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Lead endangers young Malawians’ lives

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Despite that the world recognises lead as an infamous chemical, dangerous to the human body and the environment, exposure to this poison silently continues compromising children’s health worldwide including Malawi.

This is according to a study entitled Health Risk Assessment of Lead among Children in Blantyre City, a PhD research by a Malawi Polytechnic lecturer, Wells Utembe, who is studying at Wits University in South Africa.

At least 152 children were recruited through Community Nurses and Health Surveillance Assistants (HSAS) randomly from Chilomoni, Ndirande, Bangwe, Limbe, Zingwangwa, Machinjiri and had their blood samples taken and tested in South Africa at Lancet and Protechnik Labs.

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The blood test results found that 109 children had lead levels above five microgram per decilitre with a four year old registering the highest levels amounting to 50.4 microgram per decilitre.

Although lead is said to be regulated in Malawi, but Utembe’s research shows that about 72 percent of children aged between two to seven years old in Blantyre city have high levels of lead in their blood system an indication that children are still being exposed to this chemical.

According to World Health Organisation (WHO) 143, 000 or 0.6 percent of the global burden of disease is from lead exposure with 600, 000 new cases every year of children with intellectual disabilities emanating from lead exposure.

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Sadly 99 percent of children affected by high exposure to lead live in developing countries like Malawi.

WHO set aside an International Lead Poisoning Prevention Week of Action, observed in October. This year the week was celebrated between October 26 to 31 under the theme Free Kids for a Healthy Future, but Malawi is yet to participate in this event which was established in 2013.

Although the research could be a clue that children in Malawi are still at risk of lead exposure, the government of Malawi is not subscribing to it.

Minister of Health, Peter Kumpalume, said the situation on the ground might not be as alarming as the research indicates because there are possibilities that it might have been done in an area with high lead levels.

“We cannot rush to join the world, celebrating the lead free week because we need finances to carry such awareness. We need to understand the severity of the cases. Of course, if you consider family it is a big issue but as a country it might not be a pressing issue. We also need to know the situation for other kids in areas where the research did not cover,” he said.

Kumpalume also said there was need to find out how these kids got exposed to those high lead levels. He hinted that it could be possible that these kids are victims of lead standards before they were revised internationally.

Effects of lead exposure

The internationally recognised limit of lead is five microgram per decilitre and in excess of lead exposure leads to low IQ and violent behaviour. While very high exposure of lead causes abdominal pains, kidney problems, hallucinations, reproductive problems, blood pressure problems and anaemia. Of course, very high levels lead to death. Early this year 28 children in Nigeria died from lead poisoning.

Sources of lead exposure

The research tested dust from the houses of the recruited children, dust around their homes and both were contaminated with lead. A test was also done for all the paints on the Malawi market and a large percentage of these paints had lead levels above the recommended limit.

Even the food tested from the homes of these kids had high levels of lead as well but the water from over hundred samples tested had no lead. The research also did some test on kids plastic toys, but there was no trace of lead.

However, the toys have found to be a source of lead exposure for kids in other countries like China where only 1.32 percent of children had blood lead above the limit.

Lead regulation in Malawi

Although the Department of Environmental Affairs in the Ministry of Natural Resources, Energy and Mining and the Malawi Bureau of Standards (MBS) possess some egulations on lead, it seems enforcement of the regulations is a challenge. And at the MBS there isn’t a clear lead regulation for paint.

Environmental Officer responsible for Pollution Control in the Ministry of Natural Resources, Patrick Nyirenda, listed five initiatives being implemented to stamp government’s position on lead. For example use of lead in motor vehicle fuel is no longer allowed hence unleaded fuels are being sold and used to minimise the impact of lead on human health and the environment.

The phasing out of all incandescent bulbs (IBS), which have a lead filament, for energy saver bulbs is another Malawi government’s initiative to reduce the risk on the lives of people and environment from lead exposure as IBS bulbs are disposed as general waste.

Lead levels in drinking water have a threshold of 50 microgram per litre.

However, it is tricky to regulate lead in car batteries and in paints. With car batteries most of them are imported but their quality is regulated through Malawi Bureau of Standards.

“Damaged and spent batteries are regulated as other hazardous waste although it is very difficult to monitor how individuals dispose of their batteries after use,” Nyirenda said.

While for paints, Nyirenda said the standard is that all the paints currently being manufactured, blended in Malawi or imported from other countries are monitored for lead but this is a challenge in the absence of a standard of lead in paints.

Nonetheless, MBS Director General, Davlin Chokazinga, said he could not rule out the possibility by some paint manufacturing companies opting to use lead and not its replacement, cobalt, as the latter is expensive. Cobalt or lead is used as a drier and as pigment in paints.

Chokazinga said no paint is supposed to have an element of lead. However, our research has shown that the standard is yet to appear on the MBS catalogue.

According to the MBS 2015 online catalogue, there is no standard on lead in paint.

For the car batteries referred to as lead acid batteries, Chokazinga said since they are disposed anyhow, they can be another source of lead exposure for the children.

Regulation of dangerous waste disposal

While there are pointers towards lead exposure sources, another critical area that needs immediate attention is on how waste, especially those in the hazardous category, is disposed. Most waste in Malawi whether hazardous or not is dumped anyhow with streams and rivers being turned into dumping sites.

MBS, the ministries of Health and Natural Resources, Energy & Mining say it is the City Councils’ responsibility to monitor and enforce measures on how such waste should be disposed of without polluting the environment.

Blantyre City Council Public Relations Manager, Anthony Kasunda, said the council follows WHO standards.

“We do follow WHO standards, and in wastewater management the threshold for lead is 0.1 mg/litre. Threshold fees are charged even for discharges less than that limit. However, penalty charges are imposed on all discharges above the threshold,” he said.

On waste like car batteries, Kasunda said such waste is hazardous and there is need for car battery manufacturers to provide the sensitisation and possibly develop a recycling and safe disposal mechanism.

Treatment for lead exposure

According to Kumpalume, a research scientist himself, there are two cases that result from lead exposure; chronic and acute.

“With chronic case, sadly there is no treatment because at this level the lead becomes part of your body and it attaches itself to the protein tissue causing the tissue to malfunction,” he said adding that this happens when one has been taking lead for a long time.

The second case is called acute, which is treatable but the minister was not sure if Malawi offers such treatment. Acute condition arises when one takes a lot of lead in a short period of time.

Hospital Administrator at Queen Elizabeth Central Hospital Themba Mhango was non committal on whether the hospital had treatment for those exposed to high levels of lead. But he suggested that the Community Health Science Unit in Lilongwe should be able to speak on behalf of all hospitals in Malawi.

Disease Control Officer at the Community Health Science Unit, Isaiah Dambe, said Malawi has no capacity to test lead poisoning as the machine which is used to carry such tests is very expensive.

He, however, said the approach to those that have been exposed to lead is to take lots of fluids in order to remove excess lead from their blood.

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