National studies, supported by the World Health Organization (WHO), Country Office for Nepal, and a few other organisations, have highlighted the risk of high level of lead exposure in children, especially in Kathmandu1, Birgunj2, and Dharan-Dhankuta industrial corridor. A 2020 global study, by UNICEF and Pure Earth, also estimated that over 65% of the total child population of Nepal have elevated BLL (blood lead level)3.
Studies also attributed occupational exposure and increased risk of lead toxicity to the use of bare hands for handling solid waste in individuals who work with electronics, plastic, metal, and paint waste.
The studies found one of the main reasons of contamination to be paints containing lead. Recycling of lead batteries was found to be another major source of contamination, followed by lead used in cosmetics, pottery, ayurvedic medicines, and even adulterated spices such as turmeric.
WHO, Country Office for Nepal, has been supporting the Government of Nepal (GoN) in spearheading efforts against lead paint and its adverse effects on children since 2013 with various partners such as the Centre for Public Health and Environmental Development (CEPHED). Commemorating the International Lead Poisoning Prevention Week since 2013 which usually falls on October, WHO urges policymakers for timely implementation of policies to lessen the harmful effects of lead. While raising awareness is a first step, WHO also urges GoN to put timely, effective measures to contain lead exposure particularly among children in vulnerable communities. Experts also underline the need to measure the prevalence of lead contamination among children through testing facilities in hospitals and labs, something that will require high investments from the government.
“There is no such thing as a ‘safe limit’ of blood lead level (BLL) in children. In Nepal, with the high content of lead in paints, the situation remains grim. If timely action is not taken the country’s future citizens may not grow up to their full potential,” states Dr. Rajesh Sambhajirao Pandav, WHO Representative to Nepal.
Infants and young children crawl or walk closer to the ground, often eat dust, frequently put their hands to their mouths thus exposing themselves more to the lead that is often present in the air, water, and ground.
Young children tend to absorb lead 4-5 times more than adults do; and children under six years are at high risk of suffering lifelong neurological, cognitive and physical damage, and even death from lead poisoning. Acute lead poisoning can lead to multiple organ dysfunction mainly kidney, liver, heart, lungs, and most importantly, the brain. Chronic exposure, which is common, can be equally harmful, as neurological effects of childhood are irreversible and lifelong.
Exposure to lead can also affect the child in a pregnant mother’s womb. Children’s high absorption of lead increases when they have more nutritional deficiencies particularly iron and calcium. Lead is known to ‘mimic’ calcium and iron and children deficient in these minerals easily absorb lead in their bones, teeth, and blood leading to anemia and other complications in the kidney, liver, and other organs. Above all, lead is known to be a neurotoxin hampering children’s mental development and academic performance.
According to a New York University research paper, released in 2013, the annual losses in Nepal due to lead exposure-induced IQ losses among Nepalese children is estimated at $1.5 billion (4% of the annual GDP of Nepal for the year 2011).
“Today, only slightly over 50% of paints produced in Nepal are adhering to the government stipulated ceiling of 90 ppm lead in paints. Compliance has increased over time, but more needs to be done and it is possible as there are appropriate alternatives. Through various concerted efforts with the GoN and partners, we can continue to better the lives of the children of Nepal”, states Raja Ram Pote Shrestha, National Professional Officer for Climate Change, at WHO, Country Office for Nepal.
WHO urges children to wash their hands frequently e.g. before eating; and guardians to wash toys regularly, avoid using old or imported toys unless they are lead-free, clean surfaces with wet mop, chipping paints with moisture, avoiding molds and mildew, and provide calcium and iron supplements to children which prevent absorption of lead.
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1 BLL study carried out by National Health Research Council in Kathmandu Valley in 2014/2015 with support from WHO.
2 Study by Dr. Keyoor Gautam and team in Birgunj in 2017.
3 “The Toxic Truth: Children Exposure to Lead Pollution Undermines a Generations of Future Potential”, a study by UNICEF and PURE EARTH, 2020.