Food safety policy enforcement and associated actions reduce lead chromate adulteration in turmeric across Bangladesh

Jenna E Forsyth; Musa Baker; Syeda Nurunnahar; Shariful Islam; M Saiful Islam; Tauhidul Islam; Erica Plambeck; Peter J Winch; Dinsha Mistree; Stephen P Luby; Mahbubur Rahman

doi:10.1016/j.envres.2023.116328

Food safety policy enforcement and associated actions reduce lead chromate adulteration in turmeric across Bangladesh

Environ Res. 2023 Sep 1:232:116328. doi: 10.1016/j.envres.2023.116328. Epub 2023 Jun 5.

Authors

Affiliations

¹ Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA; Woods Institute for the Environment, Stanford University, Stanford, CA, USA. Electronic address: jforsyth@stanford.edu.
² Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
³ Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh; School of Public Health and Community Medicine, UNSW, Sydney, Australia.
⁴ Graduate School of Business, Stanford University, Stanford, CA, USA.
⁵ Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁶ Hoover Institution and School of Law, Stanford University, Stanford, CA, USA.
⁷ Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA; Woods Institute for the Environment, Stanford University, Stanford, CA, USA.

PMID: 37286126
DOI: 10.1016/j.envres.2023.116328

Abstract

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.

Keywords: Bangladesh; Food safety; Lead chromate; Lead exposure; Policy; Spices; Turmeric.

MeSH terms

Bangladesh
Chromates*
Curcuma
Food Safety
Humans
Lead* / analysis

Substances

lead chromate
Lead
Chromates