Lead in breastmilk samples from women living in the West Bank: a cross-sectional study

Background

Breastmilk is the recommended form of enteral nutrition for all infants. Infants nourishing on breastmilk contaminated with lead are at high risk of exposure to this neurotoxic heavy metal. The aim of this study was to screen lead concentrations in samples of breastmilk obtained from women living in three main regions of the West Bank and to investigate the sociodemographic characteristics associated with high lead concentrations.

Methods

In this cross-sectional study, breastmilk samples were collected from breastfeeding women living in Nablus, Ramallah, and Jerusalem. The participants' sociodemographic characteristics were recorded, and the lead concentration in breastmilk samples were quantified using a graphite furnace atomic absorption spectrophotometer. Ethical approval was obtained from the Institutional Review Board of An-Najah National University, and all participants provided written informed consent.

Findings

Breastmilk samples were obtained from 89 women. The median lead concentration was 4 μg/L (range 2–12 μg/L). The lead concentration was higher than WHO's safety limits for occupationally unexposed population in 17 (19%) samples. Lead concentrations were also significantly higher in samples obtained from women living in refugee camps and cities (p=0·003) than in women living in villages, higher in women with low monthly household income than in women with high monthly household (p=0·020), higher in women living in houses with peeling paint than in women living in houses with no peeling paint (p=0·026), higher in women who worked in agriculture for more than 3 years than in women who worked in agriculture for less than 3 years or less (p=0·005), and higher in women who frequently used eye kohl than in women who did not (p=0·004). Multiple linear regression analysis showed that using eye kohl was a significant predictor (p=0·040) of lead concentration in breastmilk above WHO's safety limits.

Interpretation

In this study, about one-fifth of women had concentrations of lead in their breastmilk above the WHO's safety limits. Authorities need to implement measures to eliminate or reduce lead exposure, especially in refugee camps and cities. Eye kohl preparations marketed in the occupied Palestinian territory should be screened for lead content.

Funding

None.