Worst Case Lead Poisoning and
Tasmanian Government Inaction
By Elizabeth O'Brien,
Manager, Lead Advisory Service Australia
Edited by Paul Spencer,
activist and roving volunteer
The
Background
The
National Health and Medical Research Council (NHMRC) has set as a goal "for all
Australians [to have] a blood lead level below ten micrograms per decilitre (µg/dL) [0.48
micromoles per litre (µmol/L)]" and stated: "there is particular urgency in
reaching this level in children aged one to four years because of the adverse effects of
lead exposure on intellectual development."
In
November 1993, the "NHMRC set target dates for the reduction of lead in all
Australians to less than 15 µg/dL (0.72 µmol/L) by the end of 1998…" and
listed recommended responses in relation to individual children (all ages) with a blood
lead concentration of: =25 µg/dL (1.20 µmol/L)" as follows:-
- Obtain a detailed
medical history and examination with particular focus on possible adverse effects based on
exposure history and blood lead level;
- Undertake personal
exposure evaluation including environmental sampling as indicated;
- Arrange remediation
/ abatement of exposure source;
- Provide personal
education and counselling on exposure control for guardian(s) and child, as indicated. If
exposure control not possible, consider relocation.
- Re-test in about 3
months to assess the effectiveness of actions taken.
The
NHMRC also listed the following "recommended responses in relation to communities
where representative surveys of blood lead concentrations in children aged 1-4 years
show… >5% above 15 µg/dL (0.72 µmol/L):-
- Investigate lead
sources in the affected community;
- Develop
environmental management plans with effective strategies for community involvement in
design and implementation;
Plan to:
- particularly target
sub-populations in the community showing blood lead levels above 15 µg/dL;
- include
specifically prepared community education programs;
- set a time-frame
for on-going re-assessment of community blood levels."
In
1994, the Commonwealth Environment Protection Agency (CEPA) published Lead Alert: A
Guide for Health Professionals by Dr Garth Alperstein [a member of The LEAD Group's
Technical Advisory Board], Dr Roscoe Taylor and Professor Graham Vimpani [also a member of
The LEAD Group's Technical Advisory Board] and a copy was distributed to every doctor in
Australia.
In
addition to publishing all of the above information about NHMRC goals, recommendations and
targets, under the heading "Clinical Assessment" the following was stated:-
"Clinical
assessment by a paediatrician should be carried out for any child with a level greater than
1.20 µmol/L (25 µg/dL), to check particularly for developmental delay, hearing deficits,
speech problems or neurological abnormalities.
"Treatment
of iron deficiency, and other nutritional measures to combat deficiencies in calcium, zinc
or ascorbate will help to reduce uptake of lead…."
Under
the heading "Environmental Assessment", the following was stated:-
"…preventing
exposure is of paramount importance. In most cases, management of the child with an
elevated blood lead level will involve discussing possible sources of lead in the child's
environment with the parents. Removal of the source of exposure is the most important
aspect of treatment."
The
"Protocol for managing children found to have elevated blood lead levels"
includes:-
"Lead
levels 1.20 - 2.61 (µmol/L) (25 - 54 µg/dL) - Retest in 0.5 - 3months."
In
1995, the Tasmanian health department issued Schedule 3 - Diseases to be Notified Under
Regulation 4(3)(A) by a Person Superintending or in Charge of a Laboratory which
listed "lead poisoning (whole blood lead level greater than 15 µg/dL or 0.72
µmol/L)" as a notifiable disease.
In
1997, the Tasmanian Public Health Act 1997 - Section 49 states "The Director [of
Public Health] is to … provide a council with a report on the occurrence of …
any notifiable disease within its municipal area." Section 54 states that "The
Director, by public notice, may declare - … that there is an outbreak of a notifiable
disease in an area."
The
undated "Manual for Local Government" published by Tasmania's Public and
Environmental Health Service states that "An outbreak may be defined as two or
more cases of the same illness (including human pathogens or contaminants…) clustered
in time and/or place."
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