A unique research project on the levels of lead pollutants in the blood of children in Gaza, Israel, the West Bank and Jordan has been published, showing that non-leaded gasoline has improved the situation and that politics can be ignored by doctors even during the intifada.
The study, just published in the journal Environmental Health Sciences, was headed by Prof. Elihu Richter of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine and colleagues from the Palestinian Authority, Amman's Jordan University, Bir Zeit University, Health Canada, New York's Maimonides Hospital, Assaf Harofe Medical Center and Laniado Hospital, with funding from the US Agency for International Development and the US Center for Disease Control and Prevention.
The field work for the project, which required taking blood from 1,400 preschoolers in the region, began in 1995 and ended in 2000, and the processing and writing took place during the height of the second intifada, but Richter said that all 17 authors insisted that their names be on it, despite the violence and the British academic boycott of Israel. It was apparently the largest multi-country project of its kind. After the blood was taken, said Richter, the investigators maintaned sporadic contacts by e-mail and phone over the years.
The findings show that in this part of the Middle East region, as elsewhere in the world, removal of lead from gasoline has been followed by falls in blood lead levels in children. Despite the major socio-economic differences among Israel, Jordan, the West Bank and Gaza, lead levels in children aged two to six years old were "strikingly within the same range - except for children living near "hot spots," the researchers wrote. The mean lead levels are now approaching those in the US and Europe. Lead emissions dropped 85% in Israel since the mid-1980s. Among the limitations of the study, Richter said, was the researchers' inability to test children in "inner cities" and in a school in Kfar Vradim who, at the time of writing, had been exposed to lead from a smelter battery factory. In addition, no children under two years of age in the four places could be tested.
Richter, who is head of occupational and environmental medicine at the school, said that these findings stood out, even though researchers may have missed "hot spots," notably secondary smelters and battery plants, and had difficulty reaching children in inner city levels where exposures to air pollution from motor vehicles are high. "These findings have to be considered in light of new research that has shown that we cannot be certain there is a threshold for safe lead exposure."
The Israeli team is now analyzing findings examining the effect of exposures to ceramics, kohl (a traditional cosmetic used around the eyes), paternal occupational exposures and breast milk on blood leads as they approach what Richter calls "the end game" in eliminating the lead from the children's environment. "We now know that lead levels once considered normal have subtle effects on behavior and IQ in infants and children," he said.
A major practical outcome of the study was the use of the LeadCare kit for analyzing several drops of blood taken by finger stick, a method which Richter recommends, which replaced taking blood from an arm vein and has produced a "revolution in surveillance for lead exposure." He called on the Health Ministry to equip itself with these portable instruments.
Richter added that international aid should fund joint projects "that keep alive the weak, flickering flame of cooperation for health in a time of incitement and hate in he region."
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