Abstract
In March 2010, Medecins Sans Frontieres/Doctors Without Borders detected an outbreak of acute lead poisoning in Zamfara State, northwestern Nigeria, linked to low-technology gold ore processing. The outbreak killed more than 400 children ≤5 years of age in the first half of 2010 and has left more than 2,000 children with permanent disabilities. The aims of this study were to estimate the statewide prevalence of children ≤5 years old with elevated blood lead levels (BLLs) in gold ore processing and non-ore-processing communities, and to identify factors associated with elevated blood lead levels in children. A representative, population-based study of ore processing and non-ore-processing villages was conducted throughout Zamfara in 2012. Blood samples from children, outdoor soil samples, indoor dust samples, and survey data on ore processing activities and other lead sources were collected from 383 children ≤5 years old in 383 family compounds across 56 villages. 17.2% of compounds reported that at least one member had processed ore in the preceding 12 months (95% confidence intervals (CI): 9.7, 24.7). The prevalence of BLLs ≥10 µg/dL in children ≤5 years old was 38.2% (95% CI: 26.5, 51.4) in compounds with members who processed ore and 22.3% (95% CI: 17.8, 27.7) in compounds where no one processed ore. Ore processing activities were associated with higher lead concentrations in soil, dust, and blood samples. Other factors associated with elevated BLL were a child's age and sex, breastfeeding, drinking water from a piped tap, and exposure to eye cosmetics. Childhood lead poisoning is widespread in Zamfara State in both ore processing and non-ore-processing settings, although it is more prevalent in ore processing areas. Although most children's BLLs were below the recommended level for chelation therapy, environmental remediation and use of safer ore processing practices are needed to prevent further exposures. Obtained. The study protocol was approved by the US Centers for Disease Control Institutional Review Board-A and the National Health Research Ethics Committee of Nigeria. The authors declare no competing financial interests.
Highlights
Childhood lead poisoning is widespread in Zamfara State in both ore processing and non-ore-processing settings, it is more prevalent in ore processing areas
A 2010 outbreak of acute lead poisoning in rural Zamfara State, northwestern Nigeria resulted in severe neurological morbidity and mortality in several hundred children, a result of lead-contaminated gold ore processed with low technology methods.[1]
97% had blood lead levels (BLLs) ≥45 μg/dL, the level recommended by the US Centers for Disease Control and Prevention (US CDC) for chelation therapy, with measured BLLs as high as 700 μg/dL.[4]
Summary
A 2010 outbreak of acute lead poisoning in rural Zamfara State, northwestern Nigeria resulted in severe neurological morbidity and mortality in several hundred children, a result of lead-contaminated gold ore processed with low technology methods.[1] Gold ore processing became common in Zamfara after gold prices rose during the 2008–2012 global economic recession.[2] Lack of emission controls during processing, and the co-occurrence of gold ore with bioaccessible lead in the region’s underlying geology caused extensive contamination of villages. In March 2010, Medecins Sans Frontieres/Doctors Without Borders detected an outbreak of acute lead poisoning in Zamfara State, northwestern Nigeria, linked to low-technology gold ore processing. The outbreak killed more than 400 children ≤5 years of age in the first half of 2010 and has left more than 2,000 children with permanent disabilities
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