Interventions to reduce lead (Pb) exposure and value of a broad environmental health monitoring capacity

Abstract

Background and aims In recent years, reports of lead (Pb) contamination have dramatically increased in Georgia. In 2018, 41% of the children who participated in the Multiple Indicator Cluster Surveys (MICS), a nationally representative among 2 to 7 years old children (n=1578), had blood Pb levels (BLL) above 5 microgram/dL. The National Centre for Disease Control and Public Health of Georgia (NCDC&PH) implemented written and verbal advice on how to reduce Pb exposure, and a state program of clinical follow-up was implemented. A significant reduction of BLL in children over a relatively short period has been documented. We aimed to identify the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. Methods In collaboration with UK Health Security Agency, British Geological Survey, and Georgian agencies, NCDC&PH conducted a Pb isotope ratio study in 36 purposefully selected children from MICS. Environmental samples collected for each included household included dust, soil, paint, spices, milk, drinking water, and toys. Pb isotope ratio analyses were conducted on both blood and environmental samples. Analyses included household level and group level ranking of environmental sources as an explanation of exposure to Pb represented by BILL. Results Preliminary results indicate that drinking water and milk are not among Pb exposure sources of concern, while the precise ranking of other Pb sources varies between children and regions of Georgia. Conclusions It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia. In addition, this experience will clarify elements of ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support the national capacity to manage the risks to public health. Keywords Lead, intervention, health surveillance