title: Mass lead intoxication from informal used lead-acid battery recycling in dakar, senegal.
abstract: OBJECTIVE
  Between November 2007 and March 2008, 18 children died from a rapidly progressive central nervous system disease of unexplained origin in a community involved in the recycling of used lead-acid batteries (ULAB) in the suburbs of Dakar, Senegal. We investigated the cause of these deaths.
  
  
  METHODS
  Because autopsies were not possible, the investigation centered on clinical and laboratory assessments performed on 32 siblings of deceased children and 23 mothers and on 18 children and 8 adults living in the same area, complemented by environmental health investigations.
  
  
  RESULTS
  All 81 individuals investigated were poisoned with lead, some of them severely. The blood lead level of the 50 children tested ranged from 39.8 to 613.9 microg/dL with a mean of 129.5 microg/dL. Seventeen children showed severe neurologic features of toxicity. Homes and soil in surrounding areas were heavily contaminated with lead (indoors, up to 14,000 mg/kg; outdoors, up to 302,000 mg/kg) as a result of informal ULAB recycling.
  
  
  CONCLUSIONS
  Our investigations revealed a mass lead intoxication that occurred through inhalation and ingestion of soil and dust heavily contaminated with lead as a result of informal and unsafe ULAB recycling. Circumstantial evidence suggested that most or all of the 18 deaths were due to encephalopathy resulting from severe lead intoxication. Findings also suggest that most habitants of the contaminated area, estimated at 950, are also likely to be poisoned. This highlights the severe health risks posed by informal ULAB recycling, in particular in developing countries, and emphasizes the need to strengthen national and international efforts to address this global public health problem.
authors.affiliation: Department of Public Health and Environment, World Health Organization, Geneva, Switzerland. haefligerp@who.int
authors.forename: Pascal
authors.initials: P
authors.lastname: Haefliger
authors.forename: Monique
authors.initials: M
authors.lastname: Mathieu-Nolf
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lociciro
authors.forename: Cheikh
authors.initials: C
authors.lastname: Ndiaye
authors.forename: Malang
authors.initials: M
authors.lastname: Coly
authors.forename: Amadou
authors.initials: A
authors.lastname: Diouf
authors.forename: Absa Lam
authors.initials: AL
authors.lastname: Faye
authors.forename: Aminata
authors.initials: A
authors.lastname: Sow
authors.forename: Joanna
authors.initials: J
authors.lastname: Tempowski
authors.forename: Jenny
authors.initials: J
authors.lastname: Pronczuk
authors.forename: Antonio Pedro
authors.initials: AP
authors.lastname: Filipe Junior
authors.forename: Roberto
authors.initials: R
authors.lastname: Bertollini
authors.forename: Maria
authors.initials: M
authors.lastname: Neira
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003246:Conservation of Energy Resources; D004736:Energy-Generating Resources; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood* / Q000633:toxicity; D020264:Lead Poisoning, Nervous System, Childhood / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012675:Senegal; D055815:Young Adult
chemical_list: D007854:Lead