regular handwashing for children, as lead can often be present in dust and dirt.
Parents are advised to wash their children’s hands with soap and water before meals and bedtime to limit the chance of ingesting lead particles. Additionally, maintaining a nutritious diet rich in iron, calcium, and vitamin C can help protect children by blocking lead absorption in the body, creating a natural defense against the harmful effects of exposure.
Good hygiene practices are also essential for adults, particularly before handling food, as lead may be present on certain household items.
Keeping children’s toys and play areas clean is equally important; officials recommend wiping toys with a damp cloth and regularly mopping floors in play spaces to remove any dust or dirt that may carry lead particles.
