By Larah Ortega Ibanez, Pure Earth Philippines Country Director
On September 19, 2024, as a result of our ongoing collaboration with Valenzuela City, 29 children with disabilities had their Blood Lead Levels (BLLs) tested. This was the first city-led BLL screening and first screening for a particular sector, children with disabilities, in the Philippines. Results showed that 3 of 29 children or 10.34% had levels equal or above the US CDC action level of 3.5 ug/dL. On the same day, all of the participating children’s parents and guardians were able to consult with doctors. After the screening, Pure Earth’s field team went to the homes of the 3 children with elevated blood lead levels to test for potential sources of lead exposure. Before the end of this year, Valenzuela City will be conducting the 2nd round of BLL screening and host a multi-stakeholder roundtable discussion on lead poisoning and the needed interventions. This is definitely a milestone worth celebrating in our global and local push for a lead-free future to become a reality!
How did this happen?
It must be remembered that in 2021, we had a breakthrough: the first inclusion of Blood Lead Level (BLL) in the Philippines’ Expanded National Nutrition Survey (ENNS). At that time, our goal was to generate local data, compare it with estimates based on published studies, and set off to strategize for solutions apt for our specific context. Close to 3000 children ages 6 through 9 participated from 25 areas nationwide and we found out that 257 or 8.76% had BLLs > 3.5 ug/dL. Using this value, we estimated 1 million children at risk in this particular age group. It is notable that the results of the recent BLL screening in Valenzuela among children with disabilities reflect similar prevalence.
What we did was to share the data to as many possible stakeholders, particularly with the government, in order to altogether come up with actionable and sustainable solutions. We also followed through with the rapid market screening and home-based assessments to give light on the lead exposure sources, which needed to be addressed. This effort to raise awareness and call attention to issues such as toxics through the years has been a tough one for us at Pure Earth. But this time, we focused on lead as it is tractable, solvable, even preventable and we have data to present along with our propositions. So, we were pleased that in early 2023, we succeeded in the 1st inclusion of lead as a priority in the Philippines’ National Environmental Health Action Plan (NEHAP) 2023 – 2030.
That was because the logical next step for us is to work towards the institutionalization of lead monitoring and surveillance in the country. We may not belong to the list of countries where childhood lead poisoning is hitting alarming levels but we remain vulnerable as shown by data and we must be ahead in terms of developing management and response mechanisms so as not to reach the worst case scenario, where solutions often appear too overwhelming to implement.
Now, while the Inter-Agency Committee on Environmental Health (IACEH) agencies are working towards such ends, we at Pure Earth continue to not only support the policy and program development at the national level but also, equally important, demonstrate pilot, replicable models of interventions in the localities. The simple rationale being – if a community is potentially vulnerable to lead poisoning, it can actually launch its own monitoring and if it succeeds in doing so, it can inspire other communities to do the same. Hence, Valenzuela City’s trailblazing act of launching local blood lead screening this 2024.
Valenzuela City has been advocating for the welfare of Valenzuelanos against non-communicable diseases, where lead is a risk factor because exposure to such renders debilitating impacts on health and development. Because of strong political will, core advocacies, and data-driven action points, the City approved City Resolution no: 3197 which stipulates the preparatory work for the institutionalization of a pilot local Lead (Pb) Monitoring among children with disabilities in the City. This resolution was turned into action last September 19 when the City Health Office, Special Education Center, Disability Affairs Office, and the office of Councilor Niña Lopez worked together to organize and implement the pilot BLL screening. Prior to this, Pure Earth already conducted training and workshops to capacitate the local offices on lead’s nature, sources, impacts, and mitigation measures; home-based assessment process; and BLL testing using LeadCare II, case detection, management and referral system.
The BLL screening participants also answered a Knowledge, Attitudes and Practices (KAP) survey, a collaboration we had with University of Nevada Las Vegas (UNLV) and University of the Philippines Manila National Poison Management and Control Center (NPMCC). The results prove to be useful for the City’s next steps. Majority of parents are aware that lead poisoning can impact their child’s health and that it can be caused by lead-based paint and dust. Knowledge gaps were identified on other sources of exposure, the signs and symptoms of exposure, and nutrition as a possible intervention. 77% are strongly concerned about childhood lead poisoning and around the same percentage, strongly believe more educational campaigns are needed to raise awareness about lead poisoning prevention and would strongly like to see more lead poisoning prevention activities in their barangay or city.
Aside from this, the Federation of Persons with Disabilities (FPWD) of Valenzuela City has been very proactive not just in raising awareness among their members within the city but also, in Metro Manila. Among their aims is to advocate for other city-based federations to take this up and ultimately, for the National Council for Disability Affairs (NCDA) to recognize lead as a cause factor for disability thereby making lead-related health services available to the disability sector nationwide.
The multi-stakeholder roundtable discussion on lead scheduled for early December will serve as a venue for more concrete and concerted action towards early detection, early intervention. Currently, we have 3 more potential local pilots to mount with a focus intervention. We hope the momentum gets going and together, we can turn lead free futures into a reality. If not for our entire country all at once, then for one community at a time.
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Watch this video about the first BLL screening in Valenzuela City.
Learn more about Pure Earth Philippines’ work to address lead exposure.