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 breastmilk
at the Pentagon. Elizabeth O'Brien sent the following response.
Dear Madam,
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 breastmilk 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 http://www.lead.org.au/lanv6n2/update002.html
and http://www.lead.org.au/lanv6n2/update014.html).
So to be absolutely
clear, your question is simply about breastmilk 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.
Kind regards
Elizabeth O'Brien
Manager, Lead Advisory Service Australia
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