Academic journal article Journal of Health Population and Nutrition

Prevalence of and Risk Factors for Lead Poisoning in Young Children in Bangladesh

Academic journal article Journal of Health Population and Nutrition

Prevalence of and Risk Factors for Lead Poisoning in Young Children in Bangladesh

Article excerpt

INTRODUCTION

Lead is the number one environmental threat to the health of children (1). Some populations and geographic areas still remain at a disproportionately-high risk of exposure to lead (2). In children, the blood lead levels (BLLs) as low as 10 [micro]g/dL are associated with developmental delays, deficits in behavioural functioning, decreased stature, and diminished hearing acuity (3-5). The high BLLs (i.e. [greater than or equal to]70 [micro]g/dL) can cause serious health effects, including seizures, coma, and death (6).

In 1991, the Centers for Disease Control and Prevention (CDC) recommended universal screening of all children aged 6-72 months because exposure to lead is still common in certain communities (7). Healthy People 2020, the nation's strategy for improving the health and well-being of all citizens, has established a goal of reducing the mean BLLs in children aged 1-5 year(s) by 10% from its existing levels (8).

Although Bangladesh adopted a policy to ban the sale of leaded gasoline in 1999, the risk of lead poisoning in young children is uncertain because of the absence of a lead-screening programme in the country. Specially, data on the BLLs are almost non-existent in rural Bangladesh. Results of a study among urban school children in Bangladesh showed high BLLs in approximately 90% of children (9). In another study, nearly all children tested in an industrial area at Tongi, Gazipur, had high BLLs (10). The major types of industries in the area, located 18 km northeast of Dhaka, included: battery, ceramic, pharmaceutical, cotton, jute, and plastic. Two major sources of lead poisoning identified in this area were industrial discharges and the use of leaded gasoline in the autorickshaw with two-stroke engines. These data are an indication of the alarming rates of lead poisoning in the country and provide evidence for the need for further studies to determine the extent of the problem in other urban and rural areas of Bangladesh.

The present study aimed to: (a) determine the prevalence of lead poisoning in preschool and school-age children in urban and rural communities of Bangladesh and (b) assess the risk factors associated with high BLLs in this population.

MATERIALS AND METHODS

Study subjects

The study was part of a Fulbright Scholar Research Program in Bangladesh conducted in two phases. The first part of the study was conducted during September 2007-July 2008, and the second part was conducted during May-July 2009. The study, which used a cross-sectional design, included children, aged less than 16 years, who were recruited from six schools and communities in urban Dhaka and one rural school in the northern area of Chirirbandar, Dinajpur.

Collection of data

A team consisting of two epidemiologists, three laboratory technicians, and volunteers from the community collected data using a pretested questionnaire. The independent variables included: age, gender, income, height, weight, haemoglobin (Hb), iron, and blood group. The possible sources of lead investigated were: type of residence, proximity to highways and industries, use of pesticides, water sources and materials used for water faucets, type of serving-plate used, and indigenous treatments. Body-weights of children were measured using a bathroom scale, with an accuracy of 1 g while their heights were measured using a standard mechanical stadiometer, with an accuracy of 1 cm. Body mass index (BMI) was computed as weight (kg), divided by the square of height in metre.

Measurements of blood lead

Samples of venous blood (0.5 mL) were collected by aseptic measures, transported using heparin tubes, and processed within 24 hours after collection. The BLLs were measured using a portable LeadCare II Blood Lead Test instrument (ESA Inc., Chelmsford, MA, USA). LeadCare II is a CLIA (Clinical Laboratory Improvement Amendments)-waived test as it meets the requirements of precision and accuracy for lead in blood test analysis. …

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