The Indian Journal of Pediatrics

, Volume 67, Issue 2, pp 87–91 | Cite as

Blood lead and efythrocyte protoporphyrin levels in Kazakhstan

  • Balkrishena Kaul
  • James 0. Rasmuson
  • Roger L. Olsen
  • Curt R. Chanda
  • Tatiana I. Slazhneva
  • Eduard I. Granovsky
  • Andrey A. Korchevsky
Original Article


A pilot study was conducted to examine the extent of lead exposure and prevalence of iron deficiency in 3 major cities of Kazakhstan. Blood lead (B-Pb.) and erythrocyte protoporphyrin (ZnPP) levels of 475 children, age range 6 months to 7 yeas were measured. The mean B-Pb. levels in the different cities ranged from 4–7 ug/dl (minimum 1 to max 29 ug/dl) and similarly the mean ZnPP levels ranged from 26–32 ug/dl (minimum 12 and maximum 95 ug/dl), thus confirming low level lead poisoning of children at some sites. One to four year olds had greater than 10 ng/dl B-Pb in 18–27% cases compared with 3–7% cases in five to seven year olds. Prevalence of iron deficiency in 6 months to 4 year old children was the highest ranging from 28–86% compared with 4 to 15% in 4–7 year olds. However, there was remarkably low prevalence (4%) of iron deficiency in a group of 5–6 years olds. This study suggests that a targeted B-Pb and ZnPP monitoring together with an iron supplementation programme in the 3 cities of Kazakhstan is essential. Environmental education appears to have had a positive impact in lowering B-Pb at one site and should thus be expanded nationwide.

Key words

Blood lead Erythrocyte protoporphyrin 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Chisolm JJ, (Jr). Chronic lead intoxication in children.Dev Med Child Neurol 1965; 7:529–536.PubMedCrossRefGoogle Scholar
  2. 2.
    Mauss EA. Childhood lead poisoning prevention. The torturous trail from human health impact assessment to effective environmental policy.Env Rev 1994; 14: 403–23.Google Scholar
  3. 3.
    Silbergeld E. The International Dimension of Lead Exposure.International J Occup and Environ Health 1995; 1:336–348.Google Scholar
  4. 4.
    Centres for Disease Control: Guidelines for the Prevention of Lead Poisoning in Children, Atlanta, GA, US, Public Health Service, 1985-1991.Google Scholar
  5. 5.
    National Academy of Sciences 1993. Measuring Lead Exposure in Infants, Children and other Sensitive Population, Committee on Measuring Lead in Critical Populations, Board on Environmental Studies and Toxicology, Commission on life Sciences, National Academy Press, Washington DC, 1993.Google Scholar
  6. 6.
    Needleman HL, Gatsonic CA. Low level lead exposure and the IQ of children.JAMA 1990; 263:673–678.PubMedCrossRefGoogle Scholar
  7. 7.
    Bellinger D, Stiles K, Needleman H. Low level lead exposure, intelligence and academic achievement. A long term follow up study.Pediatrics 1992; 90: 855–861.PubMedGoogle Scholar
  8. 8.
    Needleman H, Reiss J, Tobin Met al. Bone lead levels and delinquent behaviour.J Amer Assoc 1996; 275: 363–369.CrossRefGoogle Scholar
  9. 9.
    Smith M, Delves T, Lansdown R, Clayton B, Graham P. The effects of lead exposure on urban children. The Institute of Child Health Southampton Study.Dev Med Child Neurol 1983; 47:1–54.Google Scholar
  10. 10.
    Barbara B. Round and round it goes. The Epidemiology of Childhood Lead Poisoning 1950-1990.The Milbank Quarterly 1993; 11:3–34.Google Scholar
  11. 11.
    Ruff HA, Markowitz ME, Bijur PE, Rosen JF. Relationship-among blood lead levels, iron deficiency and cognitive development in two year old children.Environ Health Persp 1996; 104: 180–185.CrossRefGoogle Scholar
  12. 12.
    Sargent JD. The role of nutrition in the prevention of lead poisoning in children.PediatrAnn 1994; 23: 636–42.Google Scholar
  13. 13.
    Lozoff B, Wolf AW, Jimenez EJ. Iron deficiency anemia and infant development. Effects of extended oral therapy.J Pediatr 1996; 129: 389–389.Google Scholar
  14. 14.
    Lucas SR, Sexton M, Langerberg P. Relationship between blood lead and nutritional factors in preschool children: a cross sectional study.Pediatric 1996; 97: 74–78.Google Scholar
  15. 15.
    Wasserman GA, Graziano JH, Facror-Litvak P, Popovac Det al. Consequences of lead exposure and iron supplementation on childhood development at age 4 years.J Pediatr 1992; 121: 695–703.PubMedCrossRefGoogle Scholar
  16. 16.
    Kaul B. Lead exposure and iron deficiency among Jammu and New Delhi children.Indian J Pediatr 1999; 66:119–127.Google Scholar
  17. 17.
    Kaul B, Mukerjee H. Elevated blood lead and erythrocyte protoporphyrin levels of children near an auto battery recycling plant in Haina, Dominican Republic.International J Occup Environ Health 1999; 5:307–312.Google Scholar
  18. 18.
    Lamola AA, Yamane T. Zinc protoporphyrin of patients with lead intoxication and iron deficiency anemia.Science 1974; 186:936.PubMedCrossRefGoogle Scholar
  19. 19.
    Piamelli S, Seaman C, Zullow Det al. Threshold for lead damage to heme synthesis in urban children.Proc Natl Acad Sci USA 1982; 79: 3335–3339.CrossRefGoogle Scholar
  20. 20.
    Kaul B, Slavin G, Davidow B. Free erythorocyte protoporphyrin (FEP) and zinc protoporphyrin (ZnPP) measurements compared as primary screening methods for detection of lead poisoning.Clin Chem 1983; 29: 1470–73.Google Scholar
  21. 21.
    Shen XM. Childhood lead poisoning in China.Sci Total Env 1996; 18: 101–109.Google Scholar
  22. 22.
    Fischbein A, Sharif NE, Kaul Bet al. Assessment of lead exposure among Israeli children-initial findings from two surveys, international Conference of Israeli, Ecological Society and Environmental Issues; Jerusalem, 1996 June 30–July 4 (Abstracts).Google Scholar
  23. 23.
    El-Sharif N, Fischbein A, Richter E, Kaul Bet al. Blood lead concentrations in children attending primary care clinics in East Jerusalem. 1998 (In Press).Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2000

Authors and Affiliations

  • Balkrishena Kaul
    • 1
  • James 0. Rasmuson
    • 2
  • Roger L. Olsen
    • 2
  • Curt R. Chanda
    • 2
  • Tatiana I. Slazhneva
    • 3
  • Eduard I. Granovsky
    • 3
  • Andrey A. Korchevsky
    • 3
  1. 1.Kaulson Laboratories, Inc.West CaldwellUSA
  2. 2.Share International Inc.Wheat RidgeUSA
  3. 3.The Centre for Health Care and Ecological ProtectionAlmatyKazakhstan

Personalised recommendations