|, 2001, ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News ( ISSN 1440-0561)
The Journal of The LEAD (Lead Education and Abatement Design) Group Inc.
America Under Attack - Email to the Pentagon
On 20th September 2001, nine days after the terrorist attacks on the Pentagon and World Trade Center, the Lead Advisory Service Australia received an email from a woman from a military medical center asking about the lead risk for women expressing breast milk at the Pentagon. Elizabeth O'Brien sent the following response.
Thanks for your enquiry - I have been expecting such questions to arise. Is anyone measuring air lead levels either at the Pentagon or at the World Trade Center? All we have heard about out here in Australia is a concern about asbestos fibre in the air at the World Trade Center, but it is logical to assume a wide range of contaminants in the air, not just asbestos or lead, mainly due to the temperature of the fires. People out here have started to wonder whether the real death toll will ever be known, when so many people will have such varying exposures (dependent on their proximity, breathing rate / physical activity level, how assiduously they wear respiratory protection, practice hygiene to limit dust ingestion, etc) to toxic dust and fumes including carcinogens created by the fires.
Your question contains an underlying assumption that breast milk is best milk and I thoroughly applaud that belief. I am relieved that you have not asked whether mothers should consider switching to bottle-feeding. You seem to already know that a mother would have to have an enormous level of lead in her bloodstream before even considering stopping breastfeeding. Unlike the placenta, breasts filter lead and perhaps as low as 1% of the mother's blood lead, ends up in the breastmilk (I presume you have already read the fact sheets at Breastfeeding and Lead and Lead in breast milk).
So to be absolutely clear, your question is simply about breast milk becoming lead contaminated through handling. The simple answer is that strict precautions on washing hands / equipment / storage ARE adequate to minimize possible contamination.
The real question though is "are breastfeeding mothers being exposed to lead just by being there?" And as you pre-empted with your question "Are blood levels of Mom helpful??" I would answer that blood lead levels of Mom would be an essential thing to know, in order to determine whether Mom should continue to work in the disaster area.
The huge advantage of lead over many other potential occupational exposures in this situation, is that lead has a set of guidelines developed for it - we know how much lead in air is too much in an occupational setting, and at what level of lead in the blood a breastfeeding Mom should be moved out. At the disaster sites, lead could be used therefore, as a marker contaminant - which gives some guide as to other toxic exposures. The reason for this is that lead is likely to be in the air both due to lead paint, lead componentry (like old rubber, lead contacts in light bulbs, leadlighting, lead flashings), leaded PVC, wood and people's bones and teeth having been burned, and, due to lead being a likely contaminant of building cavity dust released, and building material released (like paint, plaster, lead componentry) along with fibres like asbestos, during the building destruction.
Sometimes it is useful that lead is the most common contaminant - it is in all the places and involved in all the processes by which other potential contaminants are released. I would venture that lead in air and blood measurements would be a reasonable surrogate for a range of other measurements for contaminants that don't always have guideline levels, eg PCBs released from capacitors (eg in lighting), polyaromatic hydrocarbons (PAHs), toluene, xylene, formaldehyde and benzene released during wood and fuel combustion, toluene and xylene additionally released from paint, varnish or lacquer combustion, (PAHs) additionally released from roofing tar, dioxins released during combustion of plastics and metals, mercury released from amalgam fillings being incinerated, etc.
I hope it is useful that I have answered more than you asked. I would also like to pass on my deepest sympathy for those left to deal with the loss of your fallen comrades and other countrymen.
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