HumanHealthProtection

1. High levels of lead in the Upper Meža Valley, Slovenia

	LOCATION	Upper Meža Valley, Slovenia		

	POLLUTANT	Lead		

	SOURCE	Mining and industrial waste		

	GENERAL CLEAN UP	Reduce groundwater and soil contamination		
	OBJECTIVES				
	REMEDIATION	Re-layering, biomonitoring		
					
	ACTIONS				
					
	SITE /END USE	Recreational activities, natural heritage		

	SOCIAL-LEGAL	Poissoning		
	ISSUES				

KEY LEARNING / EXPERIENCE TO SHARE

New iniciative of promoting programmes for the reduction of the lead intake. Raising awareness about human health risks of contaminated sites

152	Remediated Sites and Brownfields. Success Stories in Europe

Human Heath Protection

Matej Ivartnik

National

Institute of

Public Health,	Upper Meza Valley, Slovenia.

Slovenia

The study case

Introduction

Exceeded air and soil pollution due to lead and other toxic metals in the Upper Meža Valley is a consequence of hundreds of years of mining and industry. Despite the fact that emissions of lead have been continuously reducing during the past 30 years, the exposure to lead did not reduce simultaneously. This happened just after the implementation of the corrective measures. The most probable reason for this is that the lead gathered in the upper layer of soilwhat resulted in lead-filled dust that rises in the air.

People who lived in this area breathed polluted air and consumed food produced on the polluted soil. This is why lead consumed in humans. In 2007, the Meža Valley was declared as a degraded area1 and since then, several remediation measures were taken to reduce human´s exposure.

In order to monitor the implementation of the measures, monitoring of lead in the air, soil and biomonitoring in the blood of children is being carried out in the area of Meža Valley. Measures result in declining air quality concentrations of lead since 2007 (see table as follows in next page 154). However, concentrations are still high in comparison to values at other measuring stations across Slovenia. Compared to air quality limit

1	Ordinance on the areas of the highest environmental burden and on the programme of measures for improving the quality of the environment in the Upper Meža Vallec (Official Gazette of the RS, No. 119/07)

Value for lead stated in the European directive on ambient air quality 2008/50/EC concentrations do not exceed the limit value, that is 500 ng/m3 .

The problem

High levels of lead in the Upper Meža Valley call for an extreme precaution due to entering lead into the food chain.

In order to estimate the level of lead in the soil several different materials such as upper soil layer, construction material, and materials for macadam and road sand were analysed.

The material for macadam was especially problematic because it frequently consists of mining waste. Use of this material mainly contributed to the expansion of lead pollution from the valley to higher areas. Analyses of road materials near neighbouring farms have shown that the levels of lead in these materials were much higher than in autochthonous ground. These roads are therefore important source of the pollution next to traffic burdens (local traffic, transport to tourist points and wood transport). In the past, this material was also used for building houses, among other for the upper layer of facades.

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Soil monitoring in 2007 has shown that the lead concentration in the samples from the Slovenian territory resulted from 10 to 2,000 mg/kg in the ground. The limit value (85 mg/kg) was exceeded in 11 locations in Slovenia, among others at the Žerjav monitoring station in the Upper Meža Valley. The information value (100 mg/kg) was reached at this location, while the critical value (530 mg/kg) was reached at the Podpeca monitoring station in the proximity of the Meža Valley.

The average value of all samples that were taken in Slovenia in 2007 was above the information value. The samples, taken from the arable land had lower levels of lead, what implies that agriculture was not the main source of the pollution. Based on soil sampling the Meža Valley was declared as a degraded area in 2007 because of lead pollution. Because of this, a detailed soil monitoring is being carried out in Meža Valley since 2008 to follow the lead pollution. In September 2008, sampling was carried out at 26 locations in the Upper Meža Valley. There were samples of soil and macadam court. Lead concentrations in soil were

Average air quality concentrations of lead at the Žerjav monitoring station2

between 26 and 4,483 mg/kg. Lead concentration exceeded limit value in 40 samples, and critical level in 18 samples. The most concerning are very high concentrations of lead in soil samples taken from kindergarten playgrounds. They result from 267 mg/kg to 1,244 mg/kg in the top layer of soil.

On average, lead concentrations in samples of

Database/ Matej Ivartnik.	

The comparison of lead concentration in the upper layer soil (0-5 cm) taken from the kindergarten playgrounds in the Upper Meža Valley before (2008) and after the remediation of the upper layer soil (2009, 2010, 2013).

2  Annual Air Quality Report 2013, Slovenian Environment Agency:

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Human Heath Protection

macadam were higher than in samples of soil. The reason for this is the use of the above-mentioned mining waste. In 2009, ground material and garden vegetables were sampled at 17 locations. 19 samples of ground material showed lead concentrations between 26 and 8,355 mg/kg. Concentrations were low (41 mg/kg- 55 mg/kg) in samples taken from kindergarten playgrounds, since the upper layer of soil has been exchanged at the start of the year. In 2010, samples of ground material collected at 11 locations were analysed. Again, low lead concentrations were found at locations, which have been previously covered with clean soil.

At most other locations, lead concentrations were high, from 100,5 mg/kg to 4,200 mg/kg. Also in 2011, 11 locations were analysed for lead. In 9 samples lead concentration exceeded critical level (530 mg/kg); 3 samples of 9 originated from the gravel swept of the asphalt road. The samples of material from road sweepers contained high concentrations of lead, zinc and cadmium. In order to test the lead values in the facades, measurements have been taken in 2010 with a portable Innov-x Delta x-ray fluorescence (XRF) spectrometer, which shows the composition of the material on the surface of the walls. New facades and inner walls of recent buildings had low lead concentrations however, the values of Pb crossed 1,000 ppm on white and chipped facades; the values on one older building reached values from 15,659 to 59,475 ppm (1.5-5.9 % of lead). In 2013 samples of natural ground, macadam road stones and garden soil were analysed on lead content. Lowest lead concentrations were found on locations where soil exchange has already been carried out, they were between 62.2 mg/kg and 190.2 mg/kg.

A median lead concentration in other samples of natural ground was 661.4 mg/kg, 534.8 mg/kg in samples of garden soil and 1071.8 mg/kg in material from macadam roads. Since whole lead concentrations give us only partial information about possible exposure (absorbtion due to

3	Turner et al. 2007. Turner A, Ka -Hei lp. Bioaccessibility of metals in dust from the indoor environment: application of a physiologically based extraction test. Environ Sci Technol. 2007 Nov 15;41(22):7851-6.

ingestion) also some tests on bioaccessibility, using multivalent PBET test3 has been performed. The proportions of bioaccesiable lead in samples were from 6% to 20.7% for stomach phase and between 2.5% and 24% for intestinal phase. That seems low, but when taking in account very high total lead concentrations in the environment they present an important way of lead intake in the children. Another interesting test was comparison of lead content in washed and unwashed strawberries. The lead concentration in unwashed part of the sample was 4 times higher than in washed part of the sample, meaning that most of the lead content comes from soil and dust particles on the surface of strawberries.

The strategy

Slovenian government took several measures in order to decrease lead concentration in the upper Meža valley. One of the measures, which were intended for the reduction of lead content in the upper layer of soil, was the re-layering. This procedure is used to replace upper layer of soil and thus, reduce the content of lead in the ground. Despite this measure, the layers eventually mixed and the pollution comes back to upper layers.

The comparison of soil pollution two years after the remediation showed that the concentration of lead in the upper layer was smaller than before. After five years, the concentrations of analysed elements increased, but they are still lower than prior to remediation measures. In future, the re-layering will include the insertion of geotextile barrier.

Due to soil pollution, it is possible that the lead enters bodies by consumption, breathing or through skin. Its harmful effects can be acute or chronic. In early phases, increased concentration of lead is detected in blood, but in later phases, it enters the organs, especially brain. Lead deposits in bones where it replaces calcium. Calcium is essential for growth and regeneration of the skeleton. From medical

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point of view, it is particularly important to reduce the exposure of children aged up to six years to lead, because it can lead to neuro developmental disorders, which appear  later in life.

The lead can be associated with other diseases and symptoms, such as neurological diseases, unexplained spasms, abdominal pain, developmen-tal problems, impaired development, hyperactivity, conduct disorder, hearing loss, anaemia. Because early detection of average lead burden in children is very important, regular biomonitoring of lead

in the children’s blood is being carried out in the Meža Valley to detect their possible health hazards. 

One of the measures taken by the government is also regular lead biomonitoring in the children´s blood. Lead biomonitoring in human’s blood is the most frequent way to assess the overall lead burden in the population, because it shows lead intake and binds for the past month or two prior to blood testing. The total lead intake is dependent on various factors, such as air, drinking water, diet, soil, dust, lifestyle in the particular environment and even physiological characteristics of individuals.

	100%										Database/		
	90%												
													
	80%										National		
	70%												
share of children (%)											2014Health/PublicofInstitute		
	60%												
	50%												
	40%												
	30%												
													
	20%												
	10%												
	0%												
	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014		

	less than 50 µg/l		50 µg/l or more and less than 100 µg/l		more than 100 µg/l		

Share of blood samples in the three-year old children living in the Upper Meža Valley ( target value is 100 µg / l blood4)

4  Adapted from Environmental Indicators in Slovenia, http://kazalci.arso.gov.si/?data=indicator&ind_id=600&lang_id=94

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The beginning of implementation of measures in the environment had positive effects on the population and it encouraged them to implement activities for the reduction of exposure of heavy metals from the environment.

The biomonitoring results show that in the years from 2004 to 2010 the levels of lead in the blood samples of children (445 samples) aged three years have reduced. In the period 2004-2007 approximately one half of children had increased values (100 μg/l), in the period 2008-2009. Approximately one fifth of children and in the period 2010-2013 approximately one tenth of children had increased values of lead in their blood. In the same period, the share of children with low levels (under 50 μg/l) of lead in their blood increased;

that share overreached 70 % in 2010. From 2010 to 2013 (255 samples) the share of children with increased level of lead in their blood was 9.1 to 14.2 % and the share of children with low level of lead in their blood was 51.2 to 71.6 %. In 2014 (66 samples) the share of children with high levels (100 µg/l and more) of lead in their blood was higher (16.7 %) than in the period from 2010 to 2013. The same applies for average value (76.2 µg/l), geometric mean value (58.8 µg/l) and the median (50 µg/l). In 2008, a prevalence study was conducted in the framework of annual programme of measures in order to detect the overall lead burden of Meža Valley children.

The study included children aged one to nine years from thw Upper Meža Valley and children aged three years from the Lower Meža Valley. The study showed

Database/ National Institute of Public Health/ 2014	

Average levels of lead in blood of children from the Upper Meža Valley in 2013 according to age groups (target value is 100 µg / l blood4).

4  Adapted from Environmental Indicators in Slovenia, http://kazalci.arso.gov.si/?data=indicator&ind_id=600&lang_id=94

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significantly higher burden by the Upper Meža Valley children. The highest levels of lead were found in the age group 2-3 years, which was followed by the age group 1-2 years. The calculation from the study showed that children in the Upper Meža Valley have five times higher risk for increased levels of lead in their blood in comparison to children from the Lower part of the Meža Valley.

The study was repeated in 2013. The compared values of lead in the blood were lower in the children from the Lower Meža Valley in comparison to  children from the Upper Meža Valley. In comparison to the study performed in 2008, levels measured in 2013 shoe lower values. The average value, geometric mean value and the median were higher for all age groups of children (according to gender, age and place of living). The highest value was 393 µg/l in 2008, and 330 µg/l in 20134. In addition to the prevalence study in 2008 the “Paget’s disease and lead in the Upper Meža Valley” study has been conducted. Paget’s disease is chronic disease of skeleton with a localized disorder in bone remodelation. Etiology of the disease is not known; however lead is one of the possible causes for its occurrence.The study confirms that disease rate is significantly higher in the Upper Meža Valley than in other places of Koroška region and even Slovenia.

The results have shown that the prevalence of Paget’s disease in Upper Meža Valley is 145.1/100,000 population, in Ravne region 3.0 /100,000, in Maribor region 2.5/100,000 and in Ljubljana region 1.5/100,000 population5. In the Upper Meža Valley, a study has been conducted in 2009, using the IEUBK model6. The study was used to evaluate the connection of lead level in blood of

children aged three with the concentration of lead in the soil, house dust, air and drinking water and according to the location of living. The results have shown that children who live nearest to the polluted area are the most exposed to lead and that each individual can influence the exposure to lead and its intake with proper hygiene, diet and hygiene of living spaces. Polluted soil and house dust are the most burdening factors7.

The occurrence of lead in a person’s body is unnecessary and unwanted. The researches show that even low levels of lead in the blood have negative impacts on children’s health and that it is not possible to determine a safe level of lead in bloof. Some  researches worldvide show the connection of lead and pathologic symptoms in small levels such as 25 µg lead/l of blood8. Therefore it was suggested that the reference level of lead in the blood for children and by pregnant women  should be reduced from 100 to 50 µg lead/l of blood9. In 2012, CDC introduced new reference level of 5 micrograms lead per decilitre to identify children with higher blood lead levels. This level is based on the U.S. proposal for  children aged 1-5 . . CDC is no longer using the term “level of concern” but the reference value to identify children who have been exposed to lead and who require case management. In 2014, a comparison was made between burden of lead disease in children in smaller spatial zones. On the territory of municipalities of Mežica and Črna na Koroškem 24 spatial zones have been created. Individual zones included streets and villages that share not only geographical location, but also the similar lifestyle and potential sources of direct pollution from the near vicinity (industry, traffic). The children were located in individual zones according to their permanent address. The comparison of the calculation of the average, geometric mean, median and the share

5	Hudopisk N. (2009). Prevalenčna študija obremenjenosti otrok Zgornje Mežiške doline s svincem in program zmanjševanja škode za zdravje otrok v Zgornji Mežiški dolini zaradi izpostavljenosti svincu, specialistično

6  Hudopisk N. (2008). Pagetova bolezen in svinec v Zgornji Mežiški dolini, diplomsko delo.

7	Cornelis et al, 2006. Cornelis C., Berghmans P., van Sprundel M., “et al”, (Oct 2006). Use of the IEUBK Model for Determination of Exposure Routes in View of Site Remediation. Human and Ecological Risk Assessment 2006; 12: 963–982.

8 Ivartnik et al, 2010. Ivartnik M. in I. Eržen. Uporaba hmodela IEUBK za napoved vsebnosti svinca v krvi otrok pri raziskavah in sanaciji okolja v Zgornji Mežiški dolini. Zdravstveno Varstvo 2010; 49: 76-85. 9 O’Grady, 2001. O’Grady K., Lead Enwironmental Awareness and Detection, Canada, febr 2001.

9Jakubowski, 2006. Jakubowski M. Development of a coherent approach to human monitoring in Europe, D 6.1-6.3 Utility and sensitivity of biomarkers, ESBIO 2006.

10	Pavlič H. (2014). Primerjava obremenjenosti otrok s svincem po conah in predlogi ukrepov za zmanjšanje izpostavljenosti, diplomska naloga.

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of children with lead levels, ranged below 50, 30 to 99, 100 to 199 and above 200 µg/l of blood, showed the highest burden of children´s disease by those who lived in the zones near current or past industrial plants, near older houses or buildings, where there are more macadam surfaces and where the highest levels of lead in the soil have been detected10.

The results

Conclusions

The results have shown that the higher decline of lead levels in blood was detected immediately after the beginning of the remediation programme. The programme was most intensively implemented at the beginning due to a  a strong public support. Therefore, the measures had great success. Over the years the dynamic of the measures declined, and the substantive amendments did not take place. This stopped the decreasing trend of the lead levels in blood. In 2014, there was even a detection deterioration of the status. For further progress it is essential to work more with small groups and with  children individually (individual consultations in children’s home environment). Also implementation of measures (remediation of soil, re-layering of macadam surfaces, management of facades, etc.) will be needed on private property  Measurements of lead in the environment (air, soil, water, etc.) enable the evaluation and monitoring of the burden of diseases and are a basis for monitoring the occurrence and evaluation of the adequacy of implemented measures. Beside monitoring it is essential to implement programmes for the reduction of lead intake – raising awareness, information, motivation of the population to maintain high level of hygiene (personal hygiene and the hygiene of indoor and outdoor living spaces) and inclusion of healthy food (food with a lot of vitamin C and D, iron, calcium, proteins, etc.) in everyday diets.

11	Pavlič H. (2014). Primerjava obremenjenosti otrok s svincem po conah in predlogi ukrepov za zmanjšanje izpostavljenosti, diplomska naloga.

Human Heath Protection

Further readings

•	Environmental Indicators in Slovenia. Share of blood samples in the three-year old children living in the Upper Meža Valley (target value is 100 µg / l blood); National Institute for Public Health, 2014:

http://kazalci.arso.gov.si/?data=indicator&ind_

id=600&lang_id=94

•	Annual Air Quality Report 2013, Slovenian Environment Agency:

http://www.arso.gov.si/zrak/kakovost%20zraka/

poro%C4%8Dila%20in%20publikacije/kakovost_

letna.html 

•  Environmental indicators in Slovenia,

http://kazalci.arso.gov.si/? 

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