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Sindh's silent epidemics
Publication Date : 20-02-2013
Arsenic and lead poisoning is believed to be taking its toll on human health and causing silent epidemics in the province of Sindh in Pakistan, but not a single intervention has yet been introduced by the government to address the issue, experts said, sharing findings of their studies at a seminar on Tuesday.
The seminar titled ‘Environmental Degradation and Health Impacts’ was organised by the Department of Community Health Sciences’ Division of Environmental Health at the Aga Khan University (AKU) in collaboration with the Environmental Protection Agency, Sindh.
Giving a presentation based on his research - 'Perinatal Lead Levels and Environmental Lead Sources: A Study from an Urban Centre in Pakistan', Dr Mohammad Masood Kadir, a professor of the department of community health, AKU, said the study had shown higher levels of lead in most mothers and newborns that should be of grave concern for the public and the government.
He said lead present in the maternal bone was transferred to the foetus or child and caused health complications. Lead toxicity affecting newborn/child health was a major global concern and studies had established a direct relationship between chronic lead poisoning and mental impairment.
“About 500 mothers presenting for delivery at the study hospitals were interviewed. Seventy-five per cent of mothers and 90 per cent of newborns had high levels of lead,” Kadir said, adding that continued low levels of lead accumulated over time and affected the body.
Elaborating upon the study results, Dr Zafar Fatmi, an associate professor at the same AKU department, said scientific evidence had shown that lower levels of lead could have a grave impact on intelligence in early childhood.
“It could have a maximum impact on the mental health of a newborn/foetus which could be mental retardation in its severe form,” he said, adding that cooking utensils were also tested during the study and it was found that utensils made of aluminum-mixed alloy had higher levels of lead content while the content of the metal was lower in utensils made of stainless steel.
It was the first study in Pakistan in which utensils were tested to check lead levels, he said, pointing out that cheaper paints, surma (a traditional eye cosmetic) and petrol/diesel were the other major sources of lead contamination.
“Though Pakistan and South Asian countries are phasing out lead-based fuel, lead will remain part of our environment for at least 10 to 15 years even if the measure is rightly implemented,” he said.
Answering a question, he said the present study did not aim to analyse the impact of lead poisoning on human body, but international studies, which had already examined and established the adverse impact of lead on health, were sufficient to cause public concern and necessitate immediate intervention.
Presenting clinical evidence from his research titled ‘Health Burden of Skin Lesions at Low Arsenic Exposure Through Groundwater in Pakistan. Is River the Source?’, published more than three years ago, Dr Fatmi said that the study had shown a significant burden of skin lesions at relatively low concentration of arsenic in the Khairpur district.
“Arsenic targets all cells and organs of the body and includes complications and/or cancer of liver, lung, kidney, bladder and cardiovascular diseases and even diabetes," he said."And though the scope of the research didn’t include establishing a relationship between cancer and impact of arsenic contamination on human health, we did find significant relation of both arsenic skin lesions and groundwater contamination of wells with proximity to the Indus river."
Twenty-three per cent of wells in the district were found to be affected by arsenic contamination and the overall presence of arsenic skin lesions was found to be 13.5 per cent in the study involving a survey of more than 3,000 individuals.
“It takes 10 to 15 years to develop those lesions. We even examined apparently healthy individuals who had no skin lesions and found that their lung function was affected,” he said.
Referring to another study, he said it showed that every 10th well in the country was contaminated with arsenic. However, Pakistan, he said, had lower levels of arsenic in groundwater than China, Bangladesh and India.
Highlighting some important points from his study, he said the prevalence of skin lesions increased with increasing levels of arsenic in drinking water and urine.
Most of the population (98.5 per cent) was using groundwater for drinking and a greater proportion of water sources was found to have arsenic concentrations in sub-districts close to the Indus: Gambat, Kingri and Sobho Dero.
Arsenic, he said, had entered the river water from the soil where it was being continuously accumulating. “We shared this problem with regional countries and it is assumed that the compound is present in the mountains from where the rivers flow,” he said in reply to a question.
Recommending tried and tested cost-efficient remedial measures, he said that safe and unsafe wells needed to be identified and marked and, then, their regular monitoring be carried out.
“Easy-to-use inexpensive kits are in the market that the villagers could use to test arsenic levels and get results within 15 minutes. Monitoring of wells with low levels of arsenic might be required after three months,” he said, suggesting blanket testing of Indus river water and creating public awareness of the issue.