Abstract
BackgroundThe phasing out of lead from gasoline has resulted in a significant decrease in blood lead levels (BLLs) in children during the last two decades. Tetraethyl lead was phased out in DRC in 2009. The objective of this study was to test for reduction in pediatric BLLs in Kinshasa, by comparing BLLs collected in 2011 (2 years after use of leaded gasoline was phased out) to those collected in surveys conducted in 2004 and 2008 by Tuakuila et al. (when leaded gasoline was still used).MethodsWe analyzed BLLs in a total of 100 children under 6 years of age (Mean ± SD: 2.9 ± 1.6 age, 64% boys) using inductively coupled argon plasma mass spectrometry (ICP – MS).ResultsThe prevalence of elevated BLLs (≥ 10 μg/dL) in children tested was 63% in 2004 [n = 100, GM (95% CI) = 12.4 μg/dL (11.4 – 13.3)] and 71% in 2008 [(n = 55, GM (95% CI) = 11.2 μg/dL (10.3 – 14.4)]. In the present study, this prevalence was 41%. The average BLLs for the current study population [GM (95% CI) = 8.7 μg/dL (8.0 – 9.5)] was lower than those found by Tuakuila et al. (F = 10.38, p <0.001) as well as the CDC level of concern (10 μ/dL), with 3% of children diagnosed with BLLs ≥ 20 μg/dL.ConclusionThese results demonstrate a significant success of the public health system in Kinshasa, DRC-achieved by the removal of lead from gasoline. However, with increasing evidence that adverse health effects occur at BLLs < 10 μg/dL and no safe BLLs in children has been identified, the BLLs measured in this study continue to constitute a major public health concern for Kinshasa. The emphasis should shift to examine the contributions of non-gasoline sources to children’s BLLs: car batteries recycling in certain residences, the traditional use of fired clay for the treatment of gastritis by pregnant women and leaded paint.
Highlights
The phasing out of lead from gasoline has resulted in a significant decrease in blood lead levels (BLLs) in children during the last two decades
In the United States of America (USA) and Europe, epidemiologic evidence has driven the successful removal of lead from gasoline and paint, resulting in average BLLs in the USA today that are one-tenth what they were in the late 1970s: the prevalence of BLLs among children decreased from 8.6% in 1988–1991 to 1.4% in 1999–2004 which is an 84% decline [11]
Because leaded gasoline was a common high dose source of exposure for children living in urban area of Kinshasa [the ambient air levels in Kinshasa, ranging from 570 to 5220 ng/m3 in urban area in 2008 before the total phasing out [16]], the focus of public health efforts should continue to be on phousing out exposure to leaded gasoline
Summary
The phasing out of lead from gasoline has resulted in a significant decrease in blood lead levels (BLLs) in children during the last two decades. The phasing out of lead from gasoline, first in United States of America (USA), has resulted in a significant decrease in BLLs in children during the last two decades. Predictable reductions in BLLs have been described in other countries: in the Belgian population, the median values of blood lead concentration were 17 in 1978 and 7.8 μg/dL eleven years later, i.e., a lowering of about 55% [12]. On December the 27th, 2005, the United Nations Environment Program (UNEP) declared that the promise made to free Sub-Saharan Africa from leaded gasoline had just been fulfilled, and that the campaign in favor of suppression of lead in fuel was on the way to become a real success story in the developing world. In 2009, ongoing efforts by African countries at the UNEP to eliminate lead from gasoline are to be lauded, because they have greatly improved the cognitive potential of future generations of children [14]
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