General
Conference
on Lead Poisoning Prevention & Treatment, Banaglore, India
February 8-10, 1999
INTRODUCTORY
REMARKS BY ORGANIZER & HOST
Dr.
Abraham M. George
His Excellency,
the Governor of Karnataka, distinguished speakers and panelists, ladies
and gentlemen. I am honored to stand before this distinguished gathering
to make a few introductory remarks on lead poisoning. Before I do so,
I want to express my profound gratitude and appreciation to all of you
for partaking in this important event. Many of you have traveled far
distances, some from the other side of the globe, and that in itself
is a true affirmation of your commitment to this cause.
I must start with
a nice word about Lead. Lead is a wonderful metal – in fact, a strategic
one – and it has a variety of uses, when handled wisely. But lead is
also one of the most toxic metals to humans. It does not belong to our
body even at very low levels. With elevated levels of lead in our system,
lead influences brain development, and affects the proper functioning
of organs such as kidney and liver. Children in their early years absorb
lead 5 to 8 times as much as adults. Consequently, lead poisoning has
become the biggest environmental disease affecting urban children in
developing countries.
Recognizing the
dangers of lead poisoning to our children and others, The George Foundation
embarked 2 years ago on the first major study in India to determine
the blood lead levels among our urban population across the country.
The study was appropriately named Project Lead-Free. Using the
most advanced equipment and adhering to international protocols on screening,
the foundation completed 22,000 blood tests in 7 major cities. Today,
we are making the results of this study available to the general public.
I am afraid I do
not have a happy story to tell. In fact, I have an alarming story to
tell you. Project Lead-Free study has concluded that over 50%
of the nation’s children below the age of 12 living in urban environments
have unacceptable blood lead levels of 10 micrograms per deciliter or
more. Further, 14% of the children in our cities have seriously elevated
levels of lead of 20 m g/dl or more. When we consider the 100 million
or so of our children living in urban areas, the numbers behind these
statistics are staggering.
At the risk of being
termed an alarmist, I have no other way to say that we have an environmental
health crisis in the making in India. The evidence is clear. With all
humility I must say that it is a national disgrace that we have collectively
allowed lead poisoning to affect millions of our children and others.
If unchecked, millions more of unborn will fall victim to lead poisoning
in the future.
What does this mean
for our future workforce? Allow me to make a few simplifying assumptions
to translate the impact of lead poisoning to monetary terms. If we assume
that the average annual productivity of the urban worker in India is
Rs. 120,000 (i.e. Rs. 10,000 per month, which is, by the way, only 1/10th
of that in urban America), and also assuming a direct correlation between
loss in IQ and productivity, i.e., if we have an elevated level of 10
to 20 m g/dl, there would be 4-5% decline in IQ, and hence 4-5%
decline in productivity. Someone may argue about this assumption, but
I believe it is only a conservative assumption supported by scientific
evidence. We can now estimate the cost to the nation when our present
children enter the workforce. Simple arithmetic tells you that this
cost is no less than Rs.300 billion per annum. As the urban population
increases over time, this cost also increases exponentially if we do
not take effective measures to check the problem.
In today’s global
economy where India hopes to compete in the fields of computer technology,
communication and other specialized fields, can we afford to have future
generations of our workforce below their full intellectual potentials?
I don’t need to answer this question --- the answer is obvious to all.
During the next
3 days, all of us will discuss the problem with one single goal – to
find practical solutions to deal with the problem. We will bring together
our expertise and experiences to develop a comprehensive plan that can
be implemented at national levels for the prevention and treatment of
lead poisoning. The world’s leading scientists on the subject have gathered
here under one roof to find solutions that developing countries can
apply. This conference will present concrete solutions that must be
implemented. The time has come to act. We cannot wait any longer.
Each one of the
constituencies in our society has a role to play in the solution. Hopefully,
this will not be simply another government undertaking. Both public
and private sectors, as well as all of us as parents and citizens must
work together. I hope we will have the courage and the determination
to do so.
Thank you.
REMARKS
BY PRIMARY SPONSORS
Richard
Ackermann, The World Bank
Distinguished delegates,
ladies and gentlemen. On behalf of the Vice President, Meiko Nishimuzu
from the World Bank, it is indeed a pleasure and honour to welcome all
of you here.
It is an honour
because all of the key experts on the issue are here, and there are
delegates from nine neighboring countries, so this is truly a regional
event, which I am sure, will yield results. We are pleased to co-sponsor
such an important event on a topic to which we have tried to draw attention
now for several years because we attach indeed a lot of importance to
it. It is a serious problem but we also think there exists cost effective
solutions so it is not just a problem about which one will have wishful
thinking but it is a problem to which we can really move forward towards
solutions.
This conference
fits well with our role of the World Bank to help facilitate solutions
to critical development problems. It is also consistent with our view
that solutions require broad approaches. Scientists, doctors, politicians,
government officials, industry leaders from private and public sectors
and NGO’s will all need to contribute to solutions for this problem.
Solutions will range
anywhere from medical testing, to urban planning, tax policies, and
even privatisation. So indeed the agenda is quiet large. Let me congratulate
Dr. Abraham George and the organisers for this quiet spectacular event
to which they have managed to bring so many big names.
Lead poisoning affects
specially children, as Dr. Abraham George just said a moment ago. I
think the great thing of about this meeting is that it is increasing
the opportunities. Opportunities for the future generation to contribute
to a better world and I think this is the most worthy cause that we
can think of.
Thank you very much.
Dr.
Henry Falk, Centers for Disease Control and Prevention
Thank you very much,
His excellency the Governor, Dr. George, Admiral O.S. Dawson and my
colleagues from participating sponsoring organisations and my welcome
to all of you as delegates at this meeting.
CDC is very proud
to be a co-sponsorer of this meeting and this has been a high priority
for us as we have worked and planned for this day and this conference.
Speaking for myself but also for Dr. Jackson who heads our Center for
Environmental Health at CDC and for Dr. Copeland who is the Director
of CDC, all of us have been here before to India, and now this is my
6th trip. Both Dr. Jackson and Dr. Copeland have been here
before and we have all come to share with joint interests in seeing
a successful conclusion to this meeting. The initial impetus came from
Dr. George himself and I hope that Dr. George will sometime in this
meeting recount for you how he became interested in Lead Poisoning.
He literally re-invented the wheel, as we say, and came from his background,
which is not medical or public health, to understanding the concerns
about Lead Poisoning and the potential threat to the children. The value
that could be gained from this effort is tremendous, and so let me extend
my commendations to Dr. Abraham George for his efforts.
Several of us participated
last year at a workshop on heavy metal toxicity in Lucknow, India, which
was co-sponsored by Industrial Toxicology Research Center, EPA and CDC
and we received some first hand information, very early information
on the potential problems related to lead exposure within India. We
received just the very earliest meaningful data, very limited, heard
more environmental data, but also gained appreciation for the problems
that lay ahead enduring with this illness in India. Problems such as
difficulty in treating children, and the need for more pharmaceutical
agents, lack of laboratory monitoring equipment for measuring blood
lead levels and so on. There are many impediments at the moment for
dealing with this problem, but hopefully this particular meeting can
provide a springboard to developing solutions.
At CDC we have
had a domestic programme in the US for the past 20-30 years dealing
with Lead Poisoning, but with particularly within the last 2-3 years
we have had increasing involvement in international affairs related
to Lead. We have had projects in the last several years in Russia, China,
India, and the Middle East including Egypt as well as other countries
in Latin America including Mexico, Peru and Brazil.
So we have begun
to appreciate the diversity of Lead problem as it exists worldwide.
Yes, leaded gasoline is a very important problem but there are many
other sources, many of which are in very concentrated forms that can
lead to high exposures. So we have to appreciate the particular types
of exposures and the nature of the problem that exists in each country.
I am greatly encouraged
by being able to participate together with the World Bank, WHO and EPA
and all the Indian sponsors. I think that this could be a landmark for
India, as well as the start of programme for global eradication of Lead
Poisoning. There are many US colleagues who are here; they have battled
very hard in the US for over the last 20-30 years to eliminate childhood
Lead Poisoning. I hope they would be able to contribute as the conference
moves along and be able to participate in whatever way they can to help
you in working on the problem here in India.
You know all of
us as scientists, we think of time as a continuum, -- there are seconds
and more seconds, hours, weeks, months, -- time merges in one moment
and leads to the next. One moment is no different than the next in some
quantitative sense. However all of us thinking of our lives and thinking
from our hearts and minds know that there are always grand moments in
history. There are key moments in history highlights that always stand
out from all the others because they change the way we look at things,
and because they enable new things to happen as they energize you to
some surge of creativity. So my hope that these days we spend here together
will be such moments, and that they will start an effort leading to
the greater good both here in India as well as else where in the world.
Thank you.
Mr. William A.
Nitze, U.S. Environmental Protection Agency
Thank you Governor,
Admiral, Dr. Abraham George, colleagues, ladies and gentlemen. It is
a great honour for us at the U.S. EPA to participate in this important
conference and serve as one of the sponsors. It took me a long time
to get here as it did for many of you. It was a very long trip but I
and the agency that I represent, the US-EPA, are committed to eradicating
the silent hazard that is the Lead Poisoning. Why? Because in my country
and in your country Lead Poisoning is a major public health problem,
and a problem that is particularly severe for the children. Lead is
insidious, you cannot see it, smell it or even taste it but it is there.
It accumulates in the body and long term consumption of even very low
levels is as dangerous as a single concentrated ingestion. It has been
almost 30 years since the US began to phase lead out of gasoline. It
has been little more than 20 years we banned the use of Lead in Paint.
Our food industry has stopped using lead-soldered cans. Yet in 1996
there still estimated to be 1.7 million children that had blood lead
levels that exceeds the allowable level of 10 ug/dl. I am happy to say
that this number fell to 890,000 last year.
However this number
still represents 4.4% of our children in the US, and must be reduced
further. Our biggest single problem is still lack of knowledge about
Lead. In low levels of Lead Poisoning there are no symptoms and there
is no treatment and we cannot assume that there are no effects. This
conference will go a long way to address the lack of knowledge and information
regarding the silent threat by providing opportunities for leaders in
the field to discuss the problem of Lead Poisoning and identify sound
strategies to prevent this disease. We can perhaps convince our leaders
to take concrete action. In our own work at EPA, we struggle daily with
the issue of achieving concrete measurable improvements to our environment.
If the work of this conference serves to save one child’s life, all
of us here would have met this challenge for today.
I challenge this
distinguished group of experts from around the world to end this 3 day
conference with a concrete plan of action that we can undertake here
in India and in each nation represented to ensure that children will
no longer bear the unfortunate burden.
In closing let me
thank Dr. Abraham George and The George Foundation for this initiation
in organising this conference and I sincerely hope that their enlightened
effort is the beginning of a process focussed on eradicating the vicious
silent yet completely preventable disease.
Thank you very much.
Dr. Yasmin von
Schirnding, World Health Organization
Thank you, distinguished
delegates and attendees. On behalf of the WHO I wish to welcome you
to this important International Conference on the Prevention and Treatment
of Lead Poisoning. I would also like to express the sincere regrets
of Ms. Poonam Khetrapal Singh, Executive Director of Sustainable Development
and Healthy Environment at WHO, who is unfortunately unable to be with
us today. But she has asked me to read a statement on her behalf.
In particular I
thank the organizer, especially The George Foundation, in taking the
initiative in putting together the stimulating and innovative programme.
The surveillance that has been undertaken here in India is truly extraordinary.
We congratulate you on your efforts and hope that this important initiative
will help to stimulate further awareness of the public health impact
of Lead Poisoning throughout the world, most particularly in developing
countries.
WHO has long considered
Lead Poisoning to be a key preventable disease of immense potential
public health impact. Worldwide human exposure to Lead remains an important
issue whether the sources are in the workplace, the home environment,
or community environment at large. Lead is the one of best-studied toxic
substance, the health effects of which we probably know more about than
virtually any other chemical. It’s ill health effects have been well
documented across extremely wide range exposure right down to very low
levels approaching the very limits of detection. The very young, the
poor and occupationally exposed are normally most at risk. Over many
years WHO has been actively involved in initiatives aimed at obtaining
better understanding of the problem in all its dimensions from the toxicology
and epedimiology of clinical and sub-clinical Lead Poisoning to measures
associated with its prevention and control. This conference provides
a unique opportunity to draw on the shared experiences and lessons learned
from many different organizations and countries with varied perspectives
and insights into the nature of the problems faced.
I hope that your
discussions here during the next few days will help to influence relevant
regulations and policy issues so that current and future generations
will be protected against one of the insidious environmental health
problems that has plagued us for so long.
I wish you well
in your deliberations.
Thank you
ADDRESS
BY CHIEF GUEST
Shri.
Khurshed Alam Khan
Governor
of Karnataka
Dr. George, Admiral
Dawson, Mr. Ackermann, Mr. Nitze, Dr. Falk, Dr. Schirnding and distinguished
participants. At the outset I would like to welcome the participants
to our city. On behalf of myself and the Government of Karnataka I welcome
you all. I hope you will be very busy for next 3 days in your deliberations
but still be able to find little time to see our garden city. I hope
you would all take back very good memories when you go home from here.
It is my proud privilege
to associate myself with today’s function to inaugurate the Conference
on Lead Poisoning: Prevention and Treatment organized and sponsored
by The George Foundation, the Centers for Disease Control and Prevention
and Environment Protection Agency (USA), World Health Organization and
The World Bank.
Pollution problems
had their beginning with the growth of cities and rapid urbanization
combined with high degree of industrialization. Over population and
pollution have wrecked havoc in big cities the world over. Technological
advances in industry and agriculture introduced thousands of new chemicals
including fertilizers, insecticides, and herbicides, many of which naturally
run off into the rivers, atmosphere and ecosystem. A range of diseases
hitherto unknown to human population is throwing up challenges to human
existence. This has brought in its wide environmental and social problems.
The fruits and vegetables we eat everyday are sprayed with lethal pesticide
over a number of years. This contamination can have serious side effects
like paralysis, kidney trouble and even cancer.
Lead Poisoning is
the number one environmental pollutant effecting the health and well
being of 2/3rd of the world’s children in urban areas. Our
statistics indicate the lead pollution in our environment have reached
alarming levels by inadequately controlled industrial emissions and
insemination of leaded gasoline, which when burnt in automobile engine
is the major source of lead in urban areas in India. Though we have
issued our first national emission standard for Lead and other pollutants
in 1990, our main source of lead pollution continues to be through automobile
exhaust. The constantly increasing number of automobiles on the road
is one reason and the other is that our recommended permissible limits
of lead and carbon monoxide are still very much higher than those of
developed countries.
Long term consumption
of low levels of lead is said to be dangerous causing learning disability,
decline in IQ and even permanent brain damage. Children and pregnant
women are particularly susceptible to lead poisoning. Lead poisoning
causes anemia, blood pressure in both children and adults, and paradoxically
it is like a vicious circle as deficiency of iron, calcium, zinc causes
absorption of lead.
Bangalore has emerged
as the fifth largest metropolis in the country and its population has
reached to a phenomenal 5 million mark from just 0.4 million in 1991.
Congestion, over crowding, vehicular pollution and lack of basic amenities
made Bangalore once boasting as the garden city of India, relic of what
it was a few decades ago. Awareness of about the importance of keeping
our environment clean and pollution free among the people and especially
among the industrialists is important. Polluting the living environment
must be punishable; most stringent enforcement of available rules is
also necessary. In addition to this we must take steps to make mandatory
the use of lead-free petrol by all automobiles.
I congratulate The
George Foundation for having taken this initiative to sensitize and
create awareness among the public about the ill effects of lead pollution
and also for creating an excellent platform to scientists and scholars
in the field of health and environment. It has permitted leading industrialists
around the world to meet, discuss and share their ideas on the public
health hazards.
I hope and wish
that these deliberations will be fruitful in arriving at tangible solutions
for the problem and help in formulating the national plan, and in improving
existing plans for the prevention and treatment of lead poisoning.
Thank you.
