High blood levels of lead in children aged 6-36 months in Kathmandu Valley, Nepal: A cross-sectional study of associated factors

Abstract

Young children are at greatest risk of exposure to lead and its effects. Although lead is one of the most widely used elements with known health hazard, there is little data on the blood lead level (BLL) of children in the Kathmandu Valley. Thus, this study aimed to assess factors associated with high BLL in children who were 6–36 months of age and resided in the Kathmandu Valley. In this hospital-based cross-sectional study 6–36 month-old children visiting the Paediatrics Outpatient Department of Tribhuvan University Teaching Hospital, Patan Hospital, and Siddhi Memorial Hospital were enrolled. All three hospitals are located in different areas inside the Kathmandu Valley. Written informed consent was obtained from the parents, and exposure data were collected using a structured questionnaire. Portable Anodic Stripping Voltammetry (ASV) was used to determine BLLs in children. Data were analyzed using SPSS version 16. Of 312 children enrolled in the study, 64.4% had BLLs ≥5μg/dl. A significant association was found between BLL and exposure to enamel paints in the household in the form of painting materials used in different parts of the house like walls, windows and doors (p = 0.001). Furthermore, multivariate analyses showed that BLLs were 4.5 times higher in children playing with dirt and dust (p = 0.006) and that children belonging to the community of lower caste/ethnicity groups had significantly higher BLLs compared to those from the upper caste groups (p = 0.02). Our study demonstrated that children living in households that have used enamel paints, children belonging to lower caste/ethnic groups, and children frequently playing with dirt and dust had significantly higher BLLs. The results of this study highlight the importance of policy decisions to limit environmental lead contamination, and to roll out awareness building measures designed to limit lead exposure and break the poverty cycle associated with chronic lead poisoning.

Body iron and lead status in early childhood and its effects on development and cognition: a longitudinal study from urban Vellore

“…This current communitybased prospective study shows increasing Pb levels from 15 to 36 months of age, with high Pb levels present in 97 % of children (>5 μg/dl (0•24 μmol/l)) at 36 months of age. This has been reported also from Nepal, in a hospital-based study of 6-36 months old children, where 64•4 % had high BLL of >5 μg/dl (0•24 μmol/l) (42) . Risk factors associated with high BLL include low SES, industrial area exposure, playing with dirt and mud, exposure to enamel paints, piped water supply and mud/clay floors of the house; the last two factors being shown as predictors for high BLL in this birth cohort in an evaluation published earlier (10,(38)(39)(40)(41)(42)(43)(44) .…”

“…This has been reported also from Nepal, in a hospital-based study of 6-36 months old children, where 64•4 % had high BLL of >5 μg/dl (0•24 μmol/l) (42) . Risk factors associated with high BLL include low SES, industrial area exposure, playing with dirt and mud, exposure to enamel paints, piped water supply and mud/clay floors of the house; the last two factors being shown as predictors for high BLL in this birth cohort in an evaluation published earlier (10,(38)(39)(40)(41)(42)(43)(44) . There is evidence suggesting transplacental transfer of Pb, with sixteen (84•2 %) cord blood samples obtained from nineteen mothers, who had high BLL during their antenatal period, had elevated Pb levels (45) .…”

Hygienic Efficiency of Treatment Strongly Polluted Industrial Waste Water Using Fibrous Ion-Exchange Materials

“…Industrial enterprises and motor transport may be the sources of pollutants. Thus, in large cities the lead content in blood of children in some cases increases to 45 mkg/dl (at recommended acceptable levels of 5 mkg/dl) [16], which is the reason for mental pathologies and requires compulsory preventive antidotal procedures [17].…”

Nepal Environment Sector Diagnostic

“…While concentrations in the population are similar or lower on key heavy metals than those in neighboring countries, they remain a cause for concern. Over 24.7 percent of children in one study from the Kathmandu Valley were found to have a blood lead level above 10 μg/dl (Dhimal et al 2017). 41…”