Abstract
BackgroundEvidence of chronic low levels of exposure to heavy metals in Sri Lanka has emerged in a number of studies carried out in the recent past. The source and magnitude of such exposures have to be understood in order to assess the risk of adverse health effects of this exposure and to propose suitable public health interventions.MethodsAn assessment was carried out to quantify chronic exposure to cadmium, lead and arsenic through food in people living in an area in Sri Lanka, where prevalence of Chronic Kidney Disease of unknown origin (CKDu) is highest. First a dietary survey was carried out in the subjects to estimate the type and quantity of typical food items in order to estimate an average consumption. A model diet was formulated using this dietary consumption data; and this was thereafter used for estimation of chronic dietary exposure of selected contaminants. In parallel, the levels of contaminants of interest in the various identified food items: cadmium, lead and arsenic, were determined.ResultsAssuming the major route of intake is food, and based on the quantity and type of food items consumed, a 60 kg man is exposed to average doses of 83.7 μg cadmium, 924.1 μg lead, and 180.3 μg arsenic per week. The impact of chronic lead exposure was affirmed by a mean blood lead level of 3.0 μg/dL, with a maximum level of 8.8 μg/dL being observed in some cases.ConclusionsChronic low dose exposure of lead from food appears to be a public health concern in the studied population. Cadmium exposure through food appears to be of concern also. However, arsenic exposure through food appears to be within safe limits. As there are numbers of possible adverse health outcomes that can be associated with such estimated exposures of heavy metals, public health interventions are warranted to limit the described harmful exposures. Advocacy on dietary patterns and agronomic practices to lower the contaminants identified are the two broad strategies suggested.
Highlights
Evidence of chronic low levels of exposure to heavy metals in Sri Lanka has emerged in a number of studies carried out in the recent past
Determination of the food consumption pattern in diagnosed chronic kidney disease (CKD) patients living in a MOH area with the highest prevalence of Chronic Kidney Disease of unknown origin (CKDu). (Medawachchiya) Selection criteria A total number of 77 CKD patients were recruited from the Medawachchiya MOH (Medical Officer of Health) area which shows the highest prevalence of CKDu in Sri Lanka [27]
Food consumption pattern of diagnosed chronic kidney disease (CKD) patients living in a medical officer of health area where the CKDu is high (Medawachchiya) Food consumption patterns were studied in 77 patients with CKD
Summary
Evidence of chronic low levels of exposure to heavy metals in Sri Lanka has emerged in a number of studies carried out in the recent past. Evidence of chronic low levels of exposure to heavy metals from food in Sri Lanka has emerged in a number of studies carried out in the recent past [1,2,3,4,5,6,7]. A common feature among this cluster of countries is the high consumption of cereals, especially rice, in their diets. Because of this peculiar food preference and habits, a reasonable evaluation of dietary pattern and associated exposure to heavy metals through food needs priority attention
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