Selim AHMED, Shayla NASRIN, Arm Luthful KABIR, Ab Mohammad ZAKARIA, Mohammad SERAJI, Mahbubur RAHMAN, Mohammad ALAUDDIN

Blood lead levels of secondary school students in Dhaka, Bangladesh after the elimination of leaded gasoline and phase-out of two-stroke vehicles: study on one hundred children

Background: Lead (Pb) is a proven environmental toxicant throughout the world. Elevated blood lead level (BLL) adversely affects the neuro-cognitive and behavioral development of children. Considering the worst source of lead pollution, the government of Bangladesh banned leaded petrol and phased out two-stroked vehicles from Dhaka cityaâ‚¬”the capital of Bangladeshaâ‚¬”in late 1999. In 2000, on the verge of introducing unleaded gasoline, a baseline survey showed high mean value of BLLs (15 µg/dL) in school children of Dhakaaâ‚¬”much higher than the CDC's permissible level of 10 µgm/dL. Methods: This cross sectional, follow-up study was conducted to see the current status of BLLs in school children of Dhaka city. Total 100 students from two schools, 50 girls and 50 boys from grade six through ten, were randomly selected and their finger-pricked bloods were analyzed for Pb levels. Results: The mean (±SD) BLLs was 15.31±5.81 µgm/dL; and the majority (84%) of the students tested had BLLs higher than 10µg/dL. The BLLs was found significantly higher among the students who used to play outside house premises in a dusty environment (p=0.03) and among the frequent users of a traditional eye cosmetics aâ‚¬Å“surmaaâ‚¬ (p= 0.032). No significant associations were noted between BLLs and the gender of the study subjects, their housing status, and the distance of the houses from the school. Conclusion: The mean BLL is still alarmingly high in the studied school children that have not declined significantly despite taking several visibly effective measures. Recommendation: The possible causes and source(s) of such persistently higher BLLs in children need priority exploration, since this important environmental health issue is of crucial importance so far the health and wellbeing of the future generations of the country are concern.

Keywords:

blood lead level, school children, Bangladesh, leaded petrol, surma,

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1. American Academy of Pediatrics, Committee on Environmental Health. Lead exposure in children: prevention, detection and management. Pediatrics. 2005, 116:1036-1046
2. Bellinger DC. Lead. Pediatrics. 2004,113:1016- 1022.
3. Centers for Disease Control and Prevention (CDC). Preventing Lead Poisoning in Young Children. 2005, Atlanta, GA.
4. Solon, O; Riddell, T.J.; Quimbo, S.A.; Butrick, E.; Aylward, G.P.; Bacate, M.L. et al. Association between cognitive function, blood lead concentration, and nutrition among children in the central Philippines. J. Pediatr. 2008, 152:237-243.
5. Wang HL, Chen XT, Yang B. Case-control study of blood lead levels and attention deficit hyperactivity disorder in Chinese children. Environ Health Perspect. 2008, 116(10):1401-6.
6. Braun JM, Kalm RS, Frochlich T, Aninger P, Lamphear BP. Exposure to environmental toxicants and Attention Deficit Hyperactivity Disorder in U.S. Children. Environ Health Perspect. 2006, 114: 1904-1909.
7. John Paul Wright, Kim N. Dietrich, M. Douglas Ris, Richard W. Hornung, Stephanie D. Wessel, Bruce P. Lanphear. Association of Prenatal and Childhood Blood Lead Concentrations with Criminal Arrests in Early Childhood. PLoS Medicine. 2008, Vol 5, Issue 5, e101; downloaded from www.plosmedicine.org].
8. Cecil KM, Brubaker CJ, Adler CM, Dietrich KN, Altaye M, Egelhoff JC et al. Decreased brain volume in adults with childhood lead exposure. PLoS Med. May 2008; 5(5): e112
9. CDC. Screening young children for lead poisoning: Guidance for state and local public health officials. Centers for Disease Control and Prevention. 1997. Available at http://www.cdc.gov/nech/lead/guide/guide97.htm, accessed in July, 2009.
10. Steven G. Gilbert, Bernard Weiss. A rational for lowering the blood lead action level from 10µg to 2µg/dL. Neurotoxicology. 2006, 27(5): 693-701
11. Martha M. Téllez-Rozo, David C. Bellinger, Carmen Arroyo-Quiroz, Héctor LamadridFigueroa, Adriana Mercado-García, Lourdes Schnaas-Arrieta et al. Longitudinal Association Between Blood Lead Concentrations Lower Than 10µg/dL and Neurobehavioral Development in Environmentally Exposed Children in Mexico City. Pediatrics. 2006,Volume 118, Number 2.
12. Bernerd SM. Should the Centers for Disease Control and Prevention‘s childhood lead poisoning intervention be lowered? Am J Public Health. 2003, 93:1253-60.
13. Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. Intellectual impairment in children with blood lead concentration below 10µg/dL. N Engl J Med. 2003, 348:1517-26.
14. Howard W. Mielke and Patrick L. Reagan. Soil is an important pathway of human lead exposure. Environtal Health Perspective. 1990, vol.106 (supplement):217-229
15. Rahbar MH, White F, Aqboatwalla M, Hozhabri S, Luby S. Factors associated with elevated blood lead concentrations in children in Karachi, Pakistan. Bull World Health Organ. 2002, 80(10): 769-75.
16. Vasikaran SD. Lead poisoning due to traditional herbal preparations. Med J Aus. 1993, 158(4): 292
17. Gogte ST, Basu N, Sinclair S, Ghai OP, Bhide NK. Blood lead levels of children with pica and surma use. Indian J Pediatr. 1991, 58(4): 513-9
18. C Parry and J Eaton. Kohl: a lead-hazardous eye makeup from the Third World to the First World. Environ Health Perspect. 1991, 94: 121–123.
19. Bangladesh Studies of Pollution Levels. IAEA (International Atomic Energy Agency) Newsbriefs. Nov-Dec 1996; Vol 11, no 4 (73): 11
20. Khalequzzaman M. Objectives, structures and expected follow-up. Paper presented at the Consultative Meeting on Integrated approach to vehicular air pollution control in Dhaka held between April 26-27, 1998 jointly by World Bank and Department of Environment, Government of Bangladesh
21. Khan NZ, Khan AH. Lead poisoning and psychomotor delay in Bangladeshi Children [Letter]. Lancet.1999;353:754
22. Ijaz Hossain, Saleemul Huq. The clean cabs of Dhaka. Article downloaded from http://www. opendemocracy.net/globalization climate_ change _ebate/article_2499.jsp#
23. www.doe-bd.org
24. Reinhard Kaiser, Alden K. Henderson, W. Randolph Daley, Mary Naughton, Manzurul H. Khan, Mushior Rahman et al. Blood Lead Levels of Primary School Children in Dhaka, Bangladesh. Environ Health Perspect. 2001,109: 563-366.
25. Thomas VM, Socolow RH, Fanelli JJ, Spiro TG. Effects of reducing lead in gasoline: an analysis of the international experience . Environ Sci Technol. 1999;33: 3942-3948
26. Nichani V. Li Wi, Smith MA, Noonan G, Kulkarni M, Kodavor M et al. Blood lead levels in children after phase-out of leaded gasoline in Bombay, India. Sci Total Environ. 2006, 363 (1- 3):95-106
27. Ahamed M, Verma S, Kumar A, Siddiqui MK. Blood lead levels in children of Lucknow, India. Environ Toxicol. 2009, Jan 22. Epub ahead of print
28. Pirkle JL, Brody DJ, Gunter EW, Kramer RA, Paschal DC, Flegal KM. The decline in blood lead levels in the United States: The National Health and Nutritional Surveys NHANES. JAMA. 1994, 272(4): 284-291.
29. Tong S, von Schirnding YE, Prapamontol T. Environmental lead exposure: a public health problem of global dimensions. Bull WHO. 2000;78:1068–1077.
30. Tracey Bushnik, Douglas Haines, Patrick Levallois, Johanne Levesque, Jay Van Oostdam and Claude Viau. Lead and bisphenol A concentrations in the Canadian population. Health Reports, September 2010; Vol. 21, no. 3. Statistics Canada, Catalogue no. 82-003-XPE. Available at: www.statcan.gc.ca/pub/82-003- x/2010003/article/11324-eng.pdf. Accessed on March 10, 2011
31. Romieu I, Palazuelos E, Meneses F, HermandezAvila M. Vehicular traffic as a determinant of blood-lead levels in children: a pilot study in Mexico City. Arch Environ Health. 1992; 47: 246-249
32. Brody DJ, Pirkle JL, Kramer RA, Flegal KM, Matte TD, Gunter EW, Paschal DC. Blood lead levels in the U.S. population: Phase 1 on the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1991). JAMA. 1994; 272: 277-283
33. Baghurst PA, Shi-lu T, McMicheal AJ, Robertson EF, Wigg NR, Vimpani GV. Determinants of blood lead concentrations to age 5 in a birth cohort study of children living in the lead smelting city of Port Pirie and surrounding areas. Arch Environ Health. 1992; 47: 203-210
34. Agency of Toxic Substances and Disease Registry. Toxicological Profile for Lead. Available at: http://www.atsdr.cdc.gov/toxprofiles /tp13.html.
35. T. M. Young, D. A. Heeraman, G. Sirin, and L. L. Ashbaugh. Resuspension of soil as a source of airborne lead near industrial facilities and highways. Environmental Science & Technology. 2002; 36: 2484
36. F. Ahmed, and H. Ishiga. Trace metal concentrations in street dusts of Dhaka city, Bangladesh. Atmos. Environ. 2006;40:3835
37. Impact of Lead-Contaminated Soil on Public Health. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Agency for Toxic Substances and Disease Registry, Charles Xintaras, Sc.D. Publication date: 05/01/1992. Available at: http://wonder.cdc.gov/wonder/prevguid/p000001 5/p0000015.asp
38. Charney E, Sayre J, Coulter M. Increased lead absorption in inner city children: where does the lead come from? Pediatrics. 1980, 65:226-231.
39. Jacobs DE, Clickner RP, Zhou JY, Viet SM, Marker DA, Rogers JW et al. The prevalence of lead-based paint hazards in U.S. housing. Environ Health Perspect. 2002, 110: A599-A606.
40. Study on Lead in Paints in Bangladesh, Environment and Social Dev. Org ESDO 2010 Available at: http://www.ipen.org/ipenweb /work/lead/bangladesh_report_2.pdf
41. Bilkis AB, Biswas SK. Trends in particulate matter (PM) and lead pollution in ambient air of Dhaka city in Bangladesh. Journal of Bangladesh Academy of Sciences. 2008; 32 (2):155 -164
42. Amal K. Mitra, Akhlaque Haque, Manirul Islam, S.A.M.K. Bashar. Lead Poisoning: An Alarming Public Health Problem in Bangladesh. Int J Environ. Res. Public Health. 2009, 6:84-95
43. R. A. Root. Lead loading of urban streets by motor vehicles wheel weights. Environmental Health Perspective. 2000;108: 937