Eliminating Childhood Lead Toxicity in Australia – a Little Is Still Too Much Tuesday 5 June 2012, 9.45Am to 4Pm Session 3 - Preventing Lead Poisoning

Macquarie University Public Health Network

Supported by

Faculty of Science Genes to Geoscience Research Centre Macquarie Law Centre for Legal Governance Eliminating Childhood Lead Toxicity in Australia – A Little is Still Too Much Tuesday 5 June 2012, 9.45am to 4pm Session 3 - Preventing Lead Poisoning

1.30 pm - 1.45pm Personal experience of lead poisoning in the community. Speaker - Sergeant Jeff Farmer, Port Stephens, NSW.

1.45 pm - 2.05 pm The science of preventing childhood lead toxicity. Speaker - Professor B.P. Lanphear.

2.05 pm - 2.30 pm Standards and regulation for environmental lead exposure. Speaker – Dr Alana Mackay, Research Scientist, Environmental Research Institute of the Supervising Scientist (ERISS), Dept. of Sustainability, Environment, Water, Population and Communities (Federal Govt).

2.30 pm - 2.45 pm Consumer products and lead exposures. Speaker - Elizabeth O’Brien, Manager, Global Lead Advice & Support Service (GLASS), NSW. Macquarie University Public Health Network

Supported by

Session 3 - Preventing Lead Poisoning

Personal experience of lead poisoning in the community. Speaker - Sergeant Jeff Farmer, Port Stephens, NSW.

Prevention of Lead Toxicity

Bruce Lanphear, MD, MPH Child & Family Research Institute BC Children’s Hospital Faculty of Health Science Simon Fraser University “Prevention is easy. Paint containing lead should never be employed ... where children, especially young children, are accustomed to play.” A.J. Turner, 1909 Countries Banning Lead-based Paints

France 1909 Belgium 1909 Austria 1909 Tunisia 1922 Greece 1922 Czechoslovakia 1924 Great Britain 1926 Sweden 1926 Belgium 1926 Poland 1927 Spain 1931 Yugoslavia 1931 Cuba 1934 ‘You may control conditions within a factory ... but how can you control the whole country?’

Alice Hamilton, 1925 ConsumptionConsumption of Lead of Lead in in thethe United United States States

Gasoline Additives

White Lead Paint Metric Tons Metric Tons Lead Consumption in 1000

Year The Lead Pandemic Decline in Blood Lead Levels after the Phase-out of Leaded Gasoline, United States

110 17

100 Predicted Blood Lead 16

90 15

80 14 g/dL) Gasoline Lead µ 13 70

12 60 11 50 Observed Blood Lead 10 40 Mean blood lead ( 9 Lead used in petrol (1000s of tons) Lead used in petrol 30 1975 1976 1977 1978 1979 1980 1981 Year Courtesy of Larry Needham, CDC Steps to Prevent Childhood Lead Exposure

• Identify sources of lead • Identify unacceptable levels of lead in contributing sources • Test efﬁcacy and safety of interventions to reduce lead exposure • Develop and implement regulations and screening programs Blood Lead Levels > 10 μg/dL among Children in Rochester, 1995

Percent > 10 μg/dL < 10 10 - 19 20 - 29 30 - 39 40 - 49 > 50 Non-residential

Lanphear BP, et al. Pediatrics 1998;101:264-271 Frequency of Mouthing Behaviors during Early Childhood and Blood Lead Levels

Percent

Months of Age

Lanphear BP et al. Journal of Pediatrics 2002;140:40-47 Frequency of Mouthing Behaviors during Early Childhood and Blood Lead Levels

Blood Lead

Percent

Months of Age

Lanphear BP et al. Journal of Pediatrics 2002;140:40-47 What is the Most Important Source of Lead Intake for Children? Sources of Lead Exposure in Early Childhood The Rochester Lead Study

Percent Increase Percent

Adapted from Lanphear BP, et al. Journal of Pediatrics 2002;140:40-47. Pathways of Childhood Lead Exposure Contribution of Lead-Contaminated Floor Dust to Children’s Blood Lead 30

10 μg/dL 20

10 Pooled Analysis LID Study 5 Percent Blood Lead > Percent 0

0 10 20 30 40 50 60 70 80 90 100

Floor Dust Lead (μg/ft2)

Lanphear BP, et al. Environmental Research 1998;79:51-68. Contribution of Lead-Contaminated Floor Dust to Children’s Blood Lead 30

10 μg/dL 20

10 Pooled Analysis LID Study 5 Percent Blood Lead > Percent 0

0 10 20 30 40 50 60 70 80 90 100

Floor Dust Lead (μg/ft2)

Lanphear BP, et al. Environmental Research 1998;79:51-68. Relationship of Lead-contaminated House Dust and Children’s Blood Lead Levels

Dixon S, et al. Env Health Persp 2009;117:468-474. Odds of Blood Lead Increase >5µg/dL in Children by Age after Lead Abatement g/dL µ AOR BPb > 5 AOR

Age (months)

Clark S, et al. Env Res 2004;96:196-205. Is it Cost-Beneﬁcial to Reduce Childhood Lead Exposure? Total Costs and Beneﬁts of Lead Control

Gould E. EHP 2009;117:1162-1167. Implications for Prevention

• Eliminate all non-essential uses of lead worldwide and develop regulations to control lead emissions • Establish empirically-derived health-based standards for lead in air, house dust, soil and water • Screen housing units for lead hazards before purchase or occupancy, after renovation and abatement • Lower blood lead “level of concern” to < 1μg/dL and set new goals to achieve population levels with margin of safety • Lower “action” level to <5 μg/dL and begin environmental interventions at lower blood lead level Regulation and standards for environmental lead exposure

Dr Alana Mackay Environmental Research Institute of the Supervising Scientist Department of Sustainability, Environment, Water, Population and Communities [email protected] Presentation Outline

• Environmental Legislation – Northern Territory • National Environmental Protection Measures (NEPMs) • Australian standards and guidance documents Legislation

Environmental Protection and Biodiversity Conservation Act 1999

Air Toxics NEPM 2004 Ambient Air Quality NEPM 1998

Assessment of Contaminated Sites National Pollutant Inventory NEPM NEPM 1999 1998

National Waste Environmental Environmental Mining Environmental Management Protection Offences and Management Water Act 1999 Assessment Act and Pollution Council Penalties Act Act 2011 1994 Control Act (Northern 2010 2009 Territory) Act 1998 Department of Resources Department of Natural Resources, Environment, The Arts and Sport NT Mining Management Act 2011

“The objects of this Act are to ensure the development of the Territory's mineral resources in accordance with environmental standards consistent with best practice in the mining industry”

“The operator for a mining site must ensure that the environmental impact of mining activities is limited to what is necessary for the establishment, operation and closure of the site.”

“The operator must (c) establish, implement and maintain an appropriate environment protection management system for the site” Environmental Best Practice and Benchmarking • Protecting the environment and community • Reduce the impact and extent of legacy mines/ contaminated lands • Governments have a key role in setting environmental standards and ensuring that individuals and organisations meet them • Increasingly governments, industry and community organisations are working as partners to protect our environment for present and future generations Rum Jungle Uranium Mine, NT • Rehabilitated in the 1980s • NT Department of Resources are unable to issue closure and return the land to the Traditional Owners Guidance level Reference Lead Pathways and Bioindicator (receptor) Exposure Assessment Blood Lead 10 µg/dL NHMRC, 2009

Exposure pathway

Water quality

Groundwater (aquatic 1-5 µg/L NEPC, 1999* ecosystem protection)

Surface water (aquatic 1-9.4 µg/L ANZECC, 2000* ecosystem protection)

Surface water 50 µg/L ANZECC, 2000* (recreational purposes)

Drinking water 10 µg/L NHMRC, 2011

Sediment

Interim sediment quality 50 mg/kg (dry wt) ANZECC, 2000* guideline - low

Interim sediment quality 220 mg/kg (dry wt) ANZECC, 2000* guideline - high

Soil (Health-based Investigation Levels)

Standard residential 300 mg/kg NEPC, 1999*

Parks, recreational open 600 mg/kg NEPC, 1999* spaces and playing fields < 10 µg/dL Residential with minimal 1,200 mg/kg NEPC, 1999* oppurtunity for soil access Modified after NHMRC, 2009 Commercial and industrial 1,500 mg/kg NEPC, 1999* Guidance level Reference

Dustus (no formal criterion inin AAustralian legislation) Australian/ New Zealand Pb ppaint abatement - floor 1,000 µg/m2 Standards, 1998

Surfaceurf dust Pb - floor 430 µg/m2 US EPA, 2001; 2008

Pb ppaint abatement - window Australian/ New Zealand 5,000 µg/m2 ssillill Standards, 1998

Surfaceurf dust Pb - window sill 2,690 µg/m2 US EPA, 2001; 2008

Pb iin surface dust 500 mg/kg USEPA/HUD, 1995

Airir

0.5 µg/m3 averaged over 1 yr, Ambient Air Quality reported as fraction of total NEPC, 1998* suspended particles

FMENCNS, 2002 Pb deposition 100 μg/m2/day (aka German TA Luft)

Pb ddeposition 250 μg/m2/day WHO, 2000

Foodoo

Brassicas 0.3 mg/kg FSANZ, 2011 Cereals, Pulses and Legumes 0.2 mg/kg FSANZ, 2011 Edible offal of cattle, sheep, pig 0.5 mg/kg FSANZ, 2011 and poultry Fish 0.5 mg/kg FSANZ, 2011 Fruit 0.1 mg/kg FSANZ, 2011

Infant formulae 0.02 mg/kg FSANZ, 2011 Meat of cattle, sheep, pig and Modified after NHMRC, 2009 0.1 mg/kg FSANZ, 2011 poultry (excluding offal) Molluscs 2 mg/kg FSANZ, 2011 Vegetables (except brassicas) 0.1 mg/kg FSANZ, 2011 Australian Standards and Guidance Documents National Environmental Protection Measures (NEPMs)

What are NEPMs?

• NEPMs are national objectives for protecting and managing particular aspects of the environment • NEPMs are broad framework-setting statutory instruments defined in the National Environmental Protection Council Act (NEPC Act) • NEPMs typically consist : ▫ a goal ▫ one or more standards ▫ one or more monitoring and reporting protocols, and ▫ may also contain guidelines. National Environmental Protection Measures (NEPMs)

Who is responsible for implementing the NEPMs?

• All Australian states and territories are part of an Intergovernmental Agreement on the Environment • Under this agreement, a National Environmental Protection Council (NEPC) was formed to develop the NEPMs • NEPC is now incorporated with the Environment Protection and Heritage Council (EPHC) • The implementation of the NEPMs are the responsibility of each participating jurisdiction • Each jurisdiction reports performance against the NEPMs annually to the NEPC Ambient Air Quality NEPM

• Air quality issues generate the most complaints from the local community compared to any other pathway • Uniform standards for ambient air quality in Australia • Initially released in 1998; revised in 2003; reviewed in 2011 • The AAQ NEPM is not applicable indoors or for occupational exposure • Health-based air quality values based on not exceeding 10 µg/dL PbB • Current level of Pb is 0.5 µg/m3 averaged over 1 yr, reported as fraction of total suspended particles • Measured for 24 hrs, once every 6 days 2011 AAQ NEPM review outcomes

“In 2003, when the NEPM was varied there were no studies conducted in Australia linking adverse health effects with exposure to air pollution. Consequently, the standards were based on evidence from studies conducted overseas, particularly the US.”

“Determining potential population health risk resulting from ambient air quality exposure has been complicated by the fact that epidemiology studies are now indicating there is no clear threshold for effect for the current NEPM pollutant, with exposures below the standards still representing a statistically significant and measureable health risk to the Australian population... In light of this new evidence, compliance with the standards alone may not achieve the desired environmental outcomes of ‘adequate protection.”

“The findings of the Pb review indicate that health effects are observed below the blood Pb target of 10 µg/dL . The Review Team considers that the standard should be revised to reduce the risk to the affected populations.”

“Where lead continues to be a point source issue, sufficient data are available to conduct an exposure assessment within the affected communities.”

“There was a desire to have a national air quality standard that could be used in communities, such as Port Pirie and Mount Isa, that are impacted by industrial sources.”

“Remove lead from the Ambient Air Quality NEPM and include in the Air Toxics NEPM during the scheduled Air Toxics NEPM review, which is due for review in 2012.” Air Toxics NEPM • Developed in 2004 • Improve the information base regarding ambient air toxics to development of standards • To facilitate management of air toxics to allow for the equivalent protection of human health and well being • Adopting a nationally consistent approach to monitoring air toxics • Pb is not in the Air Toxics NEPM – review in 2012 Assessment of Contaminated Sites NEPM

• Nationally consistent approach to the assessment of the site contamination • Ensure sound environmental management practises • Provide adequate protection of human health and the environment Assessment of Contaminated Sites NEPM

• Soil health-based investigation levels for Pb ▫ A – ‘Standard’ residential e.g. day-care, primary schools (300 mg/kg) ▫ B & C – Residential ▫ D – Residential with minimal access to soil (1,200 mg/kg) ▫ E – Parks and recreational open spaces (600 mg/kg) ▫ F – Commercial/Industrial (1,500 mg/kg) • Background soil-Pb 2-200 mg/kg • Based on a default exposure scenario for a 2 year old child Assessment of Contaminated Sites NEPM

• Groundwater health-based investigation levels ▫ Default to the Australian Drinking Water Quality Guidelines (NHMRC, 2011) ▫ Pb 10 µg/L ▫ Exposure via direct consumption or dermal • ADWQG similar to WHO’s Guideline for Drinking-water Quality (2004) but dose models use 70 kg instead of 60 kg National Pollutant Inventory NEPM

• Established in 1998 • Provide the community, industry and government with information on the types and amounts of certain substances being emitted to the air, land and water Dust deposition

No formal criterion in Australian legislation

• Surface dust-Pb: ▫ Floor - 1,000 µg/m2 (Australian/ New Zealand Standards, 1998) ▫ Floor - 430 µg/m2 (US EPA, 2001; 2008) ▫ Window sill - 5,000 µg/m2 (Australian/ New Zealand Standards, 1998) ▫ Window sill - 2,690 µg/m2 (US EPA, 2001; 2008) ▫ 500 mg/kg (US EPA/HUD, 1995)

• Surface dust-Pb loads: ▫ 100 μg/m2/day (FMENCNS, 2002)* ▫ 250 μg/m2/day( WHO, 2000)

• Multiple methods for dust deposition collection: ▫ Passive collection over a designated period (usually 30 days) ▫ Flow sampler ▫ Dust wipe ▫ Vacuum cleaner

*Technical Instructions on Air Quality Control, Federal Air Pollution Control Act Dust deposition • Passive samplers, dust wipes and vacuum cleaners only give an indication of loadings • Incorporation of loading into formal legislation in Australia • Inefficient due to cleaning and time between disturbance • Instances where dust deposit on soil – when to use soil or dust criteria or both? • Use of background Surface water quality

• Recreational purpose – short exposure period • No structured framework for recreational purposes • Pb 50 µg/L • Obtaining representative sample: ▫ Morphic units ▫ Groundwater ingress ▫ Evapoconcentration ▫ Catchment flushing ▫ Total vs filtered ▫ Influence of organics

• Australia’s ephemeral systems • Linked to legislation – beneficial use; controlled or managed release Surface Water Quality – Aquatic Ecosystem Protection Framework Food Food • Food Standards Australia New Brassicas 0.3 mg/kg Zealand are enforceable under Cereals, Pulses and Legumes 0.2 mg/kg legislation Edible offal of cattle, sheep, 0.5 mg/kg • Chemical contamination of pig and poultry food that are likely to affect Fish 0.5 mg/kg human health Fruit 0.1 mg/kg Infant formulae 0.02 mg/kg Meat of cattle, sheep, pig and 0.1 mg/kg poultry (excluding offal) Molluscs 2 mg/kg Vegetables (except brassicas) 0.1 mg/kg Sediment • Identify sediments where contaminant concentrations are likely to result in adverse effects on sediment ecological health • Facilitate decisions about the potential remobilisation of contaminants into the water column and/or into aquatic food chains • Identify and enable protection of uncontaminated sediments

“Need for multiple lines of evidence for adequate assessment” • Sequential extractions (e.g. Tessier et al., 1979) • Labile contaminant fraction • Sediment ecotoxicology • Sediment chemistry (exceeding the SQG) • Contaminants bioavailability tests (pore water measurements, acid volatile sulfides) • Toxicity testing (multiple species, varying exposure pathways, acute and chronic endpoints such as mortality, growth, reproduction, avoidance) • Bioaccumulation/biomagnification • Benthic community structure Bioaccessibility/bioavailability

• No standard for bioaccessibility/ bioavailability in formal legislationn • Is it more representative of whole samples? • More targeted exposure analyses • Dose response in vivo ‘models’ - juvenile swine, rats, monkey, rabbitsi • In vitro bioaccessibility tests – PBET, SBET, RALPH, leaching procedure Are we missing a standard? What about the source?

ISO 1400:2004:

“The organization shall establish, implement and maintain a procedure… to identify the environmental aspects of its activities… and to determine those aspects that have or can have significant impact(s) on the environment (i.e. significant environmental aspects).”

There are a number methods and techniques used to identify environmental Pb sources:

• Pb isotope (e.g. 208Pb/206Pb,207Pb/206Pb) • Mineralogy (e.g. XRD, SEM-EDX) • Physico-chemical properties • Grainsize – fractionation • Background Concluding comments

• Australia’s NEPMs and guidance documents generally use values based on not exceeding 10 µg/dL PbB

• Many of Australia’s guidance documents are interim measures or are in review

• Currently, Australian standards and guidance lacks the detail required to adequately quantify and assess Pb in environmental samples

• Harmonisation of legislation to provide a better framework for assessing environmental lead across industry/s Consumer Products and Lead Exposures

Eliminating Childhood Lead Toxicity in Australia – A Little is Still Too Much Macquarie Uni Forum, 5th June 2012 Presentation by Elizabeth O’Brien, President, The LEAD Group, Delivered by Michelle Calvert, Vice President, The LEAD Group.

All these lead sources need more stringent legislation

Lead foil on wine bottle

Cronkshaw lead-free logo.jpg Leaded pewter consumer products old and new Study Concludes Beethoven Died From Lead Poisoning Lead crystal armonica Men and their white-skinned prostitutes, in a late 19th century French brothel. [Scene from the 2011 movie L'Appollonide (Souvenirs de la Maison Close), known in English as House of Tolerance, directed by France's Bertrand Bonello. [ http://eyeswiredopen.blogspot.com.au/ ] Leaded Leaded turmeric kohl eye make-up NEWS headlines! Lead laced Marijuana producing sociopaths? Hazardous battery recycling on the streets of New Delhi. A child disassembles a spent truck battery on the sidewalk to sell lead to unregistered recycling units. [ www.okinternational.org/ ] Leaded house paint – still available for purchase today by 2.5 billion earthlings

Leaded ceramicware is still a major source of lead exposure in many countries

Green Machine collects lead bullets from shooting ranges for recycling Leaded PVC copper cable recycling in Ghana

Each CRT contains 8 kg of lead

OECD Demand by end use Category

1800 1600 Miscellaneous 1400 Gasoline Additives 1200 Cable sheathing 1000 Alloys 800 shot and ammunition 600 Pigments and other Compounds 400 Rolled and extruded products 200 Batteries 0 1993 1994 1995 1996 1997 1998

Today more than 80% of world lead is in batteries, and the trend is towards 100% http://www.subsport.eu/ Evo Building Products Wakaflex non-lead roof flashing and Flashtites non-lead roof ventilation flashing are imported from Germany and distributed in Australia and New Zealand

Wakaflex Flashtite

Lead-Safe World Project

Watch this site: www.leadsafeworld.com

The National Institute of Painting and Decorating is the peak educational body for the painting industry in Australia and the Pacific. It is supported by Registered Training Organisations, and has introduced lead paint abatement training to the NT, NSW, QLD and WA; and soon on- line for painters anywhere in the world. ADRA is the first national ceiling dust removalists’ association in the world. Four videos showing how to use The LEAD Group’s

DIY-sampling lab-test kits are available on YouTube: 1.Introduction 2.Test Kit Instruction - Part 1 3.Test Kit Instruction - Part 2

4.Test Kit Result Discussion Acknowledgements

• Thanks to the following for their information, advice and support in writing this presentation: • Anne Roberts, Zac Gethin-Damon, Hims Patel, Ardhika Wira, Chris Winder, Paul Kesby (DSEWPaC), Daniel Wurm (NPDI), Gavin Clarke (ADRA), Ian Smith and Michelle Calvert.