I’ve spent nearly 3 years carrying out an extensive literature review of the effects of lead exposure, lead distribution in Queensland, Queensland Health initiatives, and treatment options for subclinical lead poisoning.

My opinion is that Queensland Health (QH) has shown little enthusiasm for the dissemination of information about the dangers of lead exposure outside Mount Isa, or even of following their own intervention protocols outside Mount Isa. Nor is there evidence of current knowledge of treatment options. I believe “don’t know don’t care” is unfortunately the attitude of senior bureaucrats in Queensland Health when it comes to lead awareness and action.

I suggest that someone at QH might like to read this ABC News article/podcast to put things in perspective; Post-flood renovators at risk of lead poisoning – ABC News

A child with a blood lead level of 22ug/d was mentioned in the ABC News article, a level that would, in most other developed countries, have resulted in an intervention process, but not in Queensland Health, despite their own published notification protocols.

I recently came across a report that QH published in 2020, “Report: Background blood lead study in Queensland 2018 -2019”. If this report represents the best efforts of QH in the areas of current knowledge about lead and meaningful epidemiology, then it indicates a profound lack of understanding of statistical epidemiology and good science.

The report absolutely reinforces my conviction that QH exhibits a concerning inactivity and ignorance when it comes to useful activities aimed at communication, managing, monitoring and alleviating exposure to lead. Then again, it is entirely possibly the apparent ignorance is due to external influence.

A good point of focus is a rather concerning comment in the report: “There is no available clinical intervention for low concentrations of lead in the body; hence the objective of any public health action is to minimise, or if possible eliminate the exposure.“

Admittedly, the consensus 40 years ago was that nothing useful could be done to reverse the effects of lead poisoning, and also that efforts had to be expended in minimising exposure to lead, but they ought to know better by now (even 5 years ago!).

In the USA, minimising lead exposure included enacting legislation for the safe removal of lead paint, subsidising lead paint removal, and activities such as wooden window (painted with lead paint) exchange so children were not exposed directly to lead paint. An essential adjunct for minimising lead exposure is surely monitoring blood lead levels in children and adults as appropriate.

But the past 40 years have also introduced technologies and treatments which have radically changed the possibilities for the determination of lead contamination, the decontamination of lead-affected areas, the assessment of medical risk from lead poisoning and the effective removal of absorbed lead.

And yet the 2020 QH report that is the focus of this blog doesn’t show any evidence of activities to reduce lead exposure. All the report indicates is the sheer stark scientific ineptitude of the people who carried out the study.

It comprised the collection of child and adult blood samples, that were then pooled into 52 pools of 10 pooled samples per pool, which adds up to a total of 520 samples, or 0.01%  (520/5,100,000) of the population of Queensland in 2018/19. The rather shortsighted and indeed unjustifiable decision to pool the samples averages and masks whatever other information might possibly have been gained. The only thing more worrying than the poor quality of experimental design was that whoever vetted the report before publication must have been an idiot.

One of the justifications for this shockingly “poor science” was to reduce the cost of testing, If that is the case, it provides a clear indication that QH has such a low priority when it comes to managing the health aspects of lead exposure that they were unwilling to provide any meaningful funding for the execution of the testing. Queensland Health has access to Pathology Queensland, which does blood lead levels. Surely in house testing of individual (unpooled) samples could have been done even on a minimal budget?

Additional data that could have been derived is illustrated by the results of the 2007-2008 study in Mount Isa which indicated the first nations children were at higher risk.

As far as reducing exposure to lead is concerned, that requires environmental testing, and until the recent acquisition by QH (for use in Mount Isa?) of a portable x-ray fluorescence spectrometer (XRF), analysis was minimal. There is no evidence that the XRF has been used as yet, possibly because it might uncover something that the authorities don’t want uncovered.

It’s interesting that the authors of the report failed to comment on the dangers of lead paint, which is found in, on and around over approximately 700,000 buildings in Queensland, and which prompted a senior QH physician to state “As things stand, I do not believe that government owned houses, with highly contaminated soils and exposed Lead paint, are safe places for children in Mount Isa”.  (DOH-DL 17/18-048, FOI document QH). There was also no mention of the lead contamination in Townsville, where extensive lead contamination is the result of nearly 90 years of ore concentrate shipments from Mount Isa being loaded onto ships in Townsville harbour. Despite the presence of a dust monitor opposite the Glencore loading facility in the port, excess lead dust readings which occur as the ships are loaded in the mornings are averaged over 24 hours, so no “official” excess lead dust levels are found by the excuse we have for an EPA.

There is also significant lead contamination near major roads due to 70 years of using leaded petrol, lead that is still present today. We have ongoing lead contamination downwind from general aviation airports where light aircraft (piston-engined) still use leaded petrol, albeit of a lower lead content

Recent concern at the Acacia Ridge Primary school uncovered the fact that the federal EPA doesn’t have figures for leaded petrol usage, nor to they monitor lead pollution near Archefield. There is unfortunately a common perception that Avgas is superior for racing engines, so it is often still used, despite being banned and dyno testing showing it produces less power.

I should also again mention the huge area around and north of Mount Isa that is so lead-rich from natural lead that cattle, plants and humans are adversely affected by lead. In the case of the cattle, they were deemed unfit for human consumption by Indonesian authorities and are now treated to remove lead before they are sold. It’s worth noting that the cattle were also shipped to Townsville and I would hope those cattle are also now lead-free, depite no indication that’s the case.

Graziers in the lead-rich areas are decontaminating their homesteads with an industrial chelation agent (TMT, trimercapto triazine) that passivates the lead and allows them to grow chickens, fruit and vegetables free of lead. A slightly modified mixture of TMT and humectants has been patented and is now marketed as a plant growth stimulant, RC3 (Green Earth Technologies). QH neither knows about TMT or if they do don’t care. The fact that badly contaminated yards in Mount Isa and elsewhere could be decontaminated and made safe for children is after all unnecessary. Then again, there was the yard of a house in Mount Isa where that topsoil was removed and replaced with concrete and artificial grass.

First nations people also live on this lead-rich land, and that could perhaps provide an explanation for the higher incidence of cardiovascular and renal disease. How do you minimise or remove exposure to lead when the land you live on has high levels of natural lead?

Perhaps there is a need for other strategies, and different priorities.

The solution for removing lead from the body and reducing the harm caused by lead is surprisingly easy, as shown by a study of lead-affected children in Morocco. This raises the possibility of both prophylaxis (preventing the absorption of lead) and lead removal from the body to avoid the long-term deleterious effects of lead exposure. Cheap, safe, effective and unlikely in Queensland.

Queensland Health’s apparent of the effects of lead is so out of date that they still think that clinical treatment of non-clinical (less than 45 ug/dL) lead poisoning ihas no value because damage from lead poisoning is irreversible, and therefore removal of lead from the body is pointless. This is despite the current knowledge that blood lead levels above 5ug/dL cause harm. Is this ignorance or criminal negligence? My reading of internal QH documentation suggests the latter.

I couldn’t help commenting about the validity of the report to QH. Would it surprise you to learn that my comments to QH about the 2020 report have been ignored? This is despite it being over a decade since a meaningful lead exposure study has been done in Queensland, even in Mt Isa.

I’ve commented in previous blog posts that doing nothing about lead has a significant impact on our society, on our health system (cardiovascular disease, renal disease, cancer), on education (cognitive decline, learning difficulties and behavioural problems) and on the justice system (youth crime and domestic violence). And yet QH continues to ignore lead to the detriment of all Queenslanders.

Why? What are they hiding besides their own ignorance?