India’s hidden adversary, Lead poisoning

Lead poisoning:

1. More than half of the children in India (close to 20 crore) have lead levels in their blood >5 micrograms per decilitre (µg/dL) as per 2021 study.
2. WHO:  Any level >5 µg/dL is “a trigger for a thorough review of the ways in which a person is being exposed to lead and for action to reduce or end this exposure”.
3. Children are the most vulnerable to lead poisoning as their developing bodies and brains absorb lead at a higher rate leading to irreversible damage.
4. Even low levels of lead exposure have harmful effects like
   1. Neurological impairments
   2. Learning disabilities and reduced educational attainments
   3. Stunted growth
   4. Organ damage
5. Lead poisoning accounts for a fifth of the learning gap between rich and poor countries.
6. Earlier, the major sources of lead exposure were gasoline, water-pipes, and paints. 
7. Governments across the world have taken robust actions to ensure lead-free products such as removal of lead from gasoline by the US which led to reduction of >90% in mean blood lead concentration from 1976 to 1995.

India’s lead poisoning remains unaddressed:

1. Most of the housing stock and public buildings in India are coated with paints which has high levels of lead. It deteriorates with time and release toxic dust particles into the air.
2. Old water-pipes are not lead-free.
3. Common usage of lead solder in food cans, ayurvedic medicines, and toys increases the chance of exposure to lead.
4. Several occupations such as lead mining, smelting, welding, soldering, and automobile repairing involve working with lead that can potentially affect their family members.
5. Unsound and unregulated recycling of used lead-acid batteries in vehicles due to weak implementation of regulations.

Interventions that are required:

1. Replication of successful models from other countries such as that of Bangladesh’s interventions to prevent lead exposure.
   1. Turmeric adulteration with lead chromate pigment was identified as a primary source of lead exposure in Bangladesh.
   2. Multifaceted interventions such as strong regulations, rapid detection of lead contamination, and consumer education to reduce lead-tainted turmeric was launched between 2017 and 2021.
   3. The efforts enabled reduction of lead in turmeric from 47% to 0% between 2019 to 2021.
   4. The lead in blood levels also dropped to a median of 30% in the affected population.
2. A robust legislative and policy framework has to be drafted that
   1. Clearly defines health and safety standards for manufacturing and recycling of lead-acid batteries, e-waste and other consumer products that contain lead.
   2. Strict enforcement of the legally binding standards on paints and water pipes.
   3. Stringent laws preventing informal recycling and use of lead containing waste.
   4. Strict prohibition of child labour in e-waste picking or metals mining
   5. Restriction of access to toxic sites
3. Strong monitoring and reporting system for lead poisoning. 
   1. Improved capacity for blood lead level testing
   2. Introduction of blood lead level monitoring in household surveys.
   3. Adoption of a country-wide effort to identify lead-contaminated sites.
4. A multi-pronged approach with regulatory reforms and strict enforcement is required.
   1. Prioritisation of cleaning up the contaminated sites, particularly those located near schools and residential areas.
   2. Establishing sustainable waste management practices and electronic waste recycling programmes
   3. effective coordination and collaboration mechanism between government agencies, non-governmental organisations, and international technical partners is imperative.
5.  Well-targeted public awareness programmes have to be rolled out.
   1. Awareness on dangers and sources of lead exposure to key stakeholders such as parents and caregivers, schools, youth associations, community leaders and healthcare workers.
   2. Emphasis on educating workers and owners of lead-related industries, especially battery and electronic waste recyclers.

The control of lead contamination can provide high return on investment such as improved health, increased productivity, higher IQs, reduced violence, and a brighter future for children of the nation.