Lead exposure threatens children and pregnant mothers’ health

Sherab Lhamo

Children under five and pregnant mothers face heightened risks from lead exposure-a pervasive element found in numerous products.

As lead accumulates in the body over time, it poses serious health threats, impacting nearly every organ. The consequences of lead poisoning can be profound, leading to impact on IQ, learning and behavioral challenges, mental health issues, anemia, high blood pressure, strokes, and kidney diseases.

According to research, addressing lead exposure is critical, as early intervention can mitigate these harmful effects and safeguard the health of the most vulnerable members of society.

There is no known safe level of lead exposure, and unfortunately, effective treatments for most cases of lead poisoning are lacking. Young children are particularly vulnerable, often placing objects in their mouths, which increases their risk of ingestion.

The Assistant Professor at the Faculty of Nursing, Ministry of Health, Dr Phillip Erbele said children and pregnant mothers have elevated needs for micronutrients like calcium and iron, which inadvertently leads to higher lead absorption in their bodies.

Dr Erbele explained that in young children, the blood-brain barrier—a protective shield around the brain—is more permeable until the age of five, allowing lead to enter and accumulate in the brain, with potentially irreversible consequences.

Children absorb lead four to five times more than adults. Alarmingly, recent statistics reveal that three out of four children aged one to six years in Bhutan have elevated blood lead levels exceeding 3.5 micrograms per deciliter (μg/dL), highlighting a significant public health concern that demands urgent attention and action.

According to the National Blood Lead Level Survey Fact Sheet 2024 presented by the Ministry of Health (MoH) in Thimphu yesterday, alarming statistics underscore the urgency of addressing lead exposure in Bhutan.

The Centers for Disease Control and Prevention (CDC) in the USA uses a blood lead reference value of 3.5 micrograms per deciliter (µg/dL) to identify children with elevated lead levels.

The survey revealed that monastic children have an average blood lead level of 5.9 µg/dL, with 86 percent of monks under 13 years old exceeding the 3.5 µg/dL threshold. Furthermore, nearly three out of five pregnant mothers—58.9 percent—also exhibit elevated blood lead levels above this critical limit.

To mitigate the risk of lead exposure, several preventive measures are recommended. Regular handwashing with soap is crucial, as lead can linger in dust and dirt. Parents should limit children’s access to potentially hazardous environments, such as vehicle repair shops and metal artisan workshops, while also ensuring they stay away from known lead-containing items. A nutritious diet rich in iron, calcium, and vitamin C can help block lead absorption, further safeguarding children’s health.

Additionally, it is advisable to wipe children’s toys with a damp cloth and frequently mop play areas to eliminate any dust that may contain lead. For adults, washing hands with soap and water before preparing food and eating is essential, particularly since lead has been identified in certain household and religious items. These collective efforts are vital in protecting the most vulnerable populations from the harmful effects of lead exposure.

The recent survey was conducted by the Ministry of Health, Khesar Gyalpo University of Medical Sciences of Bhutan, and the Faculty of Nursing and Public Health, with support from the World Health Organization and UNICEF Bhutan, has unveiled alarming findings regarding lead exposure in the country.

Items tested revealed significant lead contamination, with jinlab showing 44.2 percent, aluminum utensils at 25 percent, drinking cups or glasses at 36 percent, brass or metal utensils at 50 percent, and spices at 20 percent exceeding the reference threshold of 3.5 micrograms per deciliter (µg/dL).

Furthermore, religious items contained lead at a staggering 75.2 percent, while latch bolts and doorknobs were found to have 60.7 percent, though these require further testing to assess exposure risks fully.

The implications of widespread lead exposure in Bhutan are profound. Lead accumulates in the body, particularly affecting children, leading to cognitive impairments and learning difficulties.

Dr Phillip Erbele said that such health issues can diminish productivity and educational attainment, ultimately harming the nation’s future.

A study by World Bank economists indicates that the cumulative effects of IQ loss and cardiovascular disease mortality attributable to lead exposure could reduce a country’s Gross Domestic Product (GDP) by as much as 9 percent.

Lower-middle-income countries, like Bhutan, face a 3.8 percent GDP loss from IQ decline and 5.6 percent from cardiovascular-related mortality. In South Asia, these figures are similarly concerning, at 3.5 percent and 5.6 percent, respectively. Dr Erbele warned that Bhutan stands to lose Nu 21 billion annually until the lead poisoning issue is effectively addressed.

The survey, which spanned from April 19 to June 13, 2024, assessed approximately 3,000 participants, including 2,959 children aged one to six years, 124 pregnant or breastfeeding mothers, and 207 children in monastic institutions.

The findings indicated that Paro had the highest blood lead level, with 92.1 percent of children exceeding the critical 3.5 µg/dL threshold, followed closely by Dagana at 98.4 percent and Haa at 96.9 percent. Notably, the survey revealed that lead levels were significantly higher in western Bhutan compared to the east.

The research team tested 2,418 items from 67 households, six early childhood care and development centres, and four schools, highlighting the urgent need for comprehensive strategies to mitigate lead exposure and safeguard the health of Bhutan’s population.