|
Forensic Files
Episode ‘Death by Poison: Sunday’s Wake’
Article researched by Elizabeth
O’Brien,
written by Yiru Rocky Huang, for The LEAD Group.
Thanks to Lance Smith of Sydney Analytical Laboratories for alerting us to this
TV documentary.
In the USA and probably in most
developed countries, the risk for elevated blood lead levels (BLLs) among
children remains high in some neighbourhoods and populations; including children
living in older housing with deteriorated leaded paint and refugee children.
Lead screening is not mandated for immigrant children in the US (or in
Australia), yet there is strong evidence for high BLLs in these groups. The
level that is reported below for a refugee child could very easily be applied to
immigrant children in Australia as well. This article is about a lead poisoning
fatality which occurred in the United States. The episode of the TV show
Forensic Files which covered the case is titled ‘Death by Poison: Sunday’s
Wake’ and is viewable online at
https://www.youtube.com/watch?v=h4dZdMGIl70 and
https://www.youtube.com/watch?v=_C8wD1qsQq0 in two parts.
On March 29, 2000, a 2 year old Sudanese
girl was seen at a community hospital Emergency Room (ER) with a low-grade fever
and vomiting. She was discharged from the ER with an antibiotic and antiemetic
to treat what was presumed to be strep throat. Her vomiting worsened and she was
then re -admitted to the same hospital and then transferred to a tertiary care
hospital the next day. She became unresponsive 5 hours after the transfer and
was intubated and placed on a ventilator. Computerised tomography showed that
she had dilated ventricles and showed diffuse cerebral edema. Later that day,
the results of a blood test drawn showed a BLL of 391 µg/dL. This sparked an
investigation by the Manchester Health Department and New Hampshire Department
of Health and Human Services. The wall of the apartment the family moved into in
March 2000 had multiple holes from which the patient had been seen removing and
ingesting plaster and two of the seven samples from the apartment contained lead
at levels of 5% and 12%. Peeling paint (35% lead) was present on the balusters
and floor (3% lead) of a porch outside the apartment where the girl had played
sometimes.
The summary of this Forensic Files
episode is that the landlord was jailed for 15 months for “violating the Lead
Disclosure Rule, after the patient consumed paint and plaster in a rental
property and died of lead poisoning”. Under the US regulation all buyers and
renters of pre-1978 housing MUST be notified of lead paint hazards. The Lead
Disclosure Rule is a federal rule in the USA.
Elizabeth O’Brien suggests that it
should be extended beyond paint (for housing built before 1997). It should
include ceiling dust for housing built before 2002 (or before today in lead
smelting and mining towns); houses with rainwater tanks added later (for housing
built anytime up to today) or houses with rainwater tanks added when the house
was being built for housing built up to 2004 or up to today in lead smelting and
mining towns.
The CDC’s current lead screening
recommendation is a part of the US government’s strategy to confront lead
hazards on both the domestic and international fronts. Brown suggests,
“Refugee children living in Manchester were significantly more likely to have
an EBLL compared with non-refugee children. And among refugee children, we found
a statistically significant difference in the mean days to BLL decline <10 µg
/dL before and after recommendations to test newly emigrated children.”
It’s important to note that government
regulations must be followed in order for this to be effective and in some cases
refugees are placed in lead-contaminated housing either because the resettlement
agency isn’t aware of the risk or the landlords don’t reveal it. Another
problem can be when cultural differences create a barrier to conveying the
notion that these products are harmful. For example Ayurvedic medications which
are often loaded with lead, zinc, arsenic and mercury
as it is though to have medicinal properties.
Lead-soldered cookware; Burmese Daw Tay (traditional medicine) and glazing on
Mexican pottery are other examples of leaded products found in products imported
into the US and Australia. This has received significant media coverage recently
but getting people to acknowledge and understand that this is a health risk is
the challenge.
Another ongoing initiative is the World
Health Organisation and United Nations Environment Programme’s Global Alliance
to Eliminate Lead in Paints (GAELP) project which aims to phase out the
manufacture and sale of lead-based paint worldwide. So it's important that we
are all aware of the risks and that we all take the matter of any lead abatement
and management issues very seriously and ensure that we understand what
landlords and our government are responsible for.
REFERENCES
Charles
W. Schmidt. Unsafe Harbor? Elevated
Blood Lead Levels in Refugee Children. Environmental Health Perspectives 121:
A190-A195 (2013). [accessed 19 February 2015]. http://ehp.niehs.nih.gov/wp-content/uploads/121/6/ehp.121-a190.pdf
Forensic Files episode ‘Death by
Poison: Sunday’s Wake’, online at
https://www.youtube.com/watch?v=h4dZdMGIl70 and
https://www.youtube.com/watch?v=_C8wD1qsQq0
|
