Editorial

1. high levels of lead in one, some or all of the environmental media (dust, soil, food, water, air) which impact upon the child; 

2. a pathway or pathways for that lead to enter the gut; 

3. a high rate of absorption of the lead

A successful intervention strategy may attack anyone, two or all three of these factors. Moving a child out of a high lead contaminated environment into a low lead contaminated environment may always be the best option blood lead-wise, but may not be possible. If you can't remove the child from the source of the lead, then the second best option is to create a barrier in any of the multitude of pathways between the lead and the child. Such barriers may be: spatial - for example, move child's bed to a room where there are no cracks in the ceiling for dust to get through; temporal - for example, don't allow children into a room which has been vacuumed until some of the dust has settled; behavioural- for example, discourage finger sucking; perpetual - for example, house­cleaning. Cutting the rate of absorption of lead from the gut involves: not skipping meals, eating five-six small meals per day, not eating an excess of fatty foods in the diet and eating sufficient iron, calcium, zinc, protein, vitamin E, ascorbic acid and thiamine. It is easy to see that following the above dietary rules will result in better nutrition which has other advantages apart from cutting lead absorption, and that action to ameliorate this third causal factor in high blood lead levels, whether by individuals or by governments, is paramount in any attempts to reduce blood lead levels. Naturally, better nutrition is not the only one. There are multiple advantages of lead abatement actions, including:

• more fuel-efficient driving (in order to cut leaded petrol consumption);

• reduced use of cars/increased emphasis on non-emitter transport modes and public transport;

• gas in preference to electricity (coal burning electric power stations emit lead);

• reduced energy consumption (in cars and houses);

• urban renewal- abatement of flaking and chalking paint on buildings and structures;

• increased community awareness of toxic metals and toxins generally in our environment;

• decreased need for lead mining and primary smelting as more lead is recycled, for example, from paint removal debris, contaminated soil and dust, and lead acid batteries;

There are also some disadvantages of lead abatement activities including:

• shifting lead contaminated paint, dust, soil, car bodies, building materials, sump oil, sediments, and so on, away from where they impact on people (especially children) raises serious concerns about how and where they should be disposed of or managed; 

• if the recommended high phosphate cleaning agents are used for wiping all hard surfaces to remove fine lead particles, then our waterways will suffer. Hosing dust from verandahs and paths wastes water;

• wrong advice about lead abatement activities could raise blood lead levels - for example, until recently health authorities advised frequent vacuuming as a way of reducing dust in houses. Unpublished research in Broken Hill now finds a strong correlation between greater frequency of vacuuming and high blood lead levels. A logical conclusion from the research is to remove carpets though this is a hazard in itself if not done safely.

I've saved the best news till last. This week my three year old son's blood lead result was the lowest it's been found to be in his lifetime, since his first high reading of 31 micrograms per decilitre (µg/dL), at the age of twelve months. His (eighth) blood test result was around 10 µg/dL, right on average for an inner western Sydney 1-4 year old child.

 Elizabeth O'Brien National Coordinator