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QUESTION: Special classes in our schools and engaging parents to help their lead-poisoned children 14/05/12 South Australia, Australia

Hi. My name is David Aldridge. I live in Port Pirie South Australia which is home to the largest Lead smelter in the southern hemisphere. My daughter lived only a couple of hundred metres from the smelter for her entire young life. She had extremely elevated blood lead levels consistently in the 20s 30s and 40s with a highest level of 73, until testing ceased when she was approx 7 yo. At 8/9 yo when she came into my care she did the year 3 basic skills test at her primary school (Pirie west). She finished in the bottom grade in EVERY aspect of that test and was placed in a special class for SLOW children. I believe that the link between her high lead levels and the fact that she achieved so poorly is NO accident.

 I spent every night week after week, month after month teaching her myself. 2 years on she did the year 5 basic skills test and finished 4th in the school. A further 2 years on after doing the year 7 basic skills test she was pretty much the TOP student in the school. She finished in the top 3 out of over 80 students when she completed high school. I went to her university graduation a couple of weeks ago. She completed a 4 year psychology degree with 1st class honours, won the university medal for high academic achievement and is now several months into her PHD. At time of writing this she has just turned 22yo. Similarly my lovely new wife's children were also blighted by high blood lead levels well in the 30s as they also lived within a few hundred metres of the local smelter. Her oldest, a daughter achieved the highest marks in the state when she did her own honours degree and has already completed her PHD. Her youngest, a son, is in the second year of his degree and is already sitting on distinctions and high distinctions.

The one thing all these children had was a parent who was prepared to put in the HARD YARDS. While we must do everything we can to reduce lead levels i believe much can also be done to reduce the EFFECTS that lead exposure has on our children by means of special classes in our schools and engaging parents to also help their children along. High lead exposure does NOT necessarily mean that these so affected children will not achieve in life. The countless hours i spent with my own child teaching her myself were the best investment i have ever made in life and have already been repaid many times over.

 Regards Dave Aldridge..

ANSWER: May 14 2012

Dear Dave,

I'm so glad that you sent in your full story. I was very interested to hear the summarised version of it on "Background Briefing" broadcast on 6th May 2012 [Lead poisoning: a silent epidemic - for the podcast and transcript]

I totally agree that there needs to be more positions for students in special classes in our schools and efforts made to engage parents to help their lead-poisoned children, including advice for parents who are keen to help but who may not themselves be naturally proficient at coaching, as you and your lovely new wife seem to be. Parents from Broken Hill report to me that there simply aren't enough special education teachers there to keep up with the supply of children who need special education classes. The best article I ever read on helping lead-poisoned kids in schools is The Early Lead Poisoned Child in the Classroom: Symptomatology and Intervention for School Psychologists and School-Based Personnel but I always send that article to parents because it is applicable to assisting children at home too.

As the paediatrician who investigated my own children's lead poisoning said to me, lead damages the brain in two ways: the architecture (this damage is irreversible) and the functioning (this damage is certainly worth attempting to reverse, with excellent nutrition and with special education and attentive parenting).

The reason that lead poisoning prevention should be the priority for all the stakeholders including the parents of lead poisoned children, is that secondary lead poisoning prevention, that is, preventing further lead exposure in a person with an elevated blood lead level (which I define as a blood lead level above 2 micrograms per decilitre), makes the most important difference to health and learning outcomes following lead poisoning, and in a town like Port Pirie, you can only bring down a blood lead level quickly, with the full cooperation of all the stakeholders. Whereas, in a lead-contaminated house that is not in close proximity to a lead mine or lead smelter or lead recycler, you can, if you have sufficient money to throw at the problem, make the home lead-safe and eliminate other lead sources and pathways, thus bringing down the blood lead level as fast as possible. The long-term damage that lead does is not best indicated by the blood lead level at any one time, but rather by the area under the blood lead (PbB) curve on a graph over time. This area is measured in microgram years per decilitre, and there are already recommendations from the USA on the maximum occupational (working) lifetime, or cumulative lead exposure [see "Adult Lead Exposure: Time for Change Brian S. Schwartz and Howard Hu. Environ Health Perspect. 2007 March;115(3) 451–454. Published online 2006 December 22 ]. A µg year/dL in lead exposure is one microgram of lead per decilitre of blood for a period of one year.

I predict that the future of best practice public health policy is similarly, to recommend the cumulative childhood exposure and cumulative lifetime exposure and invest big-time (perhaps using income from lead mining / exporting) to ensure that the recommended limits are achieved. And in the meantime, probably no one alive today will escape the very low blood lead levels that are associated with some IQ loss, so we need research into treatment for everyone, which might drag lead out of the body, rather than just let it leach out of the bones as we age, causing a second round of damage. You can read more about suggestions on tertiary lead poisoning prevention (stopping the lead that is already in you from ageing or killing you) at Model Australian Public Health Policy on Lead.

I hope this helps.

Yours Sincerely

Elizabeth O'Brien

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