Letters

Lead poisoning in Indonesia

From Susy Retnowati, to the Editor, 5th August 2010.

(Susy Retnowati was born and raised in Indonesia and then worked for The LEAD Group in the late 1990s. Susy was asked to make pre-publication comments on Suherni’s Lead Poisoning in Indonesia in English and Indonesian Keracunan Timbal di Indonesia. 

It's an honour to have my name mentioned in Suherni’s report. Thank you.

It would be interesting to know what categories of schools were chosen to have blood lead levels tested. Indonesia has 4 different categories of school: government schools, national schools, national plus and international schools.

National plus and international schools are more for those in a higher socio-economic class. The children are not exposed to contact with sources of lead at home. They have everything done for them, in clean conditions. They have a better and higher standard of living.

If the surveys were done at this higher socio-economic level, then generally, the results should have been lower blood lead levels.

About the recycled plastics industry

I have observed many syringes and other hospital wastes not being recycled or disposed of safely. It is common practice in Indonesia and has been shown on TV - where kids grow up on waste land, playing and working at the same, collecting plastics or other materials that are re-sellable for money. It is sold to a "middle man", who then sells all the plastic (which contains blood and other biological chemicals) to be made into plastic recycled materials. The recycling industry can be anything from a home-based industry up to an industrial level.

The same is true of shoe-making - it could be home-based up to industrial level.

Other possible sources of lead contamination are Batik - Indonesia traditional clothes and arts.

These use a colouring agent, and the expensive ones, gold colour. All are sewn or woven and dyed by hand. Batik Prada - it would be interesting to research this area. The colouring tools are made of bronze, heated with fire / candle-light.

The following link will show you the process of making batik: www.youtube.com/watch?v=2XdjebgIL5k

The crematorium / morgues don't have proper chimneys or waste dump facilities. The ashes just got thrown into the local river or the sea. This happens even next to fishing villages where dry salted fish is produced. It's unbelievable, but that’s the reality.

So far, I’ve been talking mainly about the island of East Java. The highest lead contamination would probably be in Papua, Irian Jaya - where the gold mines are, and Kalimantan Island - where other mining industries are.

Fairly recently – in 2006 - a mud eruption began (Lumpur Sidoarjo - Lusi) on East Java. It's still erupting today. Several villages have been destroyed and all the trees died. See http://en.wikipedia.org/wiki/Sidoarjo_mud_flow – this mud flow along with volcanic ash may be a possible source of lead poisoning.

That's all for now... I hope this adds more value to Suherni’s research.

All the best,

Susy

Lead in the Polar Ice Sheets

From Professor A.J. McMichael, to Elizabeth O’Brien, September 2010, in response to an e-mail from Elizabeth O’Brien, following a Sydney Morning Herald story on Professor McMichael and climate change (The man with our future in his hands, September 11-12, 2010). Date: September 16, 2010.

(Prof. A.J. McMichael is at the National Centre for Epidemiology & Population Health
ANU College of Medicine, Biology and Environment, The Australian National University
Canberra. Honorary Professor in Climate Change and Human Health University of Copenhagen.)

Elizabeth,

It's good to see the important work you are continuing to do, which I am aware dates back several decades…

You will be aware of the lead that has accumulated in the polar ice sheets over the past two, industrialising, centuries. That lead will be mostly in the superficial ice layers. Will it be re-mobilised into sea-water as ice sheets slowly melt? Your association might like to follow that question up.

Best wishes, 

Tony McMichael

Updating the NHMRC’s statement on blood lead levels

(Ed’s note: Elizabeth O’Brien of The LEAD Group, and other members of the National Health and Medical Research Council (NHMRC) Lead Working Committee, had been asked for information on any work being done internationally to revise the positions on acceptable blood lead levels in other countries, in order to update the NHMRC Information Paper and Public Statement on blood lead levels.)

From: Elizabeth O’Brien

To: other Members of the former Lead Working Committee of the National Health and Medical Research Council (NHMRC)

Date Sent: August 30, 2010

Dear Members of the NHMRC Lead Working Committee,

I believe Canada is looking at a very low blood lead goal for children but for me what's most important that I do have more detail on, is that I was advised that the most enlightened and useful approach has been happening in Germany for some years, when I attended the World Health Organisation meeting on lead in Geneva in May of this year.

Also, a 2009 US cost benefit analysis "The Social Costs of Childhood Lead Exposure in the Post-Lead Regulation Era" by Peter Muennig [abstract at http://archpedi.ama-assn.org/cgi/content/abstract/163/9/844] had the following results:

"Reducing blood lead levels to less than 1 µg/dL among all US children between birth and age 6 years would reduce crime and increase on-time high school graduation rates later in life. The net societal benefits arising from these improvements in high school graduation rates and reductions in crime would amount to $50000 (SD, $14000) per child annually at a discount rate of 3%. This would result in overall savings of approximately $1.2 trillion (SD, $341 billion) and produce an additional 4.8 million QALYs (SD, 2 million QALYs) for US society as a whole." These results would seem to justify a large investment in reduction of blood lead levels at least among children in Australia too, and previous cost benefit analyses, certainly justify expenditure on bringing down the blood lead levels of adults and older children as well. See for instance: "The Benefits and Costs of the Clean Air Act, 1970 to 1990" at www.epa.gov/oar/sect812/1970-1990/contsetc.pdf and "Economic Analysis for the Renovation, Repair, and Painting Program Proposed Rule" at www.epa.gov/oppt/economics/pubs/lrrpnprmea.pdf - both by US EPA.

In Germany, they have a continuous improvement towards zero blood lead level policy approach. Every so often, a national blood lead survey is done to determine the current blood lead levels in the particular sub-populations of men and women (18 to 69 years) and children (3 to14 years of age). When the results are analysed, the 95th percentile (that is, the blood lead level that 95% of the population is already below) is then set as the new goal for the entire sub-population. As of 2009 for instance, the new goals were set at:

• 9 µg/dL for men (18 to 69 years)
• 7 µg/dL for women (18 to 69 years), [these are assuredly only this high because the most recent blood lead surveys for men and women in Germany were in 1997-1999] and
• 3.5 µg/dL for children 3-14 years [based on a 2003-2006 survey]. [Ref: GERMAN www.umweltdaten.de/gesundheit/monitor/tab-metalle_2009.pdf; ENGLISH: www.umweltdaten.de/gesundheit-e/monitor/tab-ref-values-as-sb-metals.pdf]