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Child Exposure to Lead in the Vicinities of Informal Used Lead-Acid Battery Recycling Operations in Nairobi Slums, Kenya.

ABSTRACT: Background:Child exposure to lead from informal used lead-acid battery (ULAB) recycling operations is a serious environmental health problem, particularly in developing countries. Objectives:We investigated child exposure to lead in the vicinities of ULAB recycling operations in the Dandora, Kariobangi and Mukuru slums in Nairobi between January and August 2015. Methods:Top soil (n = 232) and floor dust (n = 322) samples were collected from dwelling units (n = 120) and preparatory schools (n = 44) and analyzed using an inductively coupled plasma-optical emission spectrometer at the Mines and Geological Department Laboratory in the Ministry of Mining, Nairobi. From the obtained lead levels in soil and house dust, child blood lead levels were subsequently predicted using the Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK), Windows version. Results:Lead loadings in all the floor dust samples from the Dandora, Kariobangi and Mukuru slums exceeded the United States Environmental Protection Agency (USEPA) guidance value for lead on floors with a range of 65.2 - 58,194 ?g/ft2. Control floor dust samples recorded lower lead loadings compared to the Dandora, Kariobangi and Mukuru slums. Lead concentration in 70.7% of the soil samples collected from waste dumps, industrial sites, residential areas, playgrounds and preparatory schools in Dandora, Kariobangi and Mukuru exceeded the respective USEPA guidance values for lead in soils. Lead concentration in 100% of control soil samples were below the respective USEPA limits. The IEUBK model predicted that nearly 99.9% of children ? 7 years old living near informal ULAB recycling operations in Dandora, Kariobangi and Mukuru were at risk of being lead poisoned, with predicted blood lead levels (BLL) above the Centers for Disease Control (CDC) reference value for blood lead. A total of 99.9% of exposed children living in the Mukuru slums are likely to have BLL above 34 ?g/dL. Conclusions:There is a need for coordinated efforts to decrease lead emissions from informal battery recycling in Nairobi slums and to remediate existing soils, particularly around battery workplaces and dumpsites. The BLL of local children should be clinically tested and appropriate intervention measures taken.

SUBMITTER: Ondayo MA

PROVIDER: S-EPMC6221501 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Project description:Background:Lead can cause significant biological and neurologic damage, even at small concentrations, and young children are at higher risk. Informal recycling of lead batteries and lead-based workshops/industries have increased the burden of lead toxicity in developing countries, including India. Many informal recycling lead battery workshops have been established by the local people of Patna, Bihar as self-employment opportunities. However, most of the residents are not aware of the risk factors associated with lead poisoning. Objectives:The present pilot study aimed to assess blood lead levels (BLLs) and hemoglobin levels among children aged between 3 to 12 years in the settlement of Karmalichak near Patna, India. Materials and Methods:Children residing near the informal lead battery manufacturing unit were selected for BLL assessment. A total of 41 children were enrolled in the questionnairebased survey. Results:All the children in the present study had detectable lead concentrations in their blood. Only 9% of the studied children had a BLL ?5 ?g/dl, while 91% children had a BLL above >5 ?g/dl. Conclusions:The present study carried out in children of Karmalichak region of Patna, India was an attempt to better understand the problem of lead toxicity, describe the epidemiology of its adverse effects, identify sources and routes of exposure, illustrate the clinical effects and develop strategies of prevention so that remedial measures may be taken by government agencies and regulatory bodies. In view of the high lead levels in children in the study area, attempts are being made to develop strategies for future prevention by relocating the informal battery recycling workshops from the area. Moreover, parents have been advised to increase nutritional supplementation of children by providing calcium-, iron- and zinc-rich foods, including milk and vegetables. Participant Consent:Obtained. Ethical Approval:The study was approved by the ethical committee of Era's Lucknow Medical College & Hospital, Era University, Lucknow (India). Competing Interests:The authors declare no competing financial interests.

Project description:BACKGROUND: It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program. METHODS: We used data from 2070 deaths of people aged 15-54 years that occurred between 2003 and 2010 in a population of about 72,000 individuals living in two slums covered by the Nairobi Urban Health and Demographic Surveillance System. Only deaths for which verbal autopsy was conducted were included in the study. We divided the analysis into two time periods: the "early" period (2003-2006) which coincides with the initiation of ART program in Kenya, and the "late" period (2007-2010) which coincides with the scale up of the program nationally. We calculated the mortality rate per 1000 person years by gender and age for both periods. Poisson regression was used to predict the risk of HIV mortality in the two periods while controlling for age and gender. RESULTS: Overall, HIV mortality declined significantly from 2.5 per 1,000 person years in the early period to 1.7 per 1,000 person years in the late period. The risk of dying from HIV was 53 percent less in the late period compared to the period before, controlling for age and gender. Women experienced a decline in HIV mortality between the two periods that was more than double that of men. At the same time, the risk of non-HIV mortality did not change significantly between the two time periods. CONCLUSIONS: Population-level HIV mortality in Nairobi's slums was significantly lower in the approximate period coinciding with the scale-up of ART provision in Kenya. However, further studies that incorporate ART coverage data in mortality estimates are needed. Such information will enhance our understanding of the full impact of ART scale-up in reducing adult mortality among marginalized slum populations in Kenya.

Project description:HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums.The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in urban slums in Nairobi.Blood samples were collected from residents of Viwandani and Korogocho between 2006 and 2007. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV-1. Statistical analysis was done using STATA.Samples were successfully collected from 418 (32%) men and 890 (68%) females. The HIV-1, HBV and HCV prevalence was 20.4%, 13.3% and 0.76% respectively at the time of the study. Of the 268 (20.4%) HIV-1 positive participants, 56 (4.26%) had HBV while 6 (0.46%) had HCV. Of the 1041 HIV-1 negative participants, 117 (8.9%) had HBV while 4 (0.31%) had HCV. Only two people (0.15%) were co-infected with all the three viruses together.The odds of getting hepatitis infection were higher in HIV-1 participants (for HBV OR 2.08,p<0.005 and for HCV OR 5.93, p<0.005). HIV prevalence rates were similar in both informal settlements. HIV infection was highest in age group 35-39 years and among the divorced/separated or widowed. Prevalence of all viruses was highest in those who did not have any formal education.The HIV prevalence in these informal settlements suggests a higher rate than what is observed nationally. The prevalence rates of HBV are significantly higher in the HIV-1 positive and negative populations. HCV as well as triple HIV-1, HBV and HCV coinfection are uncommon in Korogocho and Viwandani. This clearly indicates the need for HIV-1 control programmes and hepatitis B virus vaccination to be promoted through public awareness as preventive strategy.

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Child Exposure to Lead in the Vicinities of Informal Used Lead-Acid Battery Recycling Operations in Nairobi Slums, Kenya.

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