Reduction in Blood Lead Concentration in Children across the Republic of Georgia following Interventions to Address Widespread Exceedance of Reference Value in 2019.

Ekaterine Ruadze,Helen Crabbe,Lela Sturua,Tim Marczylo,Amiran Gamkrelidze,Paolo Lauriola,Vladimer Getia,Irma Khonelidze,Ayoub Saei,Giovanni S Leonardi

doi:10.3390/ijerph182211903

Abstract

In recent years, reports of lead contamination have dramatically increased in Georgia. Given concerns about the exposure of children to lead (Pb), the National Multiple Indicator Cluster Survey (MICS-2018) included a blood sampling component. The results showed that 41% of the children that participated had blood Pb levels (BLL) ≥ 5 µg/dL and that BLL in children living in Western Georgia were higher than those in Eastern regions. In response to these findings, NCDC implemented written and verbal advice to the families of children who participated in the MICS-2018 on how to reduce Pb exposure. From August 2019 onwards, the state program of clinical follow-up was implemented. The design of this study was a longitudinal study. The intervention of interest was the public health advice and medical follow-up, and the outcome was defined as the difference in BLL between the MICS-2018 survey and the state program follow-up. We observed a significant overall reduction in median BLL between MICS-2018 and state program follow-up in both August 2019 and the latest results (until December 2019). However, we did not observe any significant further reduction between August and the most recent BLL results. In the Georgian setting, written and verbal communication targeting individual households, alongside home visits to the most exposed, effectively reduced BLL in children.

Highlights

The design was a longitudinal study with an observational design to monitor the changes in blood Pb levels (BLL) following the public health interventions implemented after the MICS2018 survey identified a large proportion of BLL exceeding the action level, and it was considered as a two-stage intervention in all children included in the MICS-2018 survey and their household
The first-stage intervention was based on written and verbal communication on reducing Pb exposure by NCDC and its regional partners to the families of children who participated in the MICS-2018, and the second-stage intervention was the state program of clinical follow-up, which was implemented from August 2019 onwards
In the Georgian setting, we documented a significant reduction of BLL in children over a relatively short time period

Summary

Introduction

Lead (Pb) is a widespread and harmful environmental toxicant [1,2,3] that causes adverse health effects in children, neurological and neurobehavioral deficits, lower IQ, slowed growth and anemia [4,5,6,7]. The health effects of Pb over the life course have been documented, including adverse effects on the cardiovascular [8,9], renal and hepatic systems [10,11,12]. Reports of lead poisoning/contamination have dramatically increased in Georgia [13]. Georgia’s National Center for Disease Control and Public

Methods

Results

Conclusion