Managing environmental lead in Broken Hill: a public health success

Abstract

For whoever has, to him more shall be given; and whoever does not have, even what he has shall be taken away from him" is an apt description of many health programs, in that while everyone benefits, those who have least need of the program tend to benefit most, and those who need the program most, often do not benefit at all. 1 This paper, however, describes the outcomes of a program for which this has not been the case. We describe the trend for locality to have a reduced impact on blood lead levels of young children living in Broken Hill, New South Wales (NSW), first observed in 2002. 2 Lead has been mined in Broken Hill since 1884. Lead poisoning was evident among the early miners and their families, but was seen as mainly an occupational health problem. 3

Blood lead levels in the adult Victorian population: results from the Victorian Health Monitor

“…The study did not, however, measure BLLs in children or pregnant women. Despite several studies investigating BLLs in children in at-risk areas, [17][18][19][20] and a large Australian study of children in 1995, 16 current BLLs for children at the population level remain unknown. This is of particular concern given the evidence suggesting chronic exposure to low levels of lead can affect neurological development and cognitive function in children.…”

“…15 The main focus of studies of BLLs in Australia has been on young children and, with the exception of one Australia-wide study in 1996, 16 they tend to be focused on children at high risk of lead exposure, especially those living in and around industrial and mining areas. 17,18 Studies of BLLs in Australian adults are limited in number and those that exist also tend to be focused on BLLs in at-risk groups. 19,20 Although they yield important information about lead exposure, the prevalence of elevated BLLs from studies of at-risk children and adults are not representative of the wider population.…”

Trends in notifiable blood lead levels in NSW, 1998?2008

“…3,22 Since 1991 the blood lead screening of children in Broken Hill has underpinned education and risk reduction interventions provided to individuals and their families. 23,24 These interventions resulted in almost 75% of children aged 1-4 years recording blood lead levels below 10 mg/dL by 2007. 25 In the north Lake Macquarie area, the positive influence of public health action allowed active surveillance to stop after mean blood lead levels in children decreased to less than 5 mg/dL in 2006, 18 3 years after the closure of the smelter.…”

Putting the genie back in the bottle: protecting children from lead exposure in the 21st century. A report from the field

“…Airborne lead reduced significantly in the late 1990s, and the reductions were greatest closest to the mines. 20 Average blood lead levels reduced steadily from 16.7 µg/dL in 1991 to 7.6 µg/dL in 2001. 21…”