Lead in Australia – what you didn't know

Sorry, I lied. That’s at Broken Hill. Not Mt Isa and it’s not a big deal, but it’s a lot better than nothing.

I read the short article by Donald Howarth (RACGP – Lead exposure – implications for general practice) and I thought, wow!

Dr Howarth worked in Broken HIll and Esperance and is now a senior lecturer at the University of Western Australia. I’m going to post his Broken Hill case example below, but please read the whole article.

Broken Hill is a town in an area of desert in far western New South Wales near the South Australian border. It is the site of a huge deposit of lead, zinc and silver. The town has developed around ore deposits, with open cut workings, tailings heaps and old smelter dumps in the centre of the town. In the early days lead poisoning was common. However, for much of the past century it was felt the problem had been resolved after smelting of ore in the centre of town ceased and the dust storms were controlled by a concerted revegetation program. In 1981, a small survey of school children’s blood lead levels was taken to prove that there was no problem. In retrospect, that survey was not reassuring as the upper limit of accepted blood lead levels was then 40 μg/dL, which is four times the accepted upper limit today.

It has been suggested that the awareness of the recent lead problem in Broken Hill came from noticing that dogs were being poisoned. However, in the 1980s, a geochemist working in Broken Hill measured the lead content of ceiling cavities and found up to almost 4% lead in the often 10 cm of ceiling dust in houses. Meanwhile, experienced miners raised concerns about the re-opening, by open-cut mining, of the old workings in the middle of town and the author, along with a paediatrician, reported to the Department of Environment that 32 paediatric patients had been sampled and returned worryingly elevated levels of lead.

Action was taken to survey children’s blood lead levels after the issue was raised on ABC television in a report by journalist Justin Murphy. Subsequently, there has been ongoing monitoring of paediatric blood lead levels in Broken Hill since 1991, which has confirmed a major problem of childhood lead exposure. Meanwhile, suggestions that the lead was coming from petrol and old house paint, rather than the mines, was laid permanently to rest by blood lead isotope analysis which showed the majority of the lead in the blood of Broken Hill children came from the local mines.²⁴ In addition, soil contamination surveys showed that lead pollution fell rapidly as the distance from the mines increased.

Since then, there has been a concerted campaign to reduce lead levels in children in Broken Hill that has included public health education, home remediation and reducing the flow of new lead into the environment while stabilising or removing the most polluted soils. The program has been very successful. Over a 16 year period the mean childhood blood lead level in Broken Hill has fallen by 65%.

Importantly, a major study of lead pollution and its impact on the children in the town of Port Pirie had resulted in the Port Pirie Lead Implementation Program being established there in 1984. Port Pirie receives its lead from the Broken Hill mines by rail and is the site of a very large lead smelter. The problem in Broken Hill might have been recognised earlier had officials made the connection that there was likely to be similar lead exposure in the two towns.

Wow! What a difference. At least 50% of the children have blood test every year. Thanks to Queensland Health we have no idea about Mt Isa children and their exposure to lead. Actually, that’s not quite true anymore. It seems that someone who knows how to game the system is doing blood lead tests on leftover pediatric blood samples. Now if only QH would do that at all their hospitals we’d have an idea of what was going on.

Whie the MIM/Xstrata-commissioned Lead Pathways study also looked at lead isotope distribution to see where ground lead sources originated, I haven’t found any reference to extending that to looking for sources of lead in children or adults in Mt Isa. That would be valuable information but I think I might have found out why that wasn’t done.

I’ve been talking to Emeritus Professor Jack Ng who was involved in the Lead Pathways study. He mentioned that millions were spent so the study could be done properly. But as soon as Glencore acquired MIM/Xstrata, the funding for the study was terminated.

There is a lot that could be done, but unless Queensland Health takes a more active role in managing the effects of lead exposure in Mt Isa it’s doubtful whether any progress will be made to really minimise lead exposure. I have discovered, by accident, that some paediatric blood measurement IS being done at Mt Isa hospital, where they measure blood lead in any left over paediatric blood samples. Someone worked out how to game the system, well done!

I have been informed that several requests have been made to Queensland Health from the Lead Alliance (of which QH is a member) for enhanced monitoring in Mt Isa. Maybe that’s the testing of leftover blood?

Queensland was leading the world in lead awareness for quite a while last century, but that has changed to something more like blindness than awareness.

Let’s have a bit of history.

Dr Leslie Jon Jarvis Nye was a physician in Brisbane. His 1933 paper in the Australian Medical Journal, “Chronic Nephritis and Lead Poisoning” so concerned the Lead Industry Cartel that they commissioned a “scientific” monograph to refute it.

Although anti-lead paint legislation had been enacted years previously, it was being ignored. With support from the Premier, Forgan-Smith, and the Communist secretary of the Painters’ Union, Dr Nye was able to explain to a meeting of painters the dangers associated with lead paint and from then on, they refused to use it. The final enactment prohibiting the use of lead paint did not become law until 1956.

That was a brilliant way to bypass the Lead Industry Cartel that paid a “scientist” to discredit his publications about the dangers of lead paint.

Lead paint is particularly dangerous to children because it tastes sweet and is almost irresistible to children (and animals). If a child is iron deficient, Pica (eating dirt) is one of the symptoms. What makes pica particularly dangerous is that the dirt or lead flakes can get stuck in the gut, and in the case of lead paint or ore, it now provides a continuing source of acute lead exposure to the child.

In the USA, if a child fronts up with high blood lead levels that don’t drop after serial testing, the next step is an x-ray of the abdomen. If lead is detected, it’s purged out. Not sure we do that here though. Probably not.

Australia has a long history of recognizing the effects of lead on children.

It has an equally long history of special interest groups trying to modify public awareness of the effects of lead, to reduce the perception of the dangers posed by lead to our children and to ourselves. In the 1930s it was the lead industry cartel.

I’d encourage watching a short YouTube video by Professor Mark Patrick Taylor who is now the Chief Scient of the Victorian EPA (https://www.youtube.com/watch?v=giKPKiMydms). He makes some points that are worth repeating: the most vulnerable part of the population when it comes to lead poisoning is children, and children are our future. 

It’s very hard to assess the degree of lead exposure of a child because the only indicators we have are internal, usually blood lead levels (BLL). As a result there is now a massive amount of medical, scientific, and epidemiological data about the increasing harm caused by lead as a child’s BLL increases.

BLL increases are accompanied by depressed neurological function, including reductions in cognitive function (learning and memory), altered behavior and mood (attention, hyperactivity, impulsivity, irritably, delinquency), and altered neuromotor and neurosensory function (visual-motor integration, dexterity, postural sway, changes in hearing and visual thresholds). Many of these been associated with BLL levels of 5-10ug/dl, which have been observed many times in children in our more lead contaminated cities.

There appears to be no “safe” level for lead when it come to exposure of children, especially infants 0-4 years of age.

Please, please take the time to watch Ralph Spezio’s YouTube video (https://www.youtube.com/watch?v=mSwHSE6_ZoI) because it will absolutely put things into perspective for you about what lead exposure can do to children, whether you live in Mount Isa or Townsville or Broken Hill or Port Pirie or not. If your farm is near the Cadia Gold mine, or you live in Esperance, the children he is talking about could be yours.

He is talking about levels of blood lead that our medical authorities define as non-clinical, and therefore no attempt is made to reduce a child’s body lead levels.
The only place where I disagree with Ralph is where he says the effects of lead in children are permanent. Some of the effects can be reversed, particularly the ones presenting as behavioural and learning problems. Some lead damage is reversible either through appropriate educational therapies, and some by removing the lead.

One possible argument that has been used to justify doing nothing is that most, almost all the data about lead and it’s effects are from somewhere other than Australia. That implies that Australian children are special, which they are, but also that they are possibly more “immune” to the effects of lead, which they aren’t. Or maybe it indicates that Australia values it’s children less.

The table below uses data that is almost 10 years old, but it’s interesting nonetheless.

The percentages indicate how much the various categories measured are different to the Australian norm. The bigger the number, the more affected that population of children is by lead. The data is mostly about Port Pirie and Mt Isa, but it includes Townsville because areas of Townsville near the port have been polluted by lead from Mt Isa for the past 90 years.

Then I’d like borrow some quotes from a way-too complex article that is full of useful information (pharmacokinetic model of lead absorption and calcium competitive dynamics (https://doi.org/10.1038/s41598-019-50654-7)).

I’m going to quote parts of the section on age dependence and effects in children (the bolding is mine):

Health effects include anaemia, renal alterations, impaired metabolism of vitamin D , growth retardation, delayed puberty. Exposure to lead during childhood is also well-known to result in neurobehavioral effects that persist into adulthood and may not be evident until a later stage of development (making difficult a correlation, or a precise quantitative assessment of these effects). Delays or impairment in neurological and neurobehavioral development have been noted even at very low doses, and include encephalopathy, lower cognitive performance, neuropsychiatric disorders such as attention deficit hyperactivity disorder and antisocial behaviour.

While toxicokinetics of lead in children appears to be similar to that in adults, the action of many xenobiotic metabolizing enzymes seem to depend on developmental stage. This leads to the children’s increased susceptibility to toxic effects of lead or to detoxification, although the exact mechanisms of this sensitivity is not completely understood. Children and adults may differ in their capacity to repair damage from the deleterious effects of lead poisoning. However, it is important to note that children also have a longer remaining lifetime in which to express damage from toxic exposure.

The closing comment is a bit cruel, suggesting children will be around longer to appreciate the effects of lead exposure.

To bring the information a bit closer to home I recommend you read Nancy Hallaway’s e-book (https://www.amazon.com.au/Autism-ADD-Lead-Poisoning-Turning-ebook/dp/B09KS1HF62). It will cost you $8 to download from Amazon, and it will be the best thing you’ve read if you’re at all curious about what lead exposure can do to children. Nancy’s twins were poisoned with lead when their parents renovated an old house painted with lead paint.

In Nancy’s story, removing the lead by using oral chelation therapy resulted in a profound improvement in her twins behaviour. This absolutely make the point that some of the effects are reversible if the lead is removed. It’s a pity that most doctors don’t understand that.

In case you think that couldn’t happen here, ANY home in Australia that was built before the 1970s is likely to be covered in lead paint. That probably fits a lot of the public housing initiatives in Australia. You could be living next door to one. It some ways lead is a worse danger than asbestos, particularly to children, but aside from some warning, there is no legislation in place to encourage the safe handling of lead paint.

There is an extensive review of the relationship between lead levels and youth crime (Talayero MJ, Robbins CR, Smith ER, Santos-Burgoa C (2023) The association between lead exposure and crime: A systematic review. PLOS Glob Public Health 3(8)) that has a few things worth repeating:

Children do not absorb or metabolize lead in the same way as adults and are far more susceptible to the negative impacts of lead exposure due to a hyper-permeable blood-brain barrier and rapidly developing organ systems [88–90]. Animal studies have demonstrated adverse neurobehavioral effects in animals exposed to lead [10, 11], and multiple ecological studies have demonstrated an association between lead exposure and criminal behavior [7–9, 16]. This review demonstrates an association between exposure to lead and the later development of delinquent, antisocial, and criminal behavior.

In young adults the lead induced antisocial behaviour manifests itself as increased youth crime and violence. Does that possibly ring a bell for people who live in Mt Isa or Townsville? Or suggest that jail or youth detention might not be the only solution? We treat all sorts of mental conditions with drugs, but we refuse to treat lead-affected youth offenders with chelators.

Actually that statement isn’t quite fair, because by not testing youth offenders for blood lead levels, we have no idea they’re lead-affected.

The last commentary comes from a short article that relates to the tragedy at Flint Michigan when officials trying to save money ended up poisoning the adults and children of Flint with lead.

The effects of lead poisoning are not usually detected in a short visit with a doctor. The population impacts are, however, staggering. The consequences are one or two more kids in each classroom with symptoms of attention deficit hyperactivity disorder, 10 or 15 more kids in each school in special education programs, and fewer kids who are truly gifted. A five-point reduction in average IQ caused by widespread exposure to lead
will result in a 50% increase in the number of children with IQ scores below 70 and a 50% decrease in the number with IQs higher than 130. In adults,
lead exposure results in cardiovascular and kidney problems. And some studies have shown that children exposed to lead are at increased risk for school failure, unemployment, and incarceration.

I know you’re hearing the same message over and over again, but you need to appreciate that there are children, thousands of children, in Australia who have been or are being exposed to lead, who have been and are being harmed and who are not treated. We at the very least need to make certain that exposure to lead is reduced as much as possible. Educating our doctors to test for blood lead and realise that lead causes harm wouldn’t hurt either.

A last comment, paraphrased from Mark Taylor is that the companies that mine, smelt and use lead may have licenses to pollute, which is the end result of setting pollution limits. You’re allowed to pollute, but not too much. But they are not licensed to poison our children.

I’ve used the word legacy a lot when I wrote about the accumulation of lead in a lead workers body, and what that meant in terms of health outcomes.

So I’m going to start with a blog about some of what that that legacy means.

A really good place to start is with an e-book, Lucifers Curves: The Legacy of Lead Poisoning. Lucifer Curves by Rick Nevin – Ebook | Everand

Statisticians noticed that as the amount of leaded petrol used went up, the incidence of a whole lot of other things were also increasing. Things like youth violence, number of unwed mothers and so on. The fact that these things might be related didn’t register until leaded petrol began to be phased out and as the use of leaded petrol dropped, so did youth violence and so on. The rise could have been due to changes in the living conditions of people, changes in diet, other environmental factors and so on. But when the use of leaded petrol dropped, and the incidence of a whole lot of other things dropped accordingly, people noticed.

When the graphs of lead vs everything else were compared, some of the curves matched, almost perfectly. That’s what the book is all about, the sociological and other changes that matched up with the use of leaded petrol. It also has some interesting commentary about politics in the UK.

There are other interesting statistics, like the ones that came out of a relatively large epidemiological study where over 10,000 people were studied for about a decade, with regular interviews, health checks and blood tests. One significant statistic that came out of the study was that as blood lead levels went up, so did the incidence of cardiovascular disease.

Lead is a biological irritant as well as inhibiting sulphur-containing regulatory systems, and interfering with neurotransmitters. So as the effects of lead have been studied, all sorts of other parallels have been found between blood lead levels and other diseases.

I’ve talked about atherosclerosis before, and I think I’ve mentioned the finding that blood pressure increased as blood lead levels increased in former soldiers. I view soldiers as lead risk workers that aren’t working in a safety controlled work environment. They do have armoured vehicles and flak vests though, which actually puts them in a slightly better position than workers protected by RSHQ regulations at the moment, but that’s being petty.

In case there’s any doubt about the link between lead and cardiovascular disease, please read “

A prospective study of bone lead concentration and death from all
causes, cardiovascular diseases, and cancer in the VA Normative
Aging Study” by Weisskopf et al, Basic Life Science 1990,:55:267-74.

I’ll quote their conclusions:

We found bone lead to be associated with all-cause and cardiovascular mortality in an environmentally-exposed population with low blood lead levels. This study suggests that cumulative lead exposure from prior decades of high environmental exposures continues to significantly impact risk of death despite recent declines in environmental lead exposure.

The declines in environmental lead exposure refer to decline in the use of leaded petrol in the US.

Talking about the effects of lead in children will be some later blogs, but since my time on the computer is being restricted a bit (my wife!), I thought I’d bring up a few interesting stories.

Prostate cancer was relatively rare according to a surgeon at The London Hospital (J Adams) in 1853. That’s no longer the case, with a current saying: “More men die with prostate cancer than because of it”.

So something that was uncommon before the 20th century, was relatively common in 1945 is now the commonest male malignancy.

Over the years prostate cancer treatment has progressed from surgery with hideous complications, to biochemical/drug treatments and minimally invasive surgery.

There were gloriously awful incidents where the use of estrogen for example, was thought to reduce the risks of prostate cancer, and actually made things worse, but I’m wandering.

The are a lot of other possible environmental factors that could be responsible, but when researchers started looking at possible causes, they found an interesting correlation between blood lead levels and prostate cancer. That’s not totally surprising to me, not because I’m paranoid about lead (much) but because I read a report on the distribution of lead in the body at autopsy. They basically took a whole lot of tissue samples from cadavers and analyzed them for lead content. Lead in bones won the contest, followed by lead in the brain, but while high levels of lead in the aorta fitted in nicely with the link between lead and atherosclerosis, there was also quite a bit of lead somewhere else, in the prostate. That was unexpected.

The possible message is that as blood lead levels increase in older males, and even not so old males, the incidence of prostate cancer and prostate hyperplasia goes up accordingly.

After a bit more searching in the medical literature, I came across a bunch of papers that talked about the possible effects of lead on the prostate. Think about this scenario: lead causes inflammation and the tissues in the prostate respond by producing calcium deposits. I had no idea that part of the process of prostate hyperplasia was due to the deposition of calcium calculi. I guess you could call them prostate stones. The “stones” were ignored by radiologists for quite a while, but some clinicians are starting to look at ways to reduce hyperplasia and blockage of the urethra by using ultrasound, as with kidney stones. That could lead to treatments where they no longer have to ream out your urethra as it gets blocked.

While we’re on the subject of calcium, here’s a bit on the effects of lead on your bones.

Exposure to lead is associated with decreased femur and spine bone mineral density and increased risk for fracture in premenopausal women. It also significantly decreases the mineral/matrix ratio, collagen maturity and crystallinity in the trabecular bone, increasing bone turnover and resulting in weaker cortical bone.

What this means to you is that lead will weaken your bones and make them more likely to fracture. It also delays fracture healing and as a bonus it may exacerbate bone loss and osteoporosis in the elderly.

Now a bit more on the legacy lead in your bones represents.

There is a case study in 1945 (British Medical Journal) that nicely illustrates what I’ve been trying to tell you about lead in your bones being a timebomb. It concerns a 31-year-old compositor (printer/typesetter) who had been quite healthy, but he came to hospital after becoming seriously ill. In those days hospitals still routinely measured blood lead and that uncovered something totally unexpected. Serial blood tests showed his blood lead levels rising steeply from 280ug/dl on admission to 455ug/dl 2 weeks later. It was later determined that he had leukemic hyperplasia that was responsible for the release of lead from his bones. That was from lead he had accumulated in his bones working for 12 years as a compositor.

Lead in bones isn’t biologically inactive, because bone is constantly being rebuilt and the more lead you have in your bones, the higher your blood lead levels will be in the presence of further exposure to lead. If the lead is rapidly released for any reason, such as gestation, breast feeding, osteoporosis,  blood cancer or parathyroid disorders, frank lead poisoning may result.

An article in 1996 published in Environmental Health Perspectives, looked at the relative contribution of skeletal lead to lead in the circulation using lead isotope ratios. The study used blood lead and bone lead samples from lead-affected individuals undergoing total hip or knee replacement.

One of the conclusions was that:

The skeleton is an important endogenous source of lead exposure in environmentally exposed  subjects.

A last couple of depressing examples for today, and there are many more, is a direct association between lead concentration and HPV-positive cervical cancer. Plus an Australian study that showed a 7-times greater risk of oesophageal cancer as blood lead levels exceeded 30ug/dl in lead risk workers.

I made the comment that there were many examples of a link between cancer risk and lead levels. Lead in your body not only damages cells and DNA, it has a depressive effect on your immune system. So not only can lead potentiate cancer, it weakens your bodies’ immune system so you’re less able to fight the resulting cancer.

I wish I was making this up but I’m not. Why oh why don’t our Health services take lead exposure seriously and treat it like the epidemic it is?

Isn’t that a brilliant legacy. Something to look forward to when you get older?

I think I’ve pointed out a few times that lead can be removed. So if lead causes or triggers cancers, maybe they can be avoided.

It’s nearly time for me to go up and prepare breakfast for the family (tradition on Saturday mornings, I serve pancakes with fruit and whipped cream) so I’d better finish this up now.

Sorry, I really do have to finish up. More to come 🙂

As you’d know, I’ve been trying to get some sense out of the mining safety regulator, Resources Safety and Health Queensland, RSHQ. I have to admit that I didn’t understand the “role” of RSHQ when I was trying to get a meaningful answer out of them about safety issues. An example of an email I sent to the RSHQ (chief hygienist) appears below:

— start email to RSHQ ——-

I am aware that you have been away and have a lot of catching up to do including wading through many emails.

When you get to this one, I would ask you to give it some priority because it discusses a grave failure in your organization’s lead biohazard safety processes, as outlined in the email below this one. The repercussions could be unfortunate for your organization..

A failure to recognize that lead accumulates in lead workers bodies and can have serious consequences in later life for those workers, has major ramifications.

A lead worker female of child-bearing age can accumulate a significant body lead burden, and if she has a child, years after leaving lead risk work, lead from her bones will be passed to the foetus. If she breastfeeds, that lead will be passed to her child in her milk. That can cause devastating harm to the child in terms of developmental damage, learning difficulties and behavioural problems.

There was a recent case, Sanders vs Glencore (Mt Isa Mines) that involved a child affected by non-occupational lead exposure in Mt Isa. If a female lead worker were to prosecute a similar case on behalf of her child, Glencore and RSHQ as the regulator responsible for the lead biohazard safety protocols, would undoubtedly be found at fault.

Lead also has significant neurological effects on adults, including intellectual impairment, reduced decision-making ability and a tendency to violence. This can manifest in many ways including violent crime, and perhaps even domestic crime.

That is the legacy that lead workers carry from their time working in a lead risk environment.  They carry that legacy because the safety protocols set up to allow them to work safely were not only inadequate, they failed to recognize the bioaccumulation of lead.

The safety regulations that should have kept them relatively safe, failed them. That’s why I’ve contacted you, in part to forewarn you..

I may be over-estimating the effect this news will have on lead workers, although my blog https://leadtox.blog is certainly attempting to keep them informed.

At the point where the news media become aware of this situation, it could become extremely awkward for all parties responsible. I don’t think that would be the best outcome in terms of solving this problem, so I urge you to communicate with me, involve Glencore and seek a sensible path to avoid notoriety.

—————

I thought that was pretty blunt really. Regardless of their level of responsibility, surely there would be some reaction to a suggestion that RSHQ might not be doing their job. After all, their logo is

Zero serious harm obviously means something else to me than the people in the organization that came up with a snappy logo. I wonder if they appreciate the joke the way I do. It obviously doesn’t mean zero harm to workers, because they’re prepared to ignore serious harm to workers and in the case of female workers, even to their children.

If RSHQ were at all serious about zero serious harm, I wouldn’t be writing this blog. 

I guess my worst case expectation was something like (this require a small quotient of giving a damn):

We recognize there appears to be a problem with the biohazard monitoring and management, but our regulations are based on the model from Safe Work Australia, and we are not in a position to change the regulations within that framework. However, we have forwarded your information to SWA together with your details for their consideration.

Please be assured that’s not what happened. Instead, I received the following reply from the Chief Inspector:

Under Queensland Legislation, mines are required to ensure a safety and health management system is in place which ensures the level of risk to persons is at an acceptable level. Site senior executives must also ensure that persons carrying out work at a mine are fit for work and carry out relevant health surveillance measures including a medical from an appropriate doctor when a person first joins or re-joins industry and periodically (not more than five years) while they are a worker.

I realise RSHQ’s job is the enforcement of regulations, not the modification of regulations, but this reply shows a pretty severe case of tunnel vision or a lack of imagination, particularly in the face of my comments in the email about legal consequences. Then again, I may just be unrealistic in my expectations.

Think about what I said in the email to RSHQ, about accumulated lead being passed from mother to child, and what that means. I’d better spend some more time talking about what lead that’s stored in the bones does to people in the long run, and what it does to children.

In the midst of all the bad things that lead “could” do to you, remember one thing., lead can be removed from the body. That won’t necessarily reverse any damage already done, but it will stop things getting worse, and removing lead can make things a lot better, especially some of the neurological effects.

It should absolutely be possible to work in a lead risk environment and still be safe from the toxic effects of lead. It should absolutely be possible to safely have and raise children in that scenario. If only the people that could make things safe stopped covering their butts and did something.

But it rather looks like RSHQ limit their interest to their regulations, and even there, there are failures. Think about the cartoon below if you disagree.

I’ve been getting some feedback, specifically relating to sections of the Safe Work Australia guidelines and RSHQ Regulations. Some of this has been presented before but I think it’s important to go over it again. with a bit of emphasis.

In a nutshell, your employer has a regulatory obligation to inform you of risks you face as a lead worker. That is, you have the legal right to know what you’re signing up for when you engage in lead risk work. (The italics and bolding below are mine).

From the RSHQ regulations,

145B Giving information about health risks of lead process
(1) A site senior executive for a mine must give information about
a lead process carried out at the mine to a worker at the mine
before the worker is first exposed to the lead process.
(2) If work is identified as a lead process after a worker is
exposed to the work, the site senior executive must give
information about the lead process to the worker as soon as
practicable after the lead process is identified.
(3) The information that must be given is—
(a) information about the health risks and toxic effects
associated with exposure to lead; and
(b) the need for, and details of, lead health surveillance and
biological monitoring under schedule 2E, part 4

That’s pretty clear. You are supposed to be told about the risks of lead exposure. There’s a lot more detail about what you are supposed to be told in the Safe Work Australia Guidelines:

Workers should be informed of the potential health effects associated with exposure to inorganic lead including the different risks to men and women and people of younger age (i.e. less than18 years of age).

Workers should be informed of the bioaccumulation of lead and be advised to minimise exposure particularly for long term lead risk work.

Family planning

Workers who consider they have not completed their family should be counselled on the health effects of lead on male and female reproduction, as appropriate.

Female workers working in lead risk jobs should be informed exposure to lead during pregnancy may be associated with pregnancy complications and may pose a risk to the development of the foetus. Female workers should be counselled on the effects of lead on foetal and childhood development, in particular cognitive development.

Females of reproductive capacity should be informed about the reproductive health risks where blood lead levels may exceed 10 μg/dL (0.48 μmol/L). It is highly recommended that in order to give maximum protection to the foetus, women who are planning a pregnancy should endeavour to limit lead exposure to a blood lead level well below 5 μg/dL (0.24 μmol/L) for a period of at least a year prior to pregnancy.

Male workers should be informed that exposure to lead may adversely affect reproductive function.

I’ve posted more of this guideline, with my comments, in a previous blog about the harm, particularly to women of child-bearing age but I’ve presented that before, and I’d rather concentrate on the disclosure aspects.

In other industries, when employees are informed about issues like security that are potentially part of a legal process, they are asked to sign a statement that they have read and understood the contents of the statement.

Disclosure of the risks incurred in a lead risk procedure appears to be a legal requirement, so I would expect that Glencore would have proof that each and every one of their lead workers has read and understood a comprehensive list of health hazards they face due to enhanced lead exposure.

A legal requirement. And yet I’m getting feedback this may not have happened.

IF that’s the case, and it’s entirely possible people have simply forgotten, but IF that’s the case, then not only have you not been informed, but you haven’t been properly or effectively monitored and you haven’t been treated to remove the harmful lead either.

I’m not actually at a loss for words to describe this situation, but I am aware of libel definitions.

Unless something positive happens, every single one of you will walk away from your lead risk jobs with a toxic legacy that will cause harm for the rest of your possibly shortened life.

When I first approached Glencore, I expected some sort of affirmative reaction. Something like: “Crap, how did that happen, we need to do something to gauge the risk to our workers and do something about remedying that risk.” The meeting with Glencore suggested that might be the case. Except for the principal – health and hygiene who argued that Glencore were following state, national and even international safety standards and guidelines, and there was nothing more that needed to be done.

Okay, I can understand the bind he’s in, the regulatory maze and the sheer frustration of changing established procedures. But it couldn’t be any more frustrating than what I’ve gone through, and I’m not a paid employee responsible for the health and safety of Glencore workers.

But I carried on, telling them about XRF measurement of bone lead and therefore lead burden in the body and a way (chelation) to remove the lead if needful.

I gave them that information, offered to work with them, pro bono, to put together a full solution. But I couldn’t offer a total solution because it was largely a one-way communication, but there is enough there, including help offered from Purdue University for establishing the XRF measurement, for Glencore to deal with this situation fairly quickly.

If they wanted to.

I should explain that I’m not being noble or altruistic, I’m angry clear through because a relative of mine is in harm’s way in Mt Isa and no one seems to care, and then there are the children of Mt Isa. I guess I’m pretty disgusted too. What a mess.

If Glencore can’t prove that full disclosure about the health impacts of working in a lead risk environment was in fact provided, they have a bigger problem. The great pity is the repercussions of WHS violations are apt to fall on the local WHS people, not the people at head office responsible for blocking any change.

I really don’t care about someone at Glencore getting into trouble, what I really care about is creating a situation where lead workers can work in a lead risk environment safely. And their families too. Kids can be terribly impacted by lead exposure in their early years of development, and that doesn’t need to happen. IT SHOULDN’T HAPPEN.

Got that? Work and live in Mt Isa SAFELY. Sure, there are physical hazards in any industrial setting, but we know that if you’re reasonably careful they are avoidable. If you aren’t, shit happens.

But if you work in a lead risk environment, right now, the hazards are unavoidable. Why would you not want to be protected from biological hazards? If lead can be removed before it causes any harm, you can work as safely in a lead risk environment as anywhere else, maybe more so.

Lead continues to accumulate in the body, every single day you work in a lead rich environment AND that increases the risk until something breaks. Maybe not now, but years later. If you’re a mother after leaving Mt Isa, you’ll harm your child because of the lead in your body passing to your baby.

Why would you not want to avoid that harm if you could? Ultimately you have no control of the biological hazards that Glencore fails to manage, unless you can protect yourself by removing the lead that’s causing harm. Oral EDTA will most likely stop the further accumulation of lead and it’s possible it would reduce your lead burden. But there’s no way to prove anything until the body lead burden can be measured and until there is at least a simple trial to establish standard of care.

I’d like to apologies about this rant, but I’ve tried to connect with Glencore yet again and been ignored, yet again. I’m getting beyond disgusted. They either don’t care, or they’re not allowed to care. Either reason is a poor reflection on Glencore and what it stands for as far as the safety of its workers are concerned.

Tomorrow, I talk with the Resources Safety and Health people (if they’ll talk to me, which isn’t assured yet) to try and sort out this mess, so you stop being left in harm’s way.

But I haven’t given up. I’ve been told Robbie Katter, the member for Traeger, worked in the smelter in Mt Isa in his 20s when things were a bit wilder . He’s about to find out about the legacy he is carrying with him from his days at the smelter. I wonder what he’ll think.

This is going to be a short post from my viewpoint because I’m mostly going to quote from Safe Work Australia’ “Health monitoring – Guide for inorganic lead”. https://www.safeworkaustralia.gov.au/system/files/documents/2002/health_monitoring_guidance_-_lead.pdf Just the interesting bits though.

Remember, this document is the basis for the RSHQ regulations, but it has some interesting extra comments that you may not have seen. I’ve bolded the stuff I think you might find interesting. My comments will be in brackets.

Here are some quotes from the section on lead hazards which are supposed to be communicated to lead risk workers before they start lead risk work.

Health effects of lead

Workers should be informed of the potential health effects associated with exposure to inorganic lead including the different risks to men and women and people of younger age (i.e. less than18 years of age).
Workers should be informed of the bioaccumulation of lead and be advised to minimise exposure particularly for long term lead risk work.

(You knew this, right?. If you’ve read my previous blogs so you already knew that lead accumulates in the body, and I’m sure none of you have worked in Mt Isa for longer than 6 months?))

(I haven’t mentioned the effect of lead on reproductive function yet because it is so well known. That’s right isn’t it?)

Family planning
Workers who consider they have not completed their family should be counselled on the health effects of lead on male and female reproduction, as appropriate.

(I’m sure they would have warned you about the fact that some of the DNA damage caused by lead could muck things up in terms of eggs and sperm and offspring?)

Female workers working in lead risk jobs should be informed exposure to lead during pregnancy may be associated with pregnancy complications and may pose a risk to the development of the foetus. Female workers should be counselled on the effects of lead on foetal and childhood development, in particular cognitive development.

(May be? That ought to read WILL BE)

Females of reproductive capacity should be informed about the reproductive health risks where blood lead levels may exceed 10 μg/dL (0.48 μmol/L). It is highly recommended that in order to give maximum protection to the foetus, women who are planning a pregnancy should endeavour to limit lead exposure to a blood lead level well below 5 μg/dL (0.24 μmol/L) for a period of at least a year prior to pregnancy.

(That means don’t go anywhere near lead for at least 12 months. Bit hard in Mt Isa, and anyway, the lead you’ve accumulated is still there.)

Male workers should be informed that exposure to lead may adversely affect reproductive function.

(They told you that a vasectomy was a good idea before you signed up, didn’t they?)

Pregnancy and breastfeeding
Workers who are pregnant or breastfeeding should be advised to seek alternative duties (that do not involve lead exposure) from the person conducting the business or undertaking (PCBU).
Infants are more susceptible to the health effects of lead than adults. A breastfeeding worker should keep her blood lead level as low as possible.

(Blood lead is primarily lead bound to red blood cells). In a breastfeeding mother the calcium in her milk, and the lead, for the most part comes from her bones. Blood lead levels do not reflect bone lead except after several months of no exposure to lead. In Mt Isa?)

(How many babies have been harmed because we don’t have any accurate estimate of the amount of lead in a persons’ body, and the attendant risks? How many babies have been harmed because lead wasn’t removed, just left in place?)

Other health monitoring methods
The distribution and clearance of absorbed inorganic lead is such that urine lead levels are not considered a suitable indicator of inorganic lead exposure.
Lead inhibits the mitochondrial enzyme, ferrochelatase, and delta-aminolaevulinic acid dehydratase (ALAD); both are involved in haem synthesis. This inhibition results in the accumulation of protoporphyrin in red blood cells, which chelates with zinc instead of iron to form zinc protoporphyrin (ZPP), also resulting in increased urinary excretion of coproporphyrin.
Blood ZPP levels have been used as a measure of lead exposure to differentiate between recent exposure and chronic accumulation. As ZPP remains in erythrocytes for the average lifespan of the red blood cell, the blood ZPP level reflects averaged exposure over a three-month period. There is a wide range of inter-individual variability in the protoporphyrin response to lead absorption and it is suggested results are compared with previous results from the same individual with monitoring of the individual response rather than interpretation of a particular level. The protoporphyrin response lags behind the current blood lead level by two to three months as an increase only becomes measurable in the peripheral blood as affected erythrocytes mature and are released from the bone marrow. It is recommended testing for ZPP as a measure of lead exposure only be considered once removal limits have been reached. As with blood lead levels, continued exclusion from lead work is recommended until levels return to satisfactory levels.
There can be limitations of this method compared with measurement of blood lead levels:
– low sensitivity and potential false negatives, and
– lower specificity – ZPP levels can be influenced by conditions other than exposure to lead.

(ZPP used to be used confirm lead exposure, before that it was a stippled appearance of the blood. As lead detection methods improved, the older indicators were largely dropped. but they still don’t measure body[bone] lead), which is what really counts. )

(Talking about technologies that were used before the age of chemical and ICP-MS blood lead measurements may be an indicator of just how long it’s been since someone did a decent job of bringing these guidelines into the 21st century)

(But this gets better)

Target organ/effect
One of the main targets of inorganic lead toxicity in adults is the nervous system – central and peripheral. Severe exposures may cause encephalopathy and progressive degeneration of certain parts of the brain, coma or death.
Chronic high level workplace exposure to lead damages the peripheral nervous system, resulting in local paralysis, or ‘lead palsy’. Workers with lower levels of exposure may experience fatigue, irritability, depression, insomnia, headaches and subtle evidence of intellectual decline.
Exposure to inorganic lead may also damage the formation and functioning of red blood cells. Anaemia is one of the most characteristic symptoms of high level chronic lead exposure.

(Not quite. Once you’ve got enough lead on board anaemia is a given)

Low to moderate exposure may result in cardiovascular effects, including increased blood pressure and electrocardiographic abnormalities.
Once in the body, lead is transported in the bloodstream, entering all body tissues. Only two to five per cent of the total body lead is found in red blood cells. Approximately 94 per cent of the total body burden of lead is in the bones for adults. Lead is preferentially stored in the skeleton and in regions undergoing the most active calcification at the time of exposure – both cortical and trabecular bone.
Distribution of lead to various organs is variable as are elimination rates. Blood lead clearance after an exposure change is approximately 20 to 35 days, while red blood cells have a half-life of 120 days. Redistribution from bone is much slower and takes approximately three to 30 years. Due to the slow clearance rate from the body, lead can accumulate in various organs, including the bones.
Body recovery is slower each time exposure occurs and body burden continues to accumulate with repeated exposure. Clinical treatment using chelation therapy to reduce lead levels may decrease total lead body burden but not the risk of cognitive effects.
Lead affects people of all ages, but the effects of lead are considered most serious in young children.

Observed health effects and blood lead levels
The adverse health effects of lead have been well documented over the years in both occupational and non-occupational studies. A summary of health effects from occupational studies and their associated blood lead levels can be found in Figure 1 below.
Research in non-occupational settings has indicated:
– increased risk of spontaneous abortion and potential for postnatal developmental delay at maternal blood lead levels ≥ 5 μg/dL

– hypertension and kidney dysfunction at blood lead levels ≥ 5 μg/dL
– reduced birth weight and potential for subclinical neurocognitive deficits at maternal blood lead levels ≥ 10 μg/dL
– increased non-specific symptoms at blood lead levels ≥ 30 μg/dL
– neurocognitive effects, sperm abnormalities nephropathy, anaemia, colic, gout at blood lead levels ≥ 40 μg/dL, and
– encephalopathy and peripheral neuropathy at blood lead levels ≥ 80 μg/dL.
Medical conditions that may be exacerbated with continued exposure to lead include chronic renal dysfunction, hypertension, neurological disorders, and cognitive dysfunction.
Non-specific symptoms may include headache, fatigue, sleep disturbance, anorexia, constipation, arthralgia, myalgia, and decreased libido.

(Well that’s it from Safe Work Australia. That ought to be a reliable source. Did you get the mention about gout?)

(This is stuff you should have been advised about when you became a lead risk worker. Did they make you sign the document to prove you understood all this?)

The people (SWA) that make the broken regulations that don’t take accumulation of lead into account absolutely know what the bioaccumulation of lead will do to you. But they produced a regulatory model for lead risk workers that ignores almost everything they know. That’s an absolute travesty. How did they get away with this in the 21st century?

We now know quite a lot about the action of lead on the brain. The brain is second only to bone when it comes to retaining lead. As the amount of lead in the body, and brain increases, we see early indicators of neurotoxicity that include changes in behaviour and fatigue.

I’ve found a very interesting review on toxic metals including lead, which talks about neurotoxicity. It can be obtained here: EDTA Chelation Therapy for the Treatment of Neurotoxicity – PMC (nih.gov)

I have a a great number of scientific papers on lead neurotoxicity, especially in children, but this one covers a lot of ground, expands to other toxic metals in general and has some interesting case studies and it’s short. It also mentions chelation challenge and what it tells you.

It’s worth noting that this review was written by Italian authors because Italy is relatively enlightened compared to the US, UK and Australia when it comes to EDTA and chelation as a treatment for toxic metal poisoning. They just see chelation as one of the things you do to treat patients, not some quackery. They treat causes rather than symptoms, something I find quite refreshing. Pity that approach isn’t more common in our medical profession where it’s more usual just to treat symptoms.

Having said that, I’ve also come across a different reason for seeing reduction of exposure as being more important than chelation. Lead poisoning is a long-term condition because of lead in the bones. Parenteral or relatively high-dose oral chelation causes a near immediate drop in blood lead levels. But these increase again due to bone release. In my mind if you can only remove lead from bones very slowly, then that is surely the way you should do it, with lower doses of oral chelators administered over possibly a year or more.

There are also the oft-repeated comments about past misssteps while chelation was still in the wild west, but they are no longer relevant. Nevertheless, this topic deserves a bit more attention because it is one of the reasons Glencore uses to justify chelation as too risky and experimental.

In the meantime, I’m going to be a bit lazy and use parts of this review as the outline for my post, because if you don’t take the trouble to read it (it’s quite short, really) you still ought to know what’s there, for the sake of your own health. Direct quotes will be in italics.

I will mostly stick to the lead-relevant parts of this review, but please read it, if for no other reason than to be sure I haven’t made this up. I’m only giving you part of a quite scary story.

The chelating agent calcium disodium ethylenediaminetetraacetic acid (EDTA)—previously used to treat cardiovascular diseases—is known to be useful for the treatment of neurodegenerative diseases

…….

Oxidative injury is linked to Pb-induced neurotoxicity, and chronic exposure to Pb can induce cognitive dysfunction. It has been shown that a lifetime exposure to Pb causes neurodegenerative damage in rats (decreased neuronal densities and brain volumes) that begins to occur during infancy and is relieved during adulthood before intensifying during old age.

This appears to be true for humans as well. Infants from 0-4 years are greatly affected, older children less so and the effects are less visible in adults, until they get older. It’s not in this review but I have a case study where an elderly lady presented with dementia-like symptoms, that turned out to be due to lead from her bones that had been released by osteoporosis. She was poisoned by lead in old age, by lead she’d picked up when she was a lot younger.

But that’s not all, because lead has been directly implicated as a contributing factor in multiple sclerosis (MS). Parkinson’s disease and Alzheimer’s disease. I have to point out that aluminium and other toxic metals are implicated as well but I’m concentrating on lead. The big deal is that by removing the toxic metals, including lead, the outcome can result in really significant improvements.

But what if you could avoid this situation completely? You know, get rid of the lead before it becomes a problem? I mean take some EDTA and get rid of the lead yourself.

A common way to find out what toxic metals are in the body is with what is called a chelation test or challenge. This consists of an IV administration or oral of EDTA, followed by urine collection and analysis. The urine sample is acid digested, followed by ICP-MS (inductively coupled plasma mass spectrometry) measurement of the quantities of heavy metals.  ICP-MS is also used to measure your blood lead levels.

The review presents a case where EDTA reversed damage to the kidneys because it’s an antioxidant in addition to being a chelation agent. I need to be precise here and state that EDTA acts like an antioxidant because it prevents free radical (ROS) damage.

It’s important to remember that when you come across the medical comment about EDTA causing kidney damage. I’ll elaborate later.

We get to a couple of case studies which I found a bit frightening because I’ve had MRIs with a gadolinium contrast medium. All the radiologist asked me beforehand was if I had an allergy to gadolinium and I said no. My answer now would be a definite yes.

Anyway, the important aspects of the case studies to me, besides the gadolinium, was that the patient’s health improved after EDTA chelation therapy and removal of heavy metals.

The results underline the important relationship between the chronic body burden of some toxic metals and neurodegenerative disease. Finally, repeated EDTA chelation therapy was able to remove all toxic metals with no adverse effects.

That’s kind of important because here we have some cases where it has been shown that EDTA can reverse neurological damage by removing toxic metals including lead, so even if the lead in your body has caused some damage already, it may be reversible.

I wasn’t going to, and I’d better do a more comprehensive future blog on neurotoxicity in children, but I can’t help but mention what relatively low levels of lead do in infants.

The actionable level for blood lead (BLL) in children is now 5ug/dl and the CDC has recommended that the level be dropped to 3.5 ug/dl, and that no level of lead is safe. Considering it took the NHMRC many years to follow the rest of the world and lower the actionable level from 10ug/dl, we can only hope.

Studies in Mt Isa since 2007 have consistently shown that a significant number of children, especially aboriginal and islander, have blood lead levels above 10 ug/dl. At this blood lead level, you will start to see signs of intellectual decline (IQ drops as BLL rises), of behavioural problems and learning difficulties. One reason for the learning difficulties is that lead interferes with speech processing. It doesn’t make the kids deaf, but they might as well be. Chelation therapy can reverse some of these issues.

I’d like to finish up by putting the statements about EDTA being dangerous to bed once and for all.

The oft-quoted death of a 5 year-old autistic child due to hypocalcemia after IV infusion of disodium EDTA is used as an indicator of the danger and inappropriateness of chelation therapy in children. Would it surprise you to learn that a pharmacy error led to the provisiosn of Na EDTA instead of Ca Na EDTA which the physician had requested? if calcium disodium EDTA had been used, hypocalcemia could not have happened. How is an indication of the dangers of chelation?

Different forms of EDTA are used:

IV disodium EDTA is used for the treatment of hypercalcemia and atherosclerosis (removal of calcium plaques).

Calcium disodium EDTA is used to remove lead (and other heavy metals) without depleting body calcium.

Magnesium disodium EDTA is used for intramuscular injection as it avoids the pain of injecting either of the other two forms of EDTA.

Another claim is that EDTA causes renal impairment. There have indeed been instances of nephrotoxicity and resulting death in patients undergoing IV EDTA infusion. But the cases of renal damage happened in the 1950s, well before the establishment of a safe, standardized treatment protocol in 1989. Foreman et al in 1956 .(Foreman, H., Finnegan, C., and Lushbaugh, C. C. Nephrotoxic hazard from uncontrolled edathamil calcium-disodium therapy. J. Am. Med. Assoc. 160: 1042-1046 (1956) established that EDTA can cause nephrotoxicity and death if a high enough dose is given at short enough intervals. At the lower IV doses (3 grams, lower in children) now used, no renal damage has been observed.

Yet another example is (Gracia R.C. DABAT P.D. Snodgrass W.R. American Journal of Health-System Pharmacy, Volume 64, Issue 1, 1 January 2007, Pages 45–53), They comment in the articles abstract:

Chelation is generally not indicated for adults with blood lead concentrations of <45 μg/dL because of the potential risk of adverse drug events and concerns about remobilized lead, and chelation for children with blood lead concentrations of <45 μg/dL remains controversial.

Only to people who haven’t bothered to get acquainted with current literature on chelation.

So you will find many current reviews and comments on otherwise reputable web sites that chelation is dangerous, particularly to children and may cause death. This is a sad reflection on many practising physicians.

I’m going to start a series of blogs where I discuss scientific papers that outline the various bad effects that lead can have on your health. But before I do that, it would obviously be useful if we had an idea of just how much lead we had on board. I said we rather than you, because I’ve done enough stupid things with lead in my life to be fairly certain that I’ve probably got a reasonable amount of lead on board. Hopefully not as much as lead workers, but I used to be into shooting, had a go at making lead weights and sinkers, used lead flashing, soldered plumbing and electronics, sanded an old house and so on. All the stuff you’re supposed to be super careful with, wash your hands after handling., dust mask. Except I never took any particulalr care with lead. Bummer.

I can’t help wondering if my gout is due to the lead, and it’s entirely possible my aortic valve calcification is worse due to lead, but at least I’m doing something to get rid of the lead.

Unless you guys and girls do something to rid your body of lead, there WILL be medical consequences.

I’d love to know just how much lead I’ve got on board. You’d think that would be easy, go to the nearest GP get a referral for a whole body lead measurement and there you go. There’s a small problem though. At best you’ll got a blood lead measurement and nothing else. But unless acute lead exposure is suspected, you’ll be lucky to even get a blood lead test done. That’s why you are tested every few weeks isn’t it?

I hope I’ve already indicated that in the face of continuing exposure to lead (lead dust of whatever), blood lead levels are useless for estimating the total amount of lead in your body. IF you leave Mt Isa or whatever lead work you’re doing, your blood lead will fall to a level that reflects your total body lead, most of which is in your bones, and secondarily in your brain. But it doesn’t tell you how much lead is actually there.

We can measure the lead in your hair, but that still only indicates lead exposure. Hair analysis did however indicate that Beethoven probably died of lead poisoning, and Napolean died of arsenic poisoning. Did you know that the Borgias used lead as an undetectable way to slowly kill their victims while making them mad in the process?

In kids in Mt Isa we could measure the lead in their baby teeth, but that is still only an indication of exposure, not how much lead is on board. Measuring lead in bone in cadavers is the most accurate, but it unfortunately requires you to be dead, which is what we’re trying to avoid here.

There’s a technique called chelation challenge where you get a dose of chelation agent which grabs toxic metals like lead in your body, and they measure the heavy metals that come out in your urine. That can be a real eye-opener in terms of what’s there and, if urine lead is high, you’ve probably got a fair bit of lead on board. Doesn’t tell you how much though. I’ll talk about this some more in a future blog about lead neurotoxicity.

Anyway, It turns out there is a way to do it, something I proposed to Glencore.

X-ray fluorescence spectrometry (XRF) was first invented in the 1920s but it wasn’t used in a medical context until quite a bit later. Early lead measurement with “traditional” XRF meant you were strapped in a chair for 30 minutes at a time, while watching a movie or video. After that you had a pretty accurate idea of the lead amount in bone, and that could be extrapolated to the total amount of lead in a person’s body. The XRF equipment was huge and hideously expensive, and pretty much only used in research labs. There is an excellent paper on XRF in biological systems, which you can get from here: X-ray fluorescence imaging of metals and metalloids in biological systems – PMC (nih.gov) . This article not only has some very good explanatory diagrams of XRF it introduces something I didn’t know about, XRF microscopic imaging.

But let’s get back to something that is relevant to lead workers.

Portable XRF spectrometers, that really are portable and use a much smaller dose of x-rays became available. They were small, handheld and incredibily useful to quickly assay metal content in alloys or ores. You will now find portable XRF absolutely everywhere in the mining and metallurgy industries because it is so fast and useful.

Apparently Glencore Australia doesn’t have one, at least according to their health and hygiene people. Do they just not know or… let’s not go there.

Anyway, quite a lot of work has been done to see if portable XRF could be used to measure body leas. One of the leading research groups to do this is at Purdue University, led by Professor Linda Nie. They’ve even calibrated portable XRF against cadaver bone lead and have validated that XRF can be used to accurately estimate body lead. Professor Nie has even offered to send a post-graduate student over to help Glencore get set up with XRF bone lead measurement. She was excited at the prospect of all the research papers that could result from XRF investigations in Mt Isa.

Cool. Glencore could measure your body lead when you start employment, monitor you to make sure you don’t pick up any more lead and then measure how much lead you’re taking with you when you leave. That sounds like a win for everyone.

But as I said, Glencore have said they don’t have an XRF spectrometer, and they feel it would be risky to you to the small dose of x-rays that XRF uses. I pointed out that you are exposed to a lot more radiation (and risk) from the U235 and Pb210 in lead ore dust, but I guess they’re trying to be super careful on your behalf. It must feel good to be cared for so thoroughly.

Besides, if it turns out Glencore’s lead workers have a lot of lead on board, then what? Does Glencore (or the workers) do something about removing the lead, or are we going to see a lot of legal cases because workers weren’t monitored and protected properly while working for Glencore.

I see this as a really interesting situation because if Glencore have no idea how much lead a worker already has on board when they join the Glencore workforce, AND if a worker subsequently finds out they have a lot of lead on board and sues Glencore, what proof do Glencore have that you didn’t pick up the lead in Mt Isa.

Imagine a scenario where you leave Mt Isa and go to a clinic to have your body lead measured with XRF. If your body lead levels are high, you know who to blame. The XRF clinic is my plan B provided I can get the funding. I’m pretty sure a University would be interested in population lead studies.

Glencore at the moment are damned if they do, and damned if they don’t. Even if they don’t do something to reduce worker’s lead levels, at least their legal position would be a bit better if they embraced XRF, but we are talking about a big mining company here. Do they have a conscience or not? I there such a thing as common sense?

I think that implementing XRF and lead removal could absolutely happen if they get the regulatory go-ahead and they feel they need to do it.

That’s one of the reasons for this blog anyway, Gentle nudges in the right direction. Mind you I’m rapidly reaching the conclusion that gentle isn’t going to work.

The more lead workers read this blog, the more interesting things will get.

Spread the word, because you have nothing to lose but your lead.

It’s quite obvious that people who mine or smelt lead are lead workers, but in fact anyone who melts lead as part of their profession is a lead worker even if not officially.

The table below lists the causes of lead exposure for a Excessive Lead Exposure notification form, which does a pretty good job of identifying lead exposure:

The obvious professions are lead-acid battery manufacturers and lead acid battery recyclers. The recyclers in particular also have to deal with old battery acid which is full of soluble lead salts. Old lead acid batteries are possibly one of the more dangerous causes of lead poisoning, next to lead paint of course.

Then there are welders who remove lead paint from bridges and structures, who have some of the highest reported rates of occupational lead poisoning?

And painters that renovate old houses. If they’re not poisoning themselves, the paint dust and paint chips they leave lying around will certainly poison children. Renovating old houses is recognized as being dangerous, but unless we have regulations like we have for asbestos, we’ll continue to see painters with notifiable blood lead levels.

We’ve got people who work with stained glass for a living or hobby. Lead-free solders are starting to be used but it’s more expensive so you can guess what happens.

Potters who use lead glazes because of their brilliant colours and then fire the lead glazes are exposed to lead vapour.

Some traditionalist artists still use lead paints to replicate the older colours.

Sheet lead has been used for flashing and even roofing (old churches) for a long time. It’s still being used though it’s being replaced by other materials. Roofers were typically exposed to a lot of lead.

The roofs of old churches have slowly been replaced with new lead, exposing a whole new generation of roofers to lead. Lead when it’s been refined still contains a small amount of Pb210, so if you want lead shielding around super-sensitive radiation counters, you need lead that doesn’t contain Pb 210. Luckily Pb210 has a half-life of about 22 years so you only have to wait a couple of centuries before it’s fit to use.

That’s why old lead roofs were so attractive, get the lead that’s free of Pb210 for the cost of replacing an old roof with a new lead roof. Lead ingots in sunken roman ships are absolute gold if you want ultralow-radioactivity lead.

Plumbers used to use lead solders with copper pipes and brass and copper fittings. Legislation now only allows non-lead solders but there was a recent case where a plumber was found to have used lead solder in hundreds of houses in Queensland because lead solder was cheaper. Considering the health hazards of using lead solders, that plumber may get what he deserves.

Brass has lead added to improve workability, so brass manufacturing ought to be classed as a lead industry, but I suspect it isn’t.

Electronics technicians used to use lead solders, and a lot of hobbyists still do. Stone masons use lead to fix iron railings and fasteners into the carved stone.

Other traditional lead workers were type setters and printers. Panel beaters and restorers of old car are exposed to lead paint when they remove or sand old paint, and lead automotive paint is still used to get the authentic colours of old cars, which then includes spray painters as lead workers because automotive paint can have up to 20% lead.

One unintentional group of people exposed to high levels of lead are opium users. Opium is sold by weight and adding lead carbonate increases the weight quite handily. Breathing in lead fumes or injecting lead concentrate makes opium users almost qualify as lead workers.

The biggest remaining group of lead workers are people who use rifles, shotguns and pistols. Every time a gun is discharged, a fine puff of lead dust is produced. That’s only at the gun end and since the projectile is more often than not lead, you’ll get lead contamination at the other end as well. I’d rather not think about the amount of lead at the end of your average shooting range. Rifle and pistol ranges are some of the most lead-polluted areas on earth. When you consider that one of the effects of higher blood levels is reduced cognitive function, is it safe to let people have guns?

Shooting ranges are the second largest contributor of lead (Pb) to the
environment after the battery industry. For example, annual deposition of Pb bullets from shooting activity has been reported to be approximately 70,000 metric tons across US military ranges. That doesn’t include civilian shooting ranges.

There were 8 lead notifications due to excessive blood lead in Townsville, all from a local shooting range.

There are researchers all over the world that are looking at the serious impact of lead on wildlife because of lead pellets from hunters contaminating nature reserves and the general countryside.

If you shoot wildlife for sport, remember that the lead shot or bullets you use will contaminate whatever you’ve shot. If your hunter friend offers you a wild duck shot he on the weekend, don’t accept it. The lead pellets you spit out when you’re eating the duck have already harmed you.

There is a special class of shooters that are exposed to a lot of lead, and that is soldiers. Unless you get shot, which has obvious disadvantages beyond simple lead poisoning, they’re exposed to a lot of lead.

If you do get shot, the lead fragments the doctors couldn’t get out will give you lead poisoning for the rest of your life. Jacketed rounds are a bit better, but not much if they fragment.

This article in the New York Times ( The Army Thought He Was Faking His Health Issues. Turns Out He Had Chronic Lead Poisoning. – The New York Times (nytimes.com)) outlines the dangers faced by troops., and incidentally the benefits of removing lead with chelation treatment.

With the exception of a small number of soldiers who were lucky enough to be diagnosed with excessive lead in their bodies, chelation is rarely used in lead industries to protect workers. It ought to be, but it isn’t.

After all, according to modern medical wisdom, removal of lead from the body using chelating agents is too risky.

Makes you wonder about the Australian Defense Force.

Some countries are more enlightened when it comes to realising that carrying a lot of lead around in your body is a bad thing, and it ought to be removed, but they’re not English-speaking countries as a rule, at least not as a first language. If you don’t live in Italy or India or China, good luck.

I’d like to finish this up with some examples of another group of people exposed to high lead levels that have nothing to do with occupations. Children are people, right?

The tonnes of lead in and on older Australian homes remain a potent source of this neurotoxin, and paint remains an occupational hazard. Renovating an old house where lead paint was used is not only dangerous to the renovators, a pre-1980s house that’s being sanded can release kilograms of lead dust into the surrounding area and if there are children nearby, they are at grave risk.

Would it make you feel better to know there are thousands of Housing Commision hoses that were built, and painted with lead paint, before 1980?

There are two stories about children that really started me on my little crusade about lead, which to be honest feels more like Don Quixote fighting windmills. He thought he was attacking giants with long arms, I’m attacking sloth and indifferenece.

Sorry. The first story is a YouTube video presented by the principal of a school in New York state. https://www.youtube.com/watch?v=mSwHSE6_ZoI

The second is an e-book by a mother, Nancy Hallaway, in British Columbia (Canada) about her experiences with what turned out to be lead poisoning in her twins, caused by renovating an old house. https://www.amazon.com.au/Autism-ADD-Lead-Poisoning-Turning-ebook/dp/B09KS1HF62. The really telling part is that this was originally written in 1992 and nothing significant has changed as far as Paediatrics is concerned.

The UNICEF report, “The Toxic Truth” is pretty confronting as well. https://www.unicef.org/reports/toxic-truth-childrens-exposure-to-lead-pollution-2020

When you get to the map of lead levels around the world, Australia looks pretty good. But that’s because there’s no data on lead poisoning. That’s because there is next to no non-occupational testing for lead. In fact, Queensland Health stopped publishing how many people were affected by lead (non-occupational) after 2015.

Queensland Health as a whole doesn’t do anything to reduce lead levels in children who are deemed to have non-toxic levels of lead, that is blood lead levels below 45ug/dl. Auditing and counseling just doesn’t do enough in the absence of purposeful direction for GPs. We need to deal with lead that has already been absorbed, that is doing harm or that will do harm, particularly in young children.

We’ve got to lift our game reducing harm in children that have already been exposed to lead, so I had to start with people where lead is a close and present danger. You. I have a book about lead tilted “Brush with Death”. Unfortunately the title is to the point.

I do hope I can accomplish something to make sure no child in Queensland is disadvantaged because of lead exposure. That seems pretty unlikely at the moment, but I have to try. Always provided I can get Queensland Health to realise they have a solvable problem. Wish me luck because I’ll need it.

While I painted the Glencore people as the bad guys in the lead safety story, my criticisms were in part unfair.

I also hadn’t realised the complicated path they have to tread to be in compliance with current lead safety regulations. If you read the lead safety parts of he Mining and Quarrying Safety and Health Regulation 2017, it is likely to fry your brain. It’s downloadable, read it and I suspect you’ll agree. Staying in compliance with these regulations would be a bit like wearing a strait jacket, which you’d need after you tried to read the legalese. I now appreciate what it would take to operate within the constraints of these guidelines, and if you wanted to have a quiet life you’d just follow the rules. There’s also a high degree of censorship between people outside Glencore and Glencore employees which must make life really difficult when it comes to interacting with the community. Then there’s the Glencore corporate culture which is at best not as good as it could be.

I absolutely think there are people inside Glencore that care, but I’m retired and I don’t have to worry about what speaking up would do for my job prospects. So I’m happy to cut the Glencore people some slack in this whole debacle even though we are talking about stuff that has serious health repercussions for workers. Glencore the company doesn’t deserve any consideration, and I’d better not say what I really think.

The Lead Pathways study, which was funded by Xstrata, was intended to provide a detailed analysis and assessment of the lead in the Mt Isa area, both environmental and due to mining and smelting activities. Professor Jack Ng, who took part in running the study, commented that after taking over in Mt Isa, Glencore immediately terminated the project, despite the fact that it was almost complete. Glencore’s web site now claims “they” carried out the study. Admittedly when you acquire a company you own all it’s assets but claiming credit for something you shut down?

One company was willing to spend money to clarify the extent of pollution and public danger in the Mt Isa area, the other company just wants to keep a lid on things. Glencore obviously has its priorities elsewhere, for example see (https://www.sfo.gov.uk/cases/glencore-group-of-companies/) .

Anyway, I suspect I’m expected to fight the battles so here goes. I was directed to the people in Resources Safety & Health Queensland (the mining equivalent of WorkSafe) to try and convince them that things needed to change. This is what I wrote:

———– letter to RSHQ ———-

Lead has no place in the human body as it alters, damages and disrupts a variety of biological processes in a workers body. The resulting damage will lead to neurological disorders, cardiovascular disease, disease of the kidneys and other organs, immunosuppression and potentially cancer.

Quite obviously exposure to lead has to be monitored and risk has to be managed which is of course the intent of the Mining and Quarrying Safety and Health Regulation 2017

I have been debating a major biological monitoring flaw in in the following processes:

Removal of worker from lead risk job (Division 3 section 24),
Return to lead risk job after removal (Division 3 section 26)

My simplified interpretation of these processes is that when a workers blood lead levels exceed 30 ug/dl, they are removed from work, and when biological monitoring shows a drop in the blood lead levels to less than 20ug/dl, they are deemed fit to return to work. My comment ignores the more constrained blood lead levels for females of child-bearing age.

In my opinion, this infers that two assumptions are made about blood lead levels (BLL):

1. BLL represents a reliable estimate of the amount of lead present in the workers body.
2. Falling BLL indicates a corresponding linear reduction in the amount of lead present in a workers body.

These assumptions have to be reviewed in the following context, which is derived from current medical and scientific literature:

1. Once in the body, some lead binds to red blood cells, and the rest travels in the blood to soft tissues such as the liver, kidneys, lungs, brain, spleen, muscles, and heart, and to hard tissues such as bone. The half-life of lead in these pools varies from about a month in blood, 1-1.5 months in soft tissue, 1-2 years in the brain and about 25-30 years in bone.
2. Eventually 95% of the lead in the body ends up in bone.
3. Lead continues to accumulate in the body when a worker is exposed to lead.

So we have the following amended scenario:

1. BLL represents a measurement of the lead circulating in the blood, largely bound to red blood cells.
2. As red blood cells containing lead are consumed by macrophages at the end of their life cycle the apparent BLL drops.
3. The drop in BLL that occurs when a worker is removed from lead exposure does NOT represent a significant reduction in total body lead levels, rather it indicates a redistribution of lead to other organs.

As I see it, removing a worker from exposure to lead is not a safety measure at all because it merely slows the accumulation of lead for a short time. Once lead exposure is resumed, accumulation of lead resumes, regardless of the BLL at that time.

This raises the question of the purpose of lead surveillance, removal of workers from lead exposure when BLL exceeds 30 ug/dl, leave and reinstatement on BLL falling below 20 ug/dl.

If BLL doesn’t indicate the amount of lead in the body, except indirectly, and doesn’t measure the accumulation of lead, it is worthless for ensuring the biological safety of workers.

BLL is an indicator in two very different scenarios:

1. As an indicator of acute lead exposure or,
2. In the absence of any significant continuing lead exposure, when an equilibrium state is reached where lead leaching out of the soft tissues, brain and bone reaches a steady-state, BLL is roughly indicative of total body lead, mainly in bone

As an example, if a worker were to leave a lead risk environment permanently (or at least 1-2 years) , their BLL would then reflect total body lead, or rather bone lead stores.

I will of course supply supporting scientific and clinical literature for these observations as required.

There is then an obvious problem with the existing biological monitoring because it measures the wrong thing in a lead risk scenario. If we retain BLL as an acute exposure alarm indicator, then what do we do about estimating and managing body lead?

This is the problem I set Glencore, since they have a mandatory requirement to comply with prevailing safety regulations, and a moral requirement to protect their workers.

I have proposed a way to solve this problem by using a different biological measurement technology which measures bone lead. However, in the face of continuing accumulation of lead stored in worker’s bodies, this is simply an indicator of an escalating problem.

The second, essential part of a possible solution is a technology to safely remove lead from a workers body.. If that were accomplished then body lead levels could be controlled, allowing biological monitoring which retained the context of maintaining worker safety.

I have made a fairly comprehensive proposal about this issue to Glencore to achieve these aims, but as I stated they are constrained by the Mining and Quarrying Safety and Health Regulation 2017.

——— end of letter to RSHQ ——–

If they accept there’s a problem in the regulations , then someone would have to take the initiative to properly monitor and treat lead worker safety, maybe even Glencore.

In the meantime, think about taking some oral calcium disodium EDTA. That will ensure any lead that gets in will quickly appear in your urine. It will take quite a while to remove all the bone lead the same way, but in the interim you won’t be storing any extra lead.

You can buy calcium disodium EDTA in bulk from BulkSupplemets.com, https://www.bulksupplements.com/en-au/products/edta-calcium-disodium-powder . 1 kg of this will fill 1600 size 0 capsules with about 600 mg of calcium disodium EDTA.

You get the capsules (enteric or gelatin, size 0) from https://www.buyemptycapsules.com.au/ and a size 0 capsule filling machine that lets you fill 24 capsules at a time from here will cost $40.

Enteric capsules would probably result in more EDTA being absorbed, but this hasn’t been tested.

You can also buy EDTA capsules online, but it’ll cost at least 4-5 times more when you take the quantity of EDTA into account.

Please be aware that EDTA removes other toxic metals like cobalt and cadmium and mercury etc, BUT it also binds zinc and magnesium. Take a zinc and magnesium supplent every now and then, but not at the same time as EDTA, and you’ll be fine.

As a bit of an added incentive, here’s a little story. North Queensland is covered in lead ore, and cattle eat the dirt because lead gives it a sweet taste. Cattle end up with quite a bit of lead on board, so much lead that they were rejected by the Indonesians for live export. Those cattle now get treated with a chelation agent in a feedlot for a month to remove the lead and they’re fit for export.

I sure hope they’re treating cattle for domestic consumption the same way. But if they’re not, take your EDTA and you can give people a smug look at the next barbecue.

I’ll let you know how things pan out with the authorities. You never know.

If you want to get up to speed on how and why I’m writing this blog called part 2, just scroll down to the bottom of this post and read the previous one.

I thought I’d start things off by sending Glencore an email to highlight the fact that they now had a mention in my brand new blog. Yesterday night I got a formal response via a PDF document enclosed in an email. It was from the Principal – Health and Hygiene.

Rather than just posting the whole letter I’ll present the interesting bits.

But first let me repeat the gist of what I’ve done beforehand that’s covered pretty well in the previous post.

I went to Glencore to tell them that their existing WHS policies would lead to severe medical consequences for lead workers. I presented them with the latest scientific studies to support my claims.

In the last few weeks, I also presented them with support material for a proposal to:

(1) Use a portable X-ray fluorescence spectrometer (XRF) to measure bone lead levels because 95% of the lead in your body is in bone. XRF would take 2 minutes to estimate how much lead you’re carrying in your body, with no needles required. The amount of lead in workers bodies could be determined. This is important because in the presence of continued lead exposure, blood lead levels only indicate the level of lead circulating in the blood, not how much lead is already there, accumulated in the body.

XRF would let Glencore evaluate the legal risk it carries for not dealing with lead intoxication in their lead workers, and it provides the workers with an idea of the risk they’re facing. In an ideal world it could be used to monitor how effective the lead removal procedures were working, that’s not looking good at the moment.

(2) Use oral chelation therapy to remove dangerous levels of lead from the workers as needed, or maybe even consider using it prophylactically to stop lead ever accumulating at all.

That is a total win-win for everyone. It wouldn’t cost a lot, and might actually save money at so many levels.

After all it ought to be a lot easier to actually give some meaning to the present empty words about providing a safe work environment and all that entails for the lead workforce. It would certainly be cheaper than the present out of court settlements when workers wake up to the reality of what lead has done to them. Also much cheaper than the possibility of a class action by workers who have left Mt Isa and found out they have a dreadful legacy of their time there because workplace health and safety failed them.

I’m kind of old fashioned about not doing something to protect workers when you know better, when a bit of positive effort could completely remove a major risk factor for workers. It seems kind of obscene and amoral to ignore a scenario where you know you’re doing harm to someone. Why don’t workplace health and safety just carry out their job description? You know, keep workers healthy and safe?

But that’s not how a company like Glencore works.

I guess someone could suggest I’m against lead mining and smelting, but I’m absolutely not. Regardless of what the Greens think about mining, I realize that people need jobs, and a place like Mt Isa is an important hub for the local region.

But wouldn’t it be nice if lead wasn’t a danger to lead workers or their families? If you didn’t have the niggling worry that living in Mt Isa might end badly for you and your kids? Wouldn’t it be nice if Glencore and Queensland Health gave a damn?

Anyway, here are the highlights: of the official response letter:

(1) Whilst your point that blood lead is a labile indicator is valid, we are nonetheless compelled to manage workers in accordance with their blood lead levels, pursuant to the Mining and Quarrying Safety and Health Regulation 2017 (Schedule 2E Health surveillance; Part 4 Lead health surveillance and Division 2 Lead health surveillance).

That’s pretty blunt. We accept that the regulations are wrong and workers are at risk, but it’s easier to comply with the rules than be proactive and protect our lead workers. Misguided regulations are okay, but protecting workers health in a meaningful way isn’t. I hope that makes lead workers feel warm and fuzzy.

(2) In terms of using an XRF spectrometer, at present in Queensland there is no facility for the analysis of cortical bone lead burden nor is there a regulated standard for which there is an acceptable lead burden. In addition, we would not want to expose any of our employees to an unnecessary radiological risk.

I did suggest they had to buy or lease a portable XRF . They obviously didn’t read or understand the scientific papers I provided about the extensive work with portable XRF at Purdue University, specifically in measuring human bone lead levels. Purdue even used cadavers for validation. I passed on the offer from Purdue University to help set up a calibrated facility in Queensland. They could establish XRF if they wanted to.

The comment about radiation dose is a nice touch, but kind of ignorant when you realise the dose in 2 minutes from a portable XRF is a lot lower than the dose you get from the lead dust in your workplace. Yes, lead ore is slightly radioactive (U235 and Pb210).
It’s likely the cost of leasing an XRF spectrometer and getting someone from Purdue University over to help set everything up properly would be less than a couple of tires on the big trucks.

But worker’s health is obviously not worth that much to head office.

(3)Your proposal to trial the use of an oral chelation treatment would be experimental and the implications and applicability to a working age demographic are yet to be established. Again, we would not put our employees at risk of potential mild or serious side effects for a pilot program.

Despite the fact that oral chelators are freely available from multiple health supplement sources, and tens of thousands of people have used them for over 60 years without apparent harm if managed properly, and oral chelators have also been used to protect lead workers from the damage caused by lead 60 years ago safely and without risk? 

The much more important and well known risk faced by lead risk workers is the lead they have in the bodies as a result of regulations that only care about measuring and reducing exposure, and not what happens as the result of continued exposure.

Your employers don’t care enough about the damage lead does to you to have even run a small voluntary trial to see if it will lower lead levels.

There’s nothing stopping people from getting some calcium sodium EDTA themselves. I’ve provided all the information in a later blog.

If your employer won’t provide protection because they don’t want to, you’ll have to do it yourself. Up the workers.

And if we’re talking about risk, I’d like to point out again that the risk of doing nothing is far greater for lead workers. You are at risk from lead you breathed in or ingested despite all the other provisions to minimize dust exposure. Nothing is being done by your employer to minimize the biological risk from lead that you’ve already accumulated in your body. Nothing.

(4) We have a range of stakeholders including health experts that we engage with around the management of occupational exposure, with the implementation and monitoring of any measures based on strong clinical evidence and supported by peak medical bodies and State and/or Federal Government.

I’m prepared to label that as bullshit. The stakeholders didn’t even pick up the information in “Hunter’s Diseases of Occupations” or anywhere else that most lead absorbed or ingested sticks around in the brain (1-2) years or the bones (decades)? Or that lead accumulates in the body (bones) over time? How could anyone miss those “small” details unless they had selective blindness, or does it reflect the quality of your experts? That’s shameful. If what we have is the best that the experts can do, they aren’t interested in the best interests of their workers, only the best interests of Glencore.

I’d like to repeat the message about the extra lead burden that lead workers carry because we’re talking about something that will definitely make people sick in one way or the other in the future, it not right now. If you don’t remove the lead you get from working as a lead worker, you will suffer any number of medical conditions in the rest of your life.

There’s an official estimate that lead co-morbidities are responsible for 400,000 deaths in the USA every year. That’s deaths where lead was a contributing factor. Would it surprise you to find out the higher the body lead, the worse the risk?

So there we are. The official response is pretty much a justification for doing nothing. After all, the people at head office aren’t exposed to lead, it’s not a danger to them. If it was, they’d probably do something.

Besides, that’s what lead workers signed up for, isn’t it? You knew you were going to get sick sooner or later. That is the cost of working with lead, sacrifice your health so you can house and feed your family.

If workplace health and safety is about preventing foreseeable risks, why didn’t someone start looking at solutions to minimise the risk from lead 20 or more years ago? Chelation therapy for lead workers was first used over 60 years ago, and yet here we are, in 2023 and WHS is still not protecting lead workers from the known ill effects of lead biohazards.

I’ve been given some names to contact at Resources Safety and Health Queensland so I will do so.