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  QUESTION: Could you please give me some advice that will help me here in Vietnam?  07 Nov 2002, Vietnam

I am an Australian expatriate living in Vietnam, and mother of two boys aged 3 and 4. My husband and I have been living/working in Asia for the past three years and I have only recently become aware of the dangers of lead poisoning. What concerns me the most is that there does not seem to be any information available through the expat organisations and medical services here, and many of the people in the expat community seem to be as unaware as I am.

Could you please give me some advice that will help me here in Vietnam? Is there a way to test for lead paint and soil contamination that is accessible to us? And are there other areas we should be looking at as potential sources for lead poisoning that are not applicable in Australia (as there is not the same consumer safety standards here for products such as toys)?

And finally, is there a particular type of dietary supplement, like a multi vitamin, that I could give my family to try and reduce and exposure we have already had?

Thank you.

ANSWER: 07 Nov 2002

Dear Alison,

thankyou very much for your very thoughtful email. You have raised some important issues which I hope you will take up with the expatriate organisations and medical services available to you. I'll admit to knowing nothing in particular about the nature of the lead problem in Vietnam but I do know that it is unwise to assume that the most important and prevalent lead exposures in the wealthiest OECD countries will be the same as the most important and prevalent lead exposures in other countries. For this reason, you may want to bring to the attention of the Environment Minister, the Global Lead Initiative (see http://globalleadnet.com/10/the-global-lead-initiative) developed by the Alliance to End Childhood Lead Poisoning. The initiative, put simply, insists on national lead strategies being developed in every country with the assistance of regional leaders (countries that have their own national strategy already being enacted, eg theoretically Australia) so that national governments do not stop their efforts to eliminate lead poisoning as soon as they have completed the easiest (but essential) first step, that is, banning leaded petrol. Wherever leaded petrol is still sold, and especially in those countries where it is the highest volume vehicle fuel sold (that is more than about 30% of the market), it is usually the case that banning leaded petrol is the highest priority for that country, which is why the World Bank has made banning leaded petrol it's highest transport priority in non-OECD countries. Vietnam had one of the fastest switch times to unleaded petrol with the World Bank's help and by July 1st, 2001, leaded petrol was banned. (See attached article "Vietnam switches to unleaded gasoline".)

The usual problem whenever leaded petrol has been intensively used is that street dusts, sediments in waterways and harbours, house dust and especially ceiling dust are highly contaminated yet typically forgotten about once leaded petrol has been banned. The only emailable item in Vietnamese that we have was written by the NSW Health Dept but instigated by the Lead Advisory Service Australia and it is mainly about ceiling dust as you will see from the English version if you don't happen to read Vietnamese. Of course it is possible that if the buildings in Vietnam are of a different construction to Australian buildings, then ceiling dust may not be an issue in Vietnam. If you have observed ceiling dust in your own home (that is, if dust is falling into the living area from the under-roof area, then it may well be worth having it assessed not only for lead but for other heavy metals as well, based on the attached article (see "Vietnam chokes on development"). See: Lead Your Health & the Environment-Vietnamese

The usual advice given in Australia about finding a laboratory to assess lead in various media (paint, soil, dust, water, plastics or other components of toys, etc) is to look up "Analysis Laboratories" in the phone book and to only use a lab that has NATA (National Association of Testing Authorities) accreditation for lead in the particular medium. Not all of this may be appropriate advice in Vietnam although I know that NATA does work in Vietnam and runs a Vietnam Laboratory Accreditation Scheme (see http://vol.vnn.vn ph (84)49423975).

If you fail to be satisfied that you can obtain accurate lead and other heavy metal analyses in Vietnam, you may wish to utilise by post, a system set up by a Sydney lead assessor, JBS Environmental who can send you the equipment and instructions for taking samples which you then send to Sydney Analytical Laboratories (SAL), then SAL sends the results to the lead assessor who writes you a report to suggest what you might need to do to make your home more lead safe, and sends you the report. Normally the lab just tells you the amount of contamination you have and gives no information about acceptable levels or abatement procedures for the level you have. The other very important action that you can hopefully take, is to ask your doctor to have the children's blood lead levels assessed. This is the vital piece of information that tells you exactly how high to jump on this issue. Your own blood lead level is not a substitute for knowing theirs. They will have higher hand to mouth activity, more time spent on the ground and possibly lower nutritional status than you. They are also more sensitive to the effects of lead and will normally absorb more of what gets into their gut than you - especially if they are prone to going long periods without eating or if they often play on the ground or floor before breakfast. Depending on the blood lead levels, the children may need an iron supplement but in general a diet which provides adequate Vit C, calcium, zinc, iron, protein and omega 3 fatty acids is sufficient to reduce the absorption of lead, though supplements for these may be necessary, especially for picky eaters or if your food sources are inadequate.

There are many lead sources possible in Vietnam that may not be prevalent in Australia. There have been some efforts to reduce lead in PVC consumer items for instance, though leaded PVC is generally not banned in Australia it is not now used for drinking water pipes or miniblinds. Vietnam could easily have leaded PVC for both these purposes plus an incredibly wide range of other products, even children's products such as toys, stationery, raincoats, etc. Crayons may also contain heavy metals and some folk medicines definitely do. The paint on the outside of pencils and residential paint may well be leaded but only the manufacturer or Health Dept or Dept of Consumer Affairs could normally tell you this. There are so many other possible sources but I'm sorry I don't have Vietnam-specific knowledge. See the list of known sources in Australia at Sources of Lead

Finally, if family members are already lead poisoned, some holistic doctors may recommend taking Vit C, zinc and selenium to help rid the body of lead and some natural therapists recommend pectin (found in apples and pears) and garlic among other things.
I hope this has been of assistance and I would very much like to hear of any progress you make in investigating this potential problem in Vietnam.

Yours sincerely
Elizabeth O'Brien

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