High Lead Content detected in Bhutanese children

A study by the Ministry of Health found a high level of lead in children in a sample of children in Thimphu.

This has raised alarm bells in the Ministry which is conducting more research on this and is also looking at finding the source of the lead exposure for Bhutanese children as it can have multiple health effects on children.

The Health Minister Dasho Dechen Wangmo said a half a million US dollar study (Nu 40 mn approx) is being done to find the source of the lead exposure for children in Bhutan.

The minister said the study is important as once the ministry knows the size of the problem and the source of the lead exposure then the government can also come up with the appropriate policies to tackle it.

Lyonpo said that an important step in the study is that the ministry has bought the equipment that can test for lead in various places and products.

The ministry is looking at water source contamination but so far it is not shown up including in all the local mineral water brands.

The study is looking at lead heavy paint from India as a potential source. Though India came up with regulations to restrict lead to 90 parts per million from 1 November 2017 there are issues of regulation and monitoring, small and medium players still manufacturing lead heavy paint and many studies show heavy presence of lead even in the years following the ban.

There is concern if Bhutan is getting old stock paint with high lead or even new paint with high lead from India due to the lack of monitoring.

Lyonpo said that lead can also be inhaled from the air through pollutants and also from certain food sources.

The minister, however, clarified that they exactly don’t know the source yet.

One of the early findings is that certain bronze and yellow colored metal utensils used in southern Bhutan  had high levels of lead in them.

The minister said that they need to see in the study if the exposure to lead is also a regional phenomenon with some regions seeing higher exposure than others.

The health minister said that in the USA and even as per the World Health Organization no level of lead is acceptable as even a small limit has an impact on the brain.

“The threshold we used to have is no longer there now and now any lead is bad,” said Lyonpo.

The minister cautioned that the sampling size is very small and more studies are being done.

She said that once they know about lead exposure in a child their interview the parents and also look at the risks.

The minister said that one of the areas they will be looking at is toys and if the colour on them has lead. They will also be looking at park equipment, utensils etc.

WHO says that young children are particularly vulnerable to lead poisoning because they absorb 4–5 times as much ingested lead as adults from a given source.

Moreover, children’s innate curiosity and their age-appropriate hand-to-mouth behavior result in their mouthing and swallowing lead-containing or lead-coated objects, such as contaminated soil or dust and flakes from decaying lead-containing paint.

This route of exposure is magnified in children with a psychological disorder called pica (persistent and compulsive cravings to eat non-food items), who may pick away at and eat leaded paint from walls, door frames and furniture.

Lead exposure can have serious consequences for the health of children. At high levels of exposure to lead the brain and central nervous system can be severely damaged causing coma, convulsions and even death.

Children who survive severe lead poisoning may be left with permanent intellectual disability and behavioral disorders.

At lower levels of exposure that cause no obvious symptoms, lead is now known to produce a spectrum of injury across multiple body systems. In particular, lead can affect children’s brain development, resulting in reduced intelligence quotient (IQ), behavioral changes such as reduced attention span and increased antisocial behavior, and reduced educational attainment.

Lead exposure also causes anemia, hypertension, renal impairment, immunotoxicity and toxicity to the reproductive organs. The neurological and behavioral effects of lead are believed to be irreversible.

There is no known safe blood lead concentration; even blood lead concentrations as low as 3.5 micro grams per deci liter (µg/dL) in blood may be associated with decreased intelligence in children, behavioral difficulties and learning problems.

The World Health Organization’s 2021 update of the Public health impact of chemicals: known and unknowns estimates that nearly half of the 2 million lives lost to known chemicals exposure in 2019 were due to  exposure to lead.

People can become exposed to lead through occupational and environmental sources. This mainly results from inhalation of lead particles generated by burning materials containing lead, for example during smelting, recycling, stripping leaded paint and plastic cables containing lead and using leaded aviation fuel; and ingestion of lead-contaminated dust, water (from leaded pipes) and food (from lead-glazed or lead-soldered containers) and from hand-to-mouth behavior.

Since leaded paint is a continuing source of exposure in many countries, WHO has joined with the United Nations Environment Programme to form the Global Alliance to Eliminate Lead Paint which has the aim of encouraging all countries to have legally binding laws to control the use of lead in paint. 

Most global lead consumption is for the manufacture of lead-acid batteries for motor vehicles. Lead is, however, also used in many other products, for example pigments, paints, solder, stained glass, lead crystal glassware, ammunition, ceramic glazes, jewelry, toys, some traditional cosmetics such as kohl and sindoor, and some traditional medicines used in countries such as India, Mexico and Viet Nam.

Drinking water delivered through lead pipes or pipes joined with lead solder may contain lead. Much of the lead in global commerce is now obtained from recycling. 

The India media website Gaon connection said that environmental organization Toxics Link’s research studies in 2018, 2019 and 2020 have reflected the poor implementation of the rules on the use of lead in paints in India even after the rules came into effect in November 2017. The overall scenario across the country has not improved much as revealed by Toxics link research studies.  

Down to Earth Magazine in India reported that Half the children in India report high blood lead levels, as per a 2020 report by the UNICEF and Pure Earth, a US-based environmental health non-profit. The report says 275 million children in India record blood lead levels of beyond 5 µg/dL. Of these, 64.3 million children’s blood lead levels exceed 10 µg/dL.

The UNICEF-Pure Earth report says children with elevated blood lead levels scored three-five points lower on intelligence tests. This “permanent damage (affects) a child’s brain development and central nervous system, (causing) reduced intelligence, attention deficit disorders and lower educational attainment,” the report notes. This can lead to long-term impacts such as loss of economic productivity.

In multiple reports in 2007-11, Toxics Link, also found dangerously high levels of lead in paint —140,000 parts per million (PPM)— as against the permissible 90 PPM set by the Central Pollution Control Board.

Around this time, India initiated a phase out of lead-based paints. But even then, small and medium-scale manufacturers continue to record high levels of lead in their paints; some 31 per cent of household paints had lead concentrations of more than 10,000 PPM, as per information in the NITI Aayog-CSIR report.

The article said another common source is food. As of now, spices are the only identified sources of lead poisoning, as per experts. In northeastern states, the high moisture content does not allow for turmeric in the region to dry quickly, resulting in a lighter colour. This turmeric is transported to Bihar and West Bengal, where lead is added to the commodity to bring out a deeper yellow colour, says CSIR’s Rakesh Kumar.

The magazine said that Food Safety and Standards (Food Products Standards and Food Additives) Regulations, 2011, says the threshold for lead in food of 10 PPM. However, a 2014 study led by a researcher at KPC Medical College and Hospital, Jadavpur, published in the International Journal of Current Medical And Applied Science notes that among spice samples collected from local markets in Kolkata, “the highest levels of lead was found in chilli powder and turmeric powder, which greatly exceeded the permissible amounts.”

Down to Earth said there is a need to study the potential presence of lead in other foods, as seen in the case of the Maggi brand of instant noodles in India. In 2014-15, the noodles marketed by Swiss company Nestlé showed high levels of lead when tested for monosodium glutamate (MSG). The brand was banned for months in 2015 in India, but returned to the market after the company passed health standards.

The magazine said lead toxicity is not just a concern in India. The UNICEF-Pure Earth report notes around one in three children worldwide record blood lead levels of over 5 µg/dL. Countries with this burden include Iran, Afghanistan, Yemen, Peru, Vietnam, the Philippines and parts of Central Africa.

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