KARACHI: Severe iron deficiency and increasingly high levels of lead in blood pose a serious threat to children’s health in Pakistan, said a medical expert while sharing findings of his research at Karachi University’s L.E.J. National Science Infor­mation Centre on Wednesday.

The lecture was part of a public health awareness programme and jointly organised by the Panjwani Centre for Molecular Medicine and Drug Research, KU, and the Virtual Education Project Pakistan.

“We found that children of disadvantaged sections of society in Karachi not only had severe iron deficiency anaemia but also had higher levels of lead in their blood. This is an alarming situation,” stated Dr Nessar Ahmed of School of Healthcare Science, Manchester Metropolitan University, the UK, as he showed various slides in his presentation on ‘Lead and Childhood Iron Deficiency: A Warning Sign for Pakistan’.

Citing results of his study that was conducted in Karachi a few years ago, he said that the mean blood lead concentration in children was found to be 22 µg/dL (micrograms per deciliter) whereas the action limit of lead recommended by the Centre for Disease Control and Prevention in the US (CDC) was 10 22 µg/dL.

“It means the lead level was twice more than the action limit. Eighty per cent children in Karachi were found to have blood lead levels greater than 10 µg/dL,” Dr Ahmed said, pointing it out that though the action limit of lead as suggested by CDC was 10 µg/dL, no safe blood lead levels in children had been identified and even low blood lead levels (less than 10 µg/dL) had been shown to affect IQ, ability to pay attention and academic achievement.

According to Dr Ahmed, high level of lead in blood can cause a number of illnesses, for instance abdominal pain and renal failure, but the most important health problem is the affect on neurological development in growing children.

“Unfortunately, the neurological damage is irreversible,” he replied to a question.

Under the study, blood and hair of 269 children (male 156 and female 113) aged between six and sixty months at the Civil Hospital Karachi, the Kharadar General Hospital and the Liaquat National Hospital were examined. The children were suffering from different extents of iron deficiency.

Speaking on iron deficiency, he said that childhood iron deficiency was a common nutritional problem worldwide and caused neurological dysfunction in affected children.

“Around 30 per cent of the world’s population has iron deficiency. It is found to be more than 50pc in African and Asian population. Poor diet is one of the most common reasons for iron deficiency among children,” he said.

Explaining the link between iron deficiency and higher blood lead levels, he said that animal and some human studies had shown that iron deficiency might be accompanied by increased absorption of certain metals, such as lead. Researches, he said, had also shown that insufficient levels of iron might also be putting children at high risk of increased lead exposure.

Regarding the factors causing iron deficiency, he said that they included poor diet, mal-absorption, intestinal parasites, lack of meat and lack of Vitamin C. Iron deficiency could cause anaemia, behavioural changes, spoon nails, increased susceptibility to infection and cognitive and psychomotor deficits.

Referring to different studies on iron deficiency conducted in Pakistan, Dr Ahmed said that it had been found to be 50pc in children aged between six and sixty months in a study conducted in 2002 while it was over 50pc in researches conducted in 1988 and 1992.

“Our study investigated blood lead concentrations in children with iron deficiency in the Merseyside region of the UK and then in Karachi, Pakistan. Iron status was assessed by a full blood count and serum iron. The results were used to divide children into four categories; normal iron status, borderline iron deficiency, iron deficiency and iron deficiency anaemia. Blood lead concentrations were determined in all groups using atomic absorption spectrometry,” he said.

According to Dr Ahmed, the lack of association between blood lead and iron deficiency in the UK population reflected low environmental exposure to lead in the UK. However, environments with significant lead pollution such as Karachi may adversely affect children with iron deficiency.

Recommending measures to address childhood iron deficiency and higher levels of lead, director of ICCBS Prof Mohammad Iqbal Choudhary said that the government should impose a complete ban on lead-based paints and petroleum products having high levels of lead, besides introducing iron fortified supplements and making mothers aware of this health issue.

“There is also a need to examine lead levels in our drinking water. Lead levels in our drinking water are high as chlorine is used to disinfect water, an old method for cleaning water. Chlorine leaches out lead from the pipes and contaminates the water,” he said.

Published in Dawn, June 26th, 2014