KATHMANDU, OCTOBER 5

Although lead exposure is dangerous to all age groups, it is considerably more harmful to children and the health effects are typically irreversible with a lifelong impact.

Lead (Pb) is a toxic metal that causes adverse effects on both human health and the environment. The International Agency for Research on Cancer (IARC) has classified lead as a probable carcinogen too. 'Paint' includes varnishes, lacquers, stains, enamels, glazes, primers, or coatings used for any purpose. Paint is typically a mixture of resins, pigments, fillers, salvents, and other additives.

'Lead paint' is a paint which has more than one or more lead compounds added. The younger the child, the more harmful lead can be, and children who are malnourished absorb lead at an increased rate.

The human foetus is the most vulnerable, and a pregnant woman can transfer lead that has accumulated in her body to her developing child. If a nursing mother has lead in her body, it could be transferred on to the child through breastfeeding.

Evidence of reduced intelligence caused by childhood exposure to lead has led the World Health Organization (WHO) to list 'lead-caused mental retardation as a recognized disease.

WHO also identifies it as one of the top ten diseases whose health burden among children is due to modifiable environmental factors. Lead paint is a major source of childhood lead exposure.

A cross-sectional study of related factors in 2015 in the Kathmandu Valley of Nepal indicated high blood lead levels (BLL) in children aged 6 to 36 months.

Among 312 children enrolled in the study, 64.4% had BLL µg/dL. A significant association 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 has been discovered.

The recent study report entitled 'The Toxic Truth: Children Exposure to Lead Pollution Undermines a Generations of Future Potential' by UNICEF and PURE EARTH, 2020 revealed that 1 in every 3 children up to 8 million globally-have blood lead levels at or above 5 µg/dL. It demonstrates that 6,719, 235 Nepalese children (over 65% of the total child population of Nepal) have elevated BLL (>5 µg/dL) and some 3,512,007 children even had BLL over 10 µg/dl as per the upper bound estimates. Nepalese children are under an astonishingly extreme level of risk that urgently needs to be addressed.

Likewise, another latest study by the World Bank entitled 'Global health burden and cost of lead exposure in children and adults: a health impact and economic modelling analysis' estimates that children younger than 5 years lost 765 million (95% CI 443–1098) IQ points and that 5545000 (2305000–8271000) adults died from cardiovascular disease in 2019 due to lead exposure.

Moreover, 729 million of the IQ points lost (95·3% of the total global IQ loss) and 5004000 (90·2% of total) cardiovascular disease deaths due to lead exposure occurred in LMICs. IQ loss in LMICs was nearly 80% higher than a previous estimate. Cardiovascular disease deaths were six times higher than the GBD 2019 estimate.

Furthermore, the global cost of lead exposure was US$6·0 trillion (range 2·6–9·0) in 2019, which was equivalent to 6·9% (3·1–10·4) of the global gross domestic product. 77% (range 70–78) of the cost was the welfare cost of cardiovascular disease mortality, and 23% (22–30) was the present value of future income losses from IQ loss.

Lead is extensively used in lead-based paint; lead-acid batteries; lead plates, sheets, strip foil, lead tubes, pipes and fittings; cable sheathing and alloys (lead alloys, unwrought).

In household settings, the risk of lead exposure from lead acid batteries and lead-based paint is of greatest concern. It has been found that 48 per cent of all paint products sold in Nepal as per WHO and MOHP Supported CEPHED`s Compliance Monitoring of Lead Paint Standards in Nepal 2021 had lead levels above 90 ppm.

This 2021 study depicts maximum lead concentration up to 22850 ppm (253 times more than the lead paint standard of maximum allowable lead of 90 ppm). Previous studies conducted by Leaders Nepal have even found lead concentrations up to 200,000 ppm (20 percent lead by weight) in some brands of paints that are commonly available in Nepalese markets indicating serious population level exposure.

We need to launch campaigns to outlaw the use of lead in petrol and the progress achieved by many countries in establishing laws that limit the use of lead in paint, particularly those paints to which children are exposed in their homes, schools and playgrounds, according to experts.

'The eleventh International Lead Poisoning Prevention Week (ILPPW) is taking place between 22-28 October across the globe. Internalising its slogan, 'End Childhood Lead Poisoning', massive public awareness is a must, 'said Ram Charitra Sah, Executive Director of CEPHED.

'It could be made possible by adopting National Blood Lead Level (N-BLL) screening policy and developing required infrastructure like BLL testing laboratory facilities, trained human resources and enough budget allocation in each province of Nepal.'