Abstract
Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels among townships with both low access (p = 0.05; OR = 2.701 (1.136–6.421)) as well with high access to safe sanitation (p = 0.01; OR = 18.40 (1.794–188.745)). Local Indicators of Spatial Association (LISA) cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.
Highlights
Literacy, traditionally defined as proficiency in reading and writing, is an important determinant of health and can support an individual’s functional role in society [1]
It is assumed this relationship is due to the negative effect of lead exposure upon neurological and cognitive development of which adult literacy is a proxy measure; second, that poverty or affluence levels modify the relationship between lead mining exposure and adult literacy; third that access to safe sanitation is a proxy measure for poverty/affluence that has a relevant threshold in Myanmar; and fourth that townships with low adult literacy levels may cluster in similar locations to lead mining townships
Our findings indicate that citizens living in townships with high access to safe sanitation and lead mining activity may be more at risk of having lower adult literacy than those in similar situations but in non-mining townships
Summary
Traditionally defined as proficiency in reading and writing, is an important determinant of health and can support an individual’s functional role in society [1]. Exposure to harmful environmental contaminants has been adversely associated with cognitive function and literacy. Lead exposure has been associated with negative outcomes related to neurological function, cognitive proficiency, intelligence quotient (IQ) and literacy [3]. Additional neurological impacts include reductions in attention span and levels of educational engagement, leading to a subsequent decrease in educational attainment [5]. Heavy metals such as lead have a high affinity and can bind to N-methyl-D-aspartate receptors found in nerve cells, resulting in cognitive dysfunction due to reactive oxygen species [8]
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