Lead exposure has been recognised as a global public health problem. According to a paper published in 2000, children are more vulnerable to the adverse effects of lead exposure compared to adults.

In the region, a recent study by the National Institute of Occupational and Environmental Health (NIOEH) in Vietnam found an alarming rate of lead poisoning in both children and adults.

Secretary of the research, Lo Van Tung, said that the possible sources of lead contamination might be the air, soil or water to which children are exposed. In addition, unsafe toys are also another potent source of lead contamination.

Effect of lead exposure on children’s IQ

A recent study done by researchers from Duke University found the association between the effects of lead exposure on the IQ of children. A long-term study of over 500 children who grew up in the era of leaded gasoline revealed that exposure to powerful neurotoxin may have led to a loss of intelligence and occupational status by the time they reached 38 years of age.

The participants in this study are part of a lifelong examination of over 1,000 people born in Dunedin, New Zealand in 1972 and 1973. Blood samples were collected from 565 of them at age 11, and the samples were then tested for lead.

The mean blood level of the children was 10.99 microgrammes (mcg) per decilitre (dl) of blood; this exceeds the 5 mcg/dl reference value recommended by the United States Centres for Disease Control and Prevention (CDC). Study results showed that for each 5 mcg increase in blood lead, an individual lost about 1.5 IQ points.

Effect on children’s behavioural and emotional problems

In an earlier research funded by the National Institute of Environmental Health Sciences, published in 2014, researchers found that even a low exposure to lead can cause emotional and behavioural problems in children. This discovery was made following the blood lead concentration measurements of over 1,300 preschool children aged three to five years in the Jintan province, China.

Blood lead concentration in these children was found to be associated with increased problems such as anxiety, depression or aggressiveness. Furthermore, the risk of clinical-level behavioural problems, including total internalising problems and pervasive developmental problems, also increased with blood lead concentration.

The average blood level in the children was 6.4 mcg/dl. Additionally, researchers observed stronger associations between blood lead concentrations and an increased risk for behavioural problems for girls. Air pollution is the most common source of lead exposure in China.

Healthcare professionals play a vital role

Besides implementing laws and national policies pertaining to the use of lead in gasoline and industrial materials, the role of the medical community in identifying lead poisoning in children needs to be emphasised. Family physicians as well as paediatricians are in the key position to educate parents on the importance of avoiding lead exposure, and this can be done during consultation, antenatal appointments and checkups.

Primary prevention questioning can help physicians to determine whether screening for lead exposure should be done. In addition, continuous monitoring of blood lead concentrations and clinical assessment during doctor visits may prove beneficial especially for high-risk populations.

A clinical management guideline can be a helpful source of reference for healthcare professionals. For instance, the US CDC has published a number of screening and case management guidelines on lead exposure. These guidelines cover aspects such as identification of lead exposure in children, interpretation and management of blood lead levels, as well as educational interventions for children affected by lead exposure.

In conclusion, it is important for the medical community to recognise and be aware of the long-term behavioural changes in children resulting from lead exposure. A sound understanding of the appropriate measures for early identification as well as proper management of the problem is highly crucial.

The significant role of healthcare professionals in the primary prevention of lead exposure needs to be highlighted – as research has proven that the long-term effects to a child’s brain can be detrimental for their psychological and social well-being. MIMS

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