Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA; Woods Institute for the Environment, Stanford University, Stanford, CA, USA.
Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
Environ Res. 2023 Sep 1;232:116328. doi: 10.1016/j.envres.2023.116328. Epub 2023 Jun 5.
Turmeric adulterated with lead chromate pigment has been previously identified as a primary source of lead exposure in Bangladesh. This study assesses the impact of a multi-faceted intervention between 2017 and 2021 to reduce lead-tainted turmeric in Bangladesh. The intervention involved: i) disseminating findings from scientific studies via news media that identified turmeric as a source of lead poisoning, ii) educating consumers and businesspeople about the risks of lead chromate in turmeric via public notices and face-to-face meetings, and iii) collaborating with the Bangladesh Food Safety Authority to utilize a rapid lead detection technology to enforce policy disallowing turmeric adulteration. Before and after the intervention, evidence of lead chromate turmeric adulteration was assessed at the nation's largest turmeric wholesale market and at turmeric polishing mills across the country. Blood lead levels of workers at two mills were also assessed. Forty-seven interviews were conducted with consumers, businesspeople, and government officials to assess changes in supply, demand, and regulatory capacity. The proportion of market turmeric samples containing detectable lead decreased from 47% pre-intervention in 2019 to 0% in 2021 (n = 631, p < 0.0001). The proportion of mills with direct evidence of lead chromate adulteration (pigment on-site) decreased from 30% pre-intervention in 2017 to 0% in 2021 (n = 33, p < 0.0001). Blood lead levels dropped a median of 30% (IQR: 21-43%), while the 90th percentile dropped 49% from 18.2 μg/dL to 9.2 μg/dL 16 months after the intervention (n = 15, p = 0.033). Media attention, credible information, rapid lead detection tools and swift government action to enforce penalties all contributed to the intervention's success. Subsequent efforts should evaluate if this is an example of an effective intervention that can be replicated to reduce lead chromate adulteration of spices globally.
以前曾发现用铬酸铅颜料掺假的姜黄是孟加拉国铅暴露的主要来源。本研究评估了 2017 年至 2021 年期间实施的一项多方面干预措施对减少孟加拉国受铅污染姜黄的影响。该干预措施包括：i）通过新闻媒体传播科学研究结果，这些研究结果表明姜黄是铅中毒的来源，ii）通过公告和面对面会议向消费者和商人宣传铬酸铅在姜黄中的风险，以及 iii）与孟加拉国食品安全局合作，利用快速铅检测技术执行禁止姜黄掺假的政策。在干预前后，在该国最大的姜黄批发市场和全国各地的姜黄抛光厂评估了含铬酸铅姜黄掺假的证据。还评估了两家工厂工人的血铅水平。对消费者、商人、政府官员进行了 47 次访谈，以评估供应、需求和监管能力的变化。含可检测铅的市场姜黄样本比例从 2019 年干预前的 47%下降到 2021 年的 0%（n=631，p<0.0001）。有直接铬酸铅掺假证据（现场颜料）的工厂比例从 2017 年干预前的 30%下降到 2021 年的 0%（n=33，p<0.0001）。血铅水平中位数下降了 30%（IQR：21-43%），而干预后 16 个月，第 90 百分位下降了 49%，从 18.2μg/dL 降至 9.2μg/dL（n=15，p=0.033）。媒体关注、可靠信息、快速铅检测工具和政府迅速采取行动实施处罚都促成了干预的成功。后续工作应评估这是否是一个有效的干预示例，可以在全球范围内复制以减少铬酸铅对香料的掺假。
