Blood Lead Levels in Children Living Near an Informal Lead Battery Recycling Workshop in Patna, Bihar

Abstract

Background. Lead can cause significant biological and neurologic damage, even at small concentrations, and young children are at higher risk. Informal recycling of lead batteries and lead-based workshops/industries have increased the burden of lead toxicity in developing countries, including India. Many informal recycling lead battery workshops have been established by the local people of Patna, Bihar as self-employment opportunities. However, most of the residents are not aware of the risk factors associated with lead poisoning. Objectives. The present pilot study aimed to assess blood lead levels (BLLs) and hemoglobin levels among children aged between 3 to 12 years in the settlement of Karmalichak near Patna, India. Materials and Methods. Children residing near the informal lead battery manufacturing unit were selected for BLL assessment. A total of 41 children were enrolled in the questionnairebased survey. Results. All the children in the present study had detectable lead concentrations in their blood. Only 9% of the studied children had a BLL ≤5 µg/dl, while 91% children had a BLL above >5 µg/dl. Conclusions. The present study carried out in children of Karmalichak region of Patna, India was an attempt to better understand the problem of lead toxicity, describe the epidemiology of its adverse effects, identify sources and routes of exposure, illustrate the clinical effects and develop strategies of prevention so that remedial measures may be taken by government agencies and regulatory bodies. In view of the high lead levels in children in the study area, attempts are being made to develop strategies for future prevention by relocating the informal battery recycling workshops from the area. Moreover, parents have been advised to increase nutritional supplementation of children by providing calcium-, iron-and zinc-rich foods, including milk and vegetables.

Effects of lead poisoning in children- A narrative review

“…Of the 10 articles selected for this study, 1 was from Cuba (Fuentes, 2019), 2 from Argentina (Disalvo, n.d.;Riera et al, 2012), 1 from China (Hou et al, 2013), 2 from the USA (Keller et al, 2017;Roberts et al, 2013), 2 from India (Ansari et al, 2020;Goel & Chowgule, 2019), 1 from Egypt (Mostafa et al, 2009) and 1 from Colombia (Carlos Mauricio Hurtado, Myriam Gutiérrez, 2007). Table 1 contains the major information of each study, namely blood lead levels, probable means of exposure, average age of assessed children and effects of lead on hematopoietic tissue and cognitive skills.…”

“…The age of the children ranged from 0 to 13 years; lead levels ranged from 4g/dL to values up to 88g/dL in exposed children. Lead exposure was found to be due to contact with soil, water or air containing lead, which happened due to children living in areas close to accumulator industries; exposure was also reported to occur due to children living with parents or other family members who carry out activities involving lead handling or who work with battery repair, welding, foundry, painting, projectile factories or as hatters, or through contact with deteriorated paint chips containing lead found on the internal walls of houses (Ansari et al, 2020;Carlos Mauricio Hurtado, Myriam Gutiérrez, 2007;Disalvo, n.d.;Fuentes, 2019;Goel & Chowgule, 2019;Hou et al, 2013;Keller et al, 2017;Mostafa et al, 2009;Riera et al, 2012;Roberts et al, 2013).…”

“…The main effects of lead intoxication were reported to take place upon the hematopoietic tissue and in the central nervous system leading to cognitive disorders. It was possible to verify that lead levels ranging from ≤10µg/dL to 80µg/dL are related to iron deficiency anemia (Disalvo, n.d.;Fuentes, 2019), microcytic hypochromic anemia, microalbuminuria (Riera et al, 2012) and decreased hemoglobin level (Ansari et al, 2020). Children presenting lead levels ranging from 4 µg/dL up to 88.39µg/dL were reported to suffer from learning deficiencies, impairments of adaptive, language, motor, social and individual behaviors alongside depression, atypical body movements, hyperactivity, tiredness, headaches, lethargy and aggression (Ansari et al, 2020;Hou et al, 2013;Mostafa et al, 2009;Roberts et al, 2013).…”

“…It was possible to verify that lead levels ranging from ≤10µg/dL to 80µg/dL are related to iron deficiency anemia (Disalvo, n.d.;Fuentes, 2019), microcytic hypochromic anemia, microalbuminuria (Riera et al, 2012) and decreased hemoglobin level (Ansari et al, 2020). Children presenting lead levels ranging from 4 µg/dL up to 88.39µg/dL were reported to suffer from learning deficiencies, impairments of adaptive, language, motor, social and individual behaviors alongside depression, atypical body movements, hyperactivity, tiredness, headaches, lethargy and aggression (Ansari et al, 2020;Hou et al, 2013;Mostafa et al, 2009;Roberts et al, 2013). In addition, symptoms such as recurrent abdominal pain, anorexia, recurrent headache, saturnism and mucocutaneous pallor (Ansari et al, 2020;Carlos Mauricio Hurtado, Myriam Gutiérrez, 2007;Fuentes, 2019) have also been reported.…”

“…Children presenting lead levels ranging from 4 µg/dL up to 88.39µg/dL were reported to suffer from learning deficiencies, impairments of adaptive, language, motor, social and individual behaviors alongside depression, atypical body movements, hyperactivity, tiredness, headaches, lethargy and aggression (Ansari et al, 2020;Hou et al, 2013;Mostafa et al, 2009;Roberts et al, 2013). In addition, symptoms such as recurrent abdominal pain, anorexia, recurrent headache, saturnism and mucocutaneous pallor (Ansari et al, 2020;Carlos Mauricio Hurtado, Myriam Gutiérrez, 2007;Fuentes, 2019) have also been reported. Finally, blood lead levels as high as 42.6 ± 22.5µg/dL were reported to be associated with encephalopathy (Goel & Chowgule, 2019).…”