Overview of Lead Contamination
Campaigns against the use of lead started with the passing of the first industrial hygiene act in 1713, prohibiting the use of lead in the equipment for the distillation of rum (Bellingerm, 2016). However, the recent past saw an increase in the use of lead through applications such as boosting the octane rating of gasoline and enhancement of paint performance. The strategies maximize population exposure to lead through these ubiquitous practices. Nevertheless, significant reduction in blood lead levels of the U.S. population in the last 40 year is heralded as one of the leading public health success stories. Datko-Williams et al. (2014) attributed the success to reduction in lead emissions into the air in the country after leaded gasoline was phased out by 1995. Lead concentration in paints and soil remain high and are the leading contributors to health issues, particularly among children.
Population Affected
Lead affects diverse demographic groups including expectant women where it can cross the placenta and passed through breastmilk. Adults are exposed through work and recreational activities, or consumption of contaminated water and foods. However, children are the most vulnerable with their exposure to lead being particularly harmful because their behaviors and bodies elevate their risk of exposure. An analysis of the differences in pediatric blood lead levels incidence following the introduction of a corrosive water source in Flint, Michigan, established that incidence of elevated blood lead levels rose from 2.4% to 4.9%. In the same vein, neighborhoods with the highest lead concentration in the water experience an increase of up to 6.6% (Hanna-Attisha et al. , 2016).
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A 2017 policy statement by the American Public Health Association illustrated that children are unique in their vulnerability to harm from exposure to environmental agents, which they interact with in their immediate settings (APHA, 2017). The heightened risk of exposure to lead is associated with children’s behavioral, physiological, and behavioral traits. Children demonstrate risky behaviors such as putting fingers and items into their mouths, thus increasing their risk of exposure to lead. The CDC statistics on lead contamination show that children from at least 4 million households are exposed to high levels of lead. The figure translates to approximately 1.5 million U.S. children aged between 1-5 with blood lead levels above the recommended 5 micrograms per deciliter (µg/dL), hence in need of public health actions (CDC, 2018).
Level of Occurrence
Lead contamination is a public health concern at all levels of governance. The CDC (2018) presented the issue as a national problem, but there are some instances where some populations have higher risk of exposure. For instance, in the Greater Flint, Michigan, where the introduction of a more corrosive water source into an aging water system without adequate corrosion control resulted to increased exposure among children.
Problem Statement
Worldwide, there is growing support for calls to ban lead use in residential indoor and outdoor paints, children products, and other nonessential consumer products. Bellinger (2016) contended that lead contamination is a reflection of abject failure in policy to protect the public. The public is exposed through eating contaminated food, drinking contaminated water, or breathing contaminated air or dust. Lead is a naturally occurring metal with beneficial effects, but it can also be toxic. Criticism of the weakened environmental and health policies stems from the fact that dangers of exposure to lead have been recognized for millennia. Banning of lead use in consumable and non-consumable products is a common practice by the US policy and regulatory institutions.
Suggestions for Addressing Health Issues
Children are mainly exposed to lead through household environment, air, and water. However, cumulative risks, even at low doses, from other sources potentially compound the adverse effects of exposure to lead and necessitate concerted, intentional efforts to protect the youngest and most vulnerable (APHA, 2017). It is important to understand that exposure to lead may be asymptomatic; hence, the need for confirmatory blood tests when exposure is suspected. Therefore, it is imperative to initiate coordinated and comprehensive efforts to prevent environmental risks to all children. Success of concerted efforts can be achieved by reducing exposure through:
Keeping lead containing products away from children,
Washing children hands and toys regularly
Mopping floors, and wet-wiping windows every 2-3 weeks, and
Prevention or reduction of access to peeling lead-based paint.
Steps for Initiating Policy Change and Stakeholders
Change in policy on the environmental and health issue of lead contamination requires join efforts by governmental and private agencies, public health practitioners, community-based and environmental justice organizations, policy makers, communication leaders, health economists, and researchers to carry out advanced planning for policy development and implementation. Lead contamination is a policy issue with diverse effects. It is a multi-sectorial problem in the environmental and healthcare systems. Therefore, initiation of policy change must:
Leverage opportunities for health collaboration through community development investments that improve health outcomes,
Implement of precautionary principles in children health,
Improve health and wellness through access to safe nature,
Reduce lead containing compounds in facilities and environments with vulnerable populations,
Reform primary health care with specific emphasis on home care model, and
Invest in clinical diagnostic tools and biomonitoring for exposure to lead (APHA, 2017).
Depending on the policy initiative adopted, implementation should be targeted at the geographical locations with the most vulnerable populations. The aim is to ensure allocated funding is sufficient to realize policy outcomes.
Impact on the Health Care Delivery
Social determinants of health interact with exposure to lead creating further disparities in children. The magnitude of the problem has significant implications for the healthcare system, and can impair delivery of care. The situation is exacerbated by the fact that lead exposure is attributed to a host of developmental and physiological problems in children. The CDC (2018) observed that there is no identified safe level of lead in the blood of children. Moreover, exposure is detrimental to almost every body system. Children affected by lead poisoning are more likely to present with symptoms of slowed growth, low IQ, learning difficulties, anemia, reproductive problems in adulthood, cardiovascular problems, and decline in kidney function. Addressing these problems poses a significant challenge to the health care delivery system. Collaborative efforts from stakeholders in the education system are required to guarantee such children a normal life.
References
American Public Health Association. (2017). Protecting Children's Environmental Health: A Comprehensive Framework. Retrieved from https://apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/23/protecting-childrens-environmental-health.
Bellinger, D. C. (2016). Lead contamination in Flint—an abject failure to protect public health. New England Journal of Medicine , 374 (12), 1101-1103.
Center for Disease Control and Prevention. (2018). Childhood lead poisoning prevention program. Retrieved from https://www.cdc.gov/nceh/lead/default.htm.
Datko-Williams, L., Wilkie, A., & Richmond-Bryant, J. (2014). Analysis of US soil lead (Pb) studies from 1970 to 2012. Science of the Total Environment , 468 , 854-863.
Hanna-Attisha, M., LaChance, J., Sadler, R. C., & Champney Schnepp, A. (2016). Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. American Journal of Public Health , 106 (2), 283-290.
