Anemia in Children Due to Airborne Lead Exposure of Used Lead-Acid Battery Recycling Area in Jabodetabek, Indonesia

This study aims to determine the relationship between the concentration of airborne lead exposure to anemia in children aged 7 to 13 living near the informal used lead-acid battery recycling area in Jabodetabek. A crosssectional study was conducted at four locations in Jabodetabek (Tangerang, Bogor, Bekasi and Depok), in which there were informal battery recycling. The study population was children aged 7 to 13 living in the area of informal used lead-acid battery recycling units. The number of children who were willing to participate was 418 children. The respondents were interviewed by using structured questionnaires. Environmental samples measured the airborne lead concentration using High Volume Air Sampler (HVAS) and analyzed using atomic absorption spectrometry (AAS). To identify anemia, blood Hb measurements were taken using HemoCue® Hb 201+ System. The Logistic Regression risk factor model was used to determine the correlation of airborne lead with anemia in children. The results showed an average concentration of airborne lead (n = 52) was 2.96 μg/m3. The average blood Hb level of children (n = 418) was 11.89 g/ dL, with prevalence of anemia of 51.2%. High airborne lead concentration is strongly associated with an increased anemia incidence in children (OR: 3.96; 95% CI: 1.83-8.56) after behavioral factors of calcium intake was controlled (OR: 0.68; 95% CI: 0.46-1.01). This study reveals the correlation between airborne lead exposures and anemia as well as underlines the needs to strengthen the policies, supervision, and development of strategies to reduce airborne lead exposure.