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     Volume 7 Issue 7 | February 15, 2008 |

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Special feature

An Impending Environmental Disaster

Hana Shams Ahmed

At first sight Nazmul Hasan Shojib seems like a fairly healthy child. But on close scrutiny it becomes quite clear that the 12-year-old Shojib is quite small in stature for his age. Shojib who studies in the 5th grade of the Emersion School and College in Tongi, is slow to answer very simple questions and has a blank look on his face. His mother, Nazma Begum is worried about the state of his health. She says that he regularly complains about feeling weak and tired and sometimes gets headaches and feels nauseous. Shojib says that he doesn't feel like studying because it makes his head feel heavy. Shojib's father Kadir Hossain Babu who makes blinds in a factory in Motijheel and earns a modest income lives with his family in a small tin-roofed house close to the school in this heavily industry-dependent area.

These children from Emersion School in Tongi might look very healthy but their blood lead levels are dangerously high.

Shojib is one of about a hundred children in Tongi who were tested with high levels of lead in their blood. Young children like him are most susceptible to the toxic effects of lead. Long-term exposure to even low levels of lead can cause irreversible learning difficulties, mental retardation, and delayed neurological and physical development. Lead also damages the blood, kidneys, heart and the reproductive system. The first symptoms of lead toxicity are very general and non-specific. These include nausea, sluggishness, vomiting, painful gastrointestinal irritation, diarrhoea, loss of appetite, colic, weakness and dehydration. These symptoms are common to many disorders. In children blood lead level (BLL) > 10µg/dL have been associated with developmental delays, deficits in behavioural functioning, decreased stature and diminished hearing acuity. High BLLs (i.e., > 70µg/dL) can cause serious health effects, including seizures, coma and death.

These slum dwellers use the waters of the Turag River for their daily lives, which is where the waste from different industries is expelled.

Dr Amal K. Mitra, a Professor at the Department of Community Health Sciences from the University of Southern Mississippi recently came to Dhaka on a Fulbright scholarship to study the blood lead levels in children of the country. Firstly he took samples from a school in Uttara. Fifty-six children were tested and only three were found to have a lead level of more than 10µg/dL. “I concluded that it was not a major problem for Dhaka city,” says Mitra, “so I decided to take my survey to the village.”

Mitra contacted an NGO in Chirir Bondon in Dinajpur. There he tested 201 children and found blood lead levels high in more than 40 of them. The third place of study was Tongi where the results proved to be frightening. He took samples from 100 children there and found that 99 of them had a high level of lead in their blood.

The problem of lead pollution in Dhaka was identified as early as 1980. However in 1997 levels of lead in samples of suspended particles were recorded in the Capital and was found to be the highest in the world. In a large cross-sectional study of 779 school children, almost 90 percent had BLLs > 10µg/dL, 50 percent had BLLs > 15µg/dL, and almost 20 percent had BLLs > 20µg/dL. The government of Bangladesh executed a landmark decision of providing only unleaded gasoline from 1999 and followed it up with the withdrawal of 2-stroke engines in 2003 although the diesel-based vehicles like human haulers, maxis and riders were introduced right after that. And according to Mitra there is no total control over the use of leaded gasoline in the country. Law enforcing agencies do not monitor lead emissions through industrial waste disposal. Because of a lack of proper waste management system, disposed batteries, potteries and cans are left near areas where children living in slum areas play.

The black smoke from vehicles is a source of lead poisoning.

Liza Akhter Laboni and Rupa Akhter Shila are two sisters living in a tin-roofed house adjoining Shojib's house. Liza is 10 and her sister Rupa is nine. They both study at the Emersion School and both have been found to have a high level of lead in their blood. Liza shows no outwardly signs of lead poisoning but says that she often feels tired and does not feel like studying. Rupa has a blank stare and had recently had two seizures. In the absence of their father Lutfur Rahman who works in a hospital in Saudi Arabia, her mother Mukul Begum took her to a doctor after her seizures. Although Rupa is under medication her mother is not quite convinced that it is a medical problem and makes her wear a tabij (amulet), which her mother is convinced will keep the 'evil spirits' that cause the convulsions away from her. Although the doctors have prescribed medicine for both the sisters to neutralise the lead in their body, their mother never made the effort to even buy it, let alone ensure that they take one regularly. Mukul Begum and her family drink water from the main supply and do not boil it before drinking.

Dr Amal K Mitra plans to study the blood lead levels in children more extensively.

Lead can get inside our body from a variety of sources. Lead-based paint can be a major source of lead-contaminated soil. Industries such as lead ore mining, lead ore milling, smelting, municipal solid waste incinerators, and lead-acid battery recycling facilities can be sources of lead-contaminated soils. Sources of airborne lead include emissions from gasoline combustion, smelters, and battery manufacturers, among others. Windblown dust is another source when the dust contains lead. Inside our homes it can come from lead-based paint and lead pipes. Improper glazing on enamelled or ceramic pots and dishware can get lead into foods. Lead can get into children's bodies from the soil, toys with lead-based paints, colour pencils, whitewashing from the walls, amulets etc. And it all boils down to the fact that children from low-income families are more likely to get lead inside their bodies because they are usually not very well-nourished and so have low immunity.Because of the limited number of samples Dr Amal Mitra took this time, he could only test the blood of 350 children using an 'anodic stripping voltammetry' instrument which provides a prompt, cost-effective technique to monitor lead exposures. Mitra plans to come back in a few months' time with more resources to test blood lead levels in children in more parts of the country. “First we need to identify how big the problem is,” says Mitra, “and I also need to measure the lead levels in adults in the families of the children I tested. I took samples from children only because they are more at risk as a result of the high levels of lead in their blood than adults. Children are more vulnerable to this problem, especially those under six.”

Lead can get stuck inside the cartilage and the heart and brain. “When we're adults we don't need to grow anymore so the damage is less,” continues Mitra, “we really need to find the sources of the problem. In the US all the toys that come from China have to be tested for lead before they reach the consumers.”

Mitra is also worried about his findings in Dinajpur which is not a predominantly industrial area like Tongi. There the insecticides and pesticides (organophosphorus compounds as a whole) that are used have lead in them. “This could be a possible source of lead poisoning in this part of the area,” says Mitra, “it does not have to be the same mode of transmission in the villages as in the towns. But it is definitely a big problem in this country.”

Mitra says that although those who work in the industries are obviously at risk his research aims to find out who else besides those working inside the industries are at risk. “We need to find out how exposed the general masses are,” he says, “even if 20 percent of the general masses are exposed to lead, it's a big problem.”

Mitra recommends that it should be made mandatory to test the blood of every school-going child. “We don't want to increase the chances of mental retardation in future generations.”

If the blood test is done on a large scale the cost per test falls dramatically. Using the instrument Mitra brought from the US it took him $10 to do each test for the 350 children. “But it can be done in a different method,” he says, “and that will cost less.” Because of the nature of his study it was more convenient for Mitra to use this instrument as it is handheld and gives the reading very quickly. This instrument is used all over the US to test for lead poisoning in all school-going children.

Eight-year-old Sanjida Akhter Sadia and her nine-year-old cousin Farzana Akhter Nadia were both tested by Dr Amal Mitra. Although neither of them have any signs or symptoms of lead poisoning they were found with a high level of it in their body. Neither of their parents has followed through with the treatment. The parents don't think it's a big problem and Sadia's mother complains that it is difficult enough for her family to make ends meet, and it would be an extra burden for them to buy medicine.

Ferdousi Akhter Maya is five years old and is in the playgroup class of Emersion School. She and her 12-year-old brother Mohammad Rubel were both found to have high levels of lead in their bodies. They live in a tin-shed house near the school with their mother Roushan Akhter and an elder sister. Their father Mohammad Haji Ruhul Amin drives a lorry in Saudi Arabia. Besides occasional headaches and stomachaches, Maya does not have any health problems. But Rubel hates studying and does not eat regularly. His mother is worried about Rubel and says that she has given up all hope on her son as he does not even have the patience to sit down and do his homework.

The first treatment of lead poisoning should include an effort to decrease a child's exposure to lead. In case of the children of Emersion school, it needs to be first determined what is causing this level of lead in their blood. A diet high in calcium and iron is necessary as deficiencies in these minerals can increase the body's absorption of lead which explains why malnourished children are more prone to have high levels of lead in their blood. Lead is a completely useless thing for our body and should be removed as soon as it is detected. Elevated blood lead levels can be treated with chelation therapy. These medications are chelating agents, which decrease blood lead levels by binding to them, so that they can be excreted in the urine. The treatment is comparatively inexpensive but unfortunately, although the parents of all these children were told about the dangers of lead poisoning and prescribed with medication and advice for follow-up none of them have even bothered to buy the medicine.

But of course the main emphasis should be on preventing it from entering the bodies of the children in the first place. Dr Amal Mitra next plans to carry out his survey over different socio-economic classes. The survey till now was directed at children from low-income families only.

Mitra believes that there should be regulations to control the levels of lead in the air but there should also be regular monitoring, which has to be done by the government. According to BAPA (Bangladesh Poribesh Andolon), there has been no known study on lead levels in the air throughout the country ever since leaded gasoline was banned by the government.

The Industrial Town of Tongi
One only needs to visit a part of the Turag River once to understand why this town is an environmental disaster. The colour of the water is a strange shade of greenish black and the area around the river reeks so badly it can instantly make a healthy person nauseous. For the hundreds of slum dwellers and bede community living in the area though it is life. All the industrial waste expelled from the innumerable jute mills, garment industries, battery factories, cement factories, ceramic factories, plastic and steel factories, printing presses, car workshops, and brick fields all end up in this river which at a point connects to Buriganga. During the daytime most of these slum dwellers work in the industries around the area and during night they have to sleep with the stench from the industries they work in. This water -- which is undoubtedly nothing but poison and one would not dare to touch with bare hands -- is unfortunately part of people's livelihoods. This is where the people of the slums take their regular baths, wash their clothes and dishes and some even use it for cooking. The small pockets of water bodies around the river are infested with mosquitoes. Many of the buses and trucks in the area also emit black fumes and go unchecked. Garbage is dumped everywhere unchecked and the air is heavy and foul.

There has not been an extensive study of lead pollution in the air ever since leaded gasoline was banned by the government and 2-stroke engines taken off the capital city.

After getting rid of leaded gasoline and 2-stroke 3-wheelers from Dhaka City, the government has become complacent about the issue of lead poisoning in children. There have been no follow-up studies of any significance anywhere around the country. No studies have been carried out to measure the lead levels in the environment from insecticides, pesticides, engine boats, waste disposed from various industries and 2-stroke auto-rickshaws outside the city. But the study carried out by Dr Amal Mitra in Tongi speaks volumes. And in children, blood lead levels as low as 10µg/dL have been associated with developmental delays, deficits in intellectual performance and neurobehavioural functioning, decreased stature, and diminished hearing acuity. Long-term follow-up studies have demonstrated an inverse relation between early exposure to low levels of lead and cognitive ability in later years. The lack of awareness from parents and negligence of the symptoms makes matters worse. A combined effort from the government and environment pressure groups can prevent a future of uninspired people with low IQs.

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