That lead is a toxic element is widely known. What is not, though, is how ubiquitous it is — in the air we breathe, the spices we cook with, the toys our children play with, the paint on our walls and many more.
A 2020 report by UNICEF estimated that nearly 27 crore Indian children have unsafe blood lead levels (BLLs). Unsafe concentration of lead in the body can deter their neuro-cognitive development, leading to decreased IQ, behavioural problems, lowered educational achievement and eventually lowered earning potential.
Lead poisoning is extremely difficult to diagnose given that it may be asymptomatic or manifest with unrelated symptoms like abdominal pain, constipation and headaches. Unfortunately, there is no cure for lead poisoning. By the time it is diagnosed, the adverse impacts it has had on the child’s brain and body are irreversible. Thus the old adage, ‘Pollution Prevention Pays’ holds very true here.
Regular testing then becomes the only sure-fire way of ensuring our children are not exposed to lead in their daily lives, and if they are, can be given timely help. A simple venous blood test can reveal the level of lead in the body, at any given point of time.
Advanced equipment
Diagnostic chains offer toxic element testing, including for lead, at approximately ₹2,000 per sample. However, while individual tests, referred by physicians, can be conducted in private labs, for mass level surveillance, private labs prove prohibitively expensive and inefficient. Fortunately, our country has a robust medico-scientific infrastructure with the gold standard in BLL testing, an advanced analytical instrument known as ICPMS (inductively coupled plasma mass spectrometer) available in various academic institutes, universities, CSIR labs and ICMR bodies.
ICPMS machines can run dozens of samples a day with extremely high levels of sensitivity and accuracy. And bulk samples push the cost down to ₹500-1,000 per sample. Few other countries, let alone developing countries, have the technology or the required expertise to run ICPMS machines. If utilised efficiently, we have the capacity to regularly monitor the BLLs of our populace, and build up a database at par with that maintained in the US and other countries, which have made several successful attempts to bring down the lead levels of their citizens. After the 2020 UNICEF report came out, several conferences, working groups and financial pledges have been made to mitigate and prevent further lead poisoning, especially in lower middle income countries.
In India, the NITI Aayog commissioned CSIR-NEERI to independently review the findings of the UNICEF report, which they did in 2022. Their report validated the UNICEF data and estimated that 23 States have average BLLs above 5 μg/dL (the threshold for intervention set by the WHO). The India Working Group on Lead Poisoning, came into being a year later, on June 1, 2023. The Group has been meeting quarterly, with research and advocacy activities carried out by its Secretariat in between.
It was in the course of these meetings and visits to the premises of the institutes of its members that the full scale of India’s scientific infrastructure and top-notch expertise of our technical staff became apparent.
With proper implementation and monitoring mechanisms, support of technical staff and senior academicians, India has the potential to successfully fight lead poisoning among its children — one test at a time.
Alok is Distinguished Professor and Senior Scientific Advisor, and Ankita is Associate Fellow, Pahle India Foundation