4 lead PoisoninG

For the past three decades it has been known that considerable numbers of South African children have blood lead levels that exceed international guidelines. The health effects associated with even very low blood lead levels are beyond doubt, and include reductions in IQ scores, an inability to concentrate and learning difficulties. There is also an emerging body of evidence that links lead exposure in childhood with the emergence of aggressive and violent behaviour. Poor school performance and violence are two major socio-political concerns in South Africa, and comprehensive approaches to resolving these should include a focus on lead poisoning prevention. Two important milestones have been reached in recent years that will undoubtedly bring about a beneficial lowering of childhood blood lead distributions in South Africa: the phase-out of leaded petrol and the promulgation of legislation to control the use of lead in paint. On the whole, however, the approach to lead poisoning prevention in South African children has been piecemeal, and action has been tardy. Lead poisoning is preventable, and the prompt implementation of a comprehensive and integrated lead poisoning prevention strategy has been demonstrated to yield health, social and economic benefits that greatly outweigh the economic cost of implementation. keywords: lead poisoning, violence, children, South Africa INTRODUCTION Lead is a heavy metal that is found naturally in the earth’s crust. It has a low melting point, is malleable and also resistant to corrosion. Since it was discovered thousands of years ago, these properties have resulted in lead being used in a myriad of processes and products. However, there is now an overwhelming body of evidence associating lead exposure with a wide range of detrimental health effects. The use of lead increased dramatically around the time of the industrial revolution, making a major contribution to its current status as a global environmental contaminant and major public health concern. Before the industrial revolution, body lead burdens were more than 500 times lower than what they are today. Because lead is a persistent metal, and does not readily get converted to less toxic forms in nature, it is likely to remain of public health concern for generations to come, especially in low-income countries (Nriagu, 1983; Tong, von Schirnding & Prapamontol, 2000). The Chapter objectives are as follows: a. To outline what is known about the impacts of lead exposure on children’s health and development. b. Using the limited available information, to describe the lead exposure situation in South Africa in relation to children. c. To describe the interventions undertaken in South Africa in recent years to limit childhood lead exposure. d. To reflect on the essential outstanding actions 1 To whom correspondence may be addressed: Angela Mathee, Medical Research Council-University of South Africa Safety & Peace Promotion Research Unit, P.O. Box 19070, Tygerberg, 7505, South Africa. Email: [email protected]