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Wednesday, December 18, 2013

Lead Blood Test : Something Which We are Xposed to Everyday

An analysis of 123 blood samples of Puneites tested at the city's first blood lead level testing centre found that 30% of them had unsafe lead level in their blood, which doctors say may turn out to be a bigger threat if not monitored and treated at an early stage.
The tests were conducted over a period of one year. The individuals tested either underwent the test on their own or on their doctors' advice as they were suffering from neurological problems or chronic anemia or other physiological problems.

"Our data shows that 30% of the individuals tested in Pune had unsafe level of lead. The symptoms of lead toxicity range from decreased IQ, decreased hearing, anemia, damage to the nervous system and kidney," said senior pathologist Ajit Golwilkar.

The tests were carried out at Golwilkar Metropolis Health Services (I) Pvt Ltd that has a lead clinic operational since one year. It is under the auspices of Bangalore-based National Referral Centre for Lead Poisoning Prevention in India (NRCLPI), which was established by the George Foundation with St. John's National Institute of Health Sciences and has now become the nodal referral centre in India. Two such lead clinics in Maharashtra are functional at Golwilkar Metropolis Health Services in Pune and another in Karad.

Pathologist Manisha Patwardhan of Golwilkar Metropolis who conducted the analysis said lead level in blood should not exceed 10 micrograms per dL, and was found to be higher than that in over 30% cases of the samples tested. "In some cases the lead level was an alarming 50 micrograms per dl," said Patwardhan.

"Seven of the 123 people were children aged under seven. A few of them also showed elevated levels of lead in their blood," Patwardhan said.

Experts say conditions such as irritability, fatigue, weight and memory loss and abdominal pain among children are often linked to lead poisoning, with toys to blame in many cases. Though reputable firms use lead-free paint and safe plastic, there are daily-use items such as cheap plastic mugs, lead pencils, cheap colours and crayons that can be hazardous.

"High levels of lead in blood can cause chronic abdominal pain, anaemia, growth retardation, loss of appetite, decreased concentration level, convulsion, gum problems in children," said pediatrician Jayant Navarange, former president of Indian Medical Association (IMA), Pune branch.

People can be exposed to lead through vehicular fumes, hence traffic police are at high risk of higher levels of lead in their blood. Lead is used as a coloring agent in preparing colours and is also used in plumbing materials hence those involved in their manufacturing are also at risk.

Neurologist Rajas Deshapnde said, "High levels of lead in blood can cause inflammation as well as degeneration of brain. Such damage is mostly permanent and can be reversed with medicines, as they can only flush out lead from the body but there is no medicine to reverse the damage caused by lead toxicity."

"Permanent brain damage can be caused if a person has lead level as high as 30 micrograms per dL, but it equally depends on per-existing brain health status and associated illnesses. A lead level of 60 microgram/dL in blood is toxic enough for treatment to start immediately even if the patient is asymptomatic. Among children, the level should be less than 10 microgram/dL," said Deshpande who is director of neurology department at Ruby Hall Clinic.

"Old pipelines that supply drinking water have higher chances of corrosion and can contribute to higher lead levels in water," Deshpande said, who gets many cases of nerve degeneration that he attributes to high exposure to lead. The condition is common among those involved in manufacturing of ammunition and paint, he said.

Studies on lead poisoning have indicated how polluted water and soil, some medicines and cheap cosmetics can also be responsible.

Lead poisoning affects over 100 million people in India, especially children, pregnant women and occupational workers. A recent study conducted by The George Foundation in seven major Indian cities had found over 50% children aged under 12 with elevated levels of lead in their blood.

"The next step would be to educate the community on the major health problems associated with elevated lead levels, the paths of lead exposure in their environment and ways (by which) they can protect their families from lead exposure. Such programmes can be held in schools. There is the need for more stringent government regulation in this sector," said Thuppil Venkatesh, principal adviser, Quality Council of India (QCI) and NRCLPI. Venkatesh is known as the Lead Man of India and is instrumental in spreading awareness about lead levels and also setting up centres for lead level testing across the country.

Reference ranges of lead in blood:

* For 0-6 years -- 0-4microgms/dl

* 7 years and above --- 0-9micrograms/dl

* Levels > 10micrograms/dl --- unsafe

Lead Exposure

* People can inhale lead dust or fumes when exposed to combustion fumes

* It can be ingested through contaminated hands, food, water, cigarettes or clothing

* Lead entering the respiratory and digestive systems is released in the blood and distributed in the body

* More than 90% of the total body burden of lead is accumulated in the bones, where it is stored. Lead in bones may be released into the blood, re-exposing organ systems long after the original exposure.

Adverse health effects

The toxic nature of lead affects all organs and body functions of the body to varying degrees. The frequency and severity of symptoms among exposed individuals depends upon the amount of exposure.

Lead-induced health effects:

Neurological Effects

* Peripheral neuropathy

* Fatigue / Irritability

* Impaired concentration

* Hearing loss

* Wrist / Foot drop

* Seizures

* Encephalopathy

Gastrointestinal Effects

* Nausea

* Dyspepsia

* Constipation

* Colic

Reproductive Effects

* Miscarriages/Stillbirths

* Reduced sperm count & motility

* Abnormal sperm

Blood Effects

* Anemia

* Erythrocyte protoporphyrin elevation (that causes iron deficiency)

Renal Effects

Kidney is the main route by which lead is eliminated. Lead is absorbed by the proximal tubular cells of the renal tubules, where it binds to specific lead-binding proteins

* Chronic nephropathy with proximal tubular damage

* Hypertension

(Source: Department of Health, US)

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