title: Lead toxicity among traffic wardens: a high risk group exposed to atmospheric lead, is it still a cause for concern?
abstract: BACKGROUND
  Traffic policemen are identified to be at a higher risk of exposure to air pollution and its contaminants such as lead. A study done prior to the introduction of unleaded petroleum in Sri Lanka revealed a mean blood lead level of 53.07 μg/dL, which was well above the Center for Disease Control defined acceptable safe levels. This study aimed to determine whether unleading of fuel has made an impact on the blood lead levels of traffic police working in an urban area with high traffic density.
  
  
  METHODS
  A cross-sectional survey of 168 traffic police personnel working within Colombo city limits of Sri Lanka, a high traffic density area, was conducted. Blood lead levels of participants were measured using nitric acid, perchloric acid ashing method and atomic absorption spectrophotometry. An interviewer administered questionnaire was used for a targeted history and examination.
  
  
  CONCLUSIONS
  Mean age of the sample population was 37 years. Thirty eight percent had detectable levels of lead in blood and 24.4% of the study sample had blood lead levels above Centre for disease control defined safe limits. Sample mean was 4.82 μg/dL (95% CI 3.58-6.04), and this is a 91% overall reduction when compared to data prior to unleading. Neither symptoms nor signs of classic lead toxicity showed significant correlation with toxic lead levels.
  
  
  CONCLUSIONS
  Lead poisoning though still present in the high risk traffic warden population shows a considerable reduction following unleading. The need to have a low threshold to suspect lead poisoning is highlighted by the non-specific nature of the symptoms and signs of lead poisoning and its lack of association even in those found to have elevated lead levels. Further studies are required to elucidate a cause for the prevalence of lead poisoning despite cessation of using lead as an additive in petroleum.
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Benedict Samuel
authors: BS
authors: Sebastiampillai
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Mitrakrishnan Rayno
authors: MR
authors: Navinan
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Sahan Indeewara Talpe
authors: SI
authors: Guruge
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Dilushi Rowena
authors: DR
authors: Wijayaratne
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Buddini Samanthi
authors: BS
authors: Dissanayake
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Dissanayake Mudiyanselage Sushrutha Vajira
authors: DM
authors: Dissanayake
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Manisha Samithri
authors: MS
authors: Perera
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Sulakshi Manurika
authors: SM
authors: Thelikorala
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Hasith Dhanajaya
authors: HD
authors: Wijayasurendra
authors: Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Don Lasitha Naveen
authors: DL
authors: Wickramaratne
authors: Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Carukshi
authors: C
authors: Arambepola
authors: Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors: Ravindra
authors: R
authors: Fernando
keywords: Lead toxicity; Sri Lanka; Traffic police; Unleading