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Year : 2019  |  Volume : 20  |  Issue : 2  |  Page : 149-152

A study on knowledge of mothers on lead poisoning among children at selected hospital, Mangalore

Father Muller College of Nursing, Mangalore, Karnataka, India

Date of Submission18-Jan-2019
Date of Acceptance30-Dec-2019
Date of Web Publication01-Jun-2020

Correspondence Address:
Mrs. Priya Janifer Fernandes
Father Muller College of Nursing, Mangalore, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJCN.IJCN_17_20

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Lead is a highly toxic and poisonous metal. It can cause severe mental and physical impairment. Young children are most vulnerable because they absorb four to five times more ingested lead compared to adults from a given source. Children's curiosity behaviour and their age-appropriate hand-to-mouth behaviour results in their mouthing and swallowing lead-containing objects, such as contaminated soil or dust flakes from decaying lead-containing paints further increasing the risk of lead poisoning. Awareness about lead poisoning and a deeper understanding of its effect on children among caregivers can prevent lead poisoning. The aim of this study was to assess mothers' knowledge regarding lead poisoning in children. Descriptive study design and convenience sampling technique were used to select 99 mothers to assess their knowledge on lead poisoning among children. The data were collected with structured knowledge questionnaire. Findings show that 54.5% had average knowledge, 27.3% had good knowledge, 14.1% had very good knowledge and 4% had poor knowledge. Study reveals that nearly half of the mothers (54.5%) have average knowledge on lead poisoning which shows that there is a need for conducting health education and other awareness programmes on lead poisoning in the community.

Keywords: Knowledge, lead poisoning, mother

How to cite this article:
Fernandes J, Kurian L, Jancy M V, Angadiyath S, Fernandes PJ. A study on knowledge of mothers on lead poisoning among children at selected hospital, Mangalore. Indian J Cont Nsg Edn 2019;20:149-52

How to cite this URL:
Fernandes J, Kurian L, Jancy M V, Angadiyath S, Fernandes PJ. A study on knowledge of mothers on lead poisoning among children at selected hospital, Mangalore. Indian J Cont Nsg Edn [serial online] 2019 [cited 2020 Jul 11];20:149-52. Available from: http://www.ijcne.org/text.asp?2019/20/2/149/285585

  Introduction Top

Lead is a heavy metal which is bluish – Grey coloured. It is a highly toxic metal found in the Earth's crust and a very strong poison. It is easily moulded and shaped due to its low melting point. It has been used worldwide in a number of products such as pipes, storage batteries, pigments and paints, glazes, vinyl products, weights, shot and ammunition, cable covers and radiation shielding.[1] The major source of children's exposure to lead are, lead added to petrol, lead solder in food cans, ceramic glazes drinking water system, lead pipes, lead in products such as indigenous medicines, home remedies, cosmetics and toys, lead released by burning of lead-containing waste.[2] Lead poisoning can be detected by simple blood test. Chelating therapy is used for children with 45 μg/dl of lead in the body.

Lead poisoning can be prevented by simple measures which include, washing hands and toys, cleaning dusty surfaces, removing shoes before entering the house, running cold water in old plumbing containing lead pipes for at least a minute before use, preventing children from playing in the soil, regular healthy nutrition which include adequate calcium, Vitamin C and Iron. When lead is swallowed/inhaled, some poison remains in the body which causes serious health effect.[3]

Lead poisoning is a serious and fatal condition. In Wisconsin, the USA, surveillance of childhood lead poisoning was first conducted in 1991. During the year 2004–2006, about 80,000 children per year were affected, which then increased in 2007–2011 to > 100,000 children annually.[4]

In India, after lead was reported found in the instant food Maggi, it had raised concerns overpacked food items; an analysis of blood samples collected over a period of 1-year from across the country revealed that 23% of the total samples tested positive for lead poisoning. Maggi had undergone regulatory scanner after samples collected were found containing monosodium glutamate and lead in excess of the permissible limit and its sale was banned in many states.[5]

The knowledge of mothers has an important role in the prevention of the disastrous effects of lead poisoning in their children, which may go unrecognised for months or years.[3]

Objectives of the study

  1. To assess mothers' knowledge regarding lead poisoning in children
  2. To find the association between mothers' knowledge regarding lead poisoning in children and selected demographic variables.

  Methodology Top

Nonexperimental descriptive survey design was selected for the study. Mothers of children who visited paediatric outpatient department or admitted in paediatric wards or those who were visiting immunisation clinics at a tertiary hospital in Mangalore were included as the study population. A total of 99 mothers with children under 5 years of age were conveniently selected as participants for the study. Mothers who were health-care professionals were excluded from the study.


Tool I: Demographic performa.

The demographic performa consisted of six items to obtain information regarding age, education, occupation, income, number of children and locality of living.

Tool II: Structured knowledge questionnaire:

The structured knowledge questionnaire on lead poisoning consisted of 15 questions covering the following areas, namely definition and risk factors, causes, signs and symptoms treatment and prevention.

The tool was validated by six experts from nursing profession for its content. Data were collected from 5 mothers to check the internal consistency and subjected to split-half method. The reliability was found using split-half method correlation formula. The reliability obtained was 0.8, which was considered to be reliable.

Data collection procedure

The investigators obtained permission from the administrative authority to conduct the study. The objectives of the study were explained, and a written informed consent from the subjects was obtained. They were assured of the anonymity and confidentiality of the information provided. Participants filled the demographic pro forma and structured knowledge questionnaire on lead poisoning. It took approximately 20 min for the participants to complete the questionnaire.

  Results Top

Most of the participants were between 22 and 30 years (68.7%) and homemakers (78.8%). About half the proportion of the mothers had secondary education (49.5%) and those with two children were 43.4%. Most of the participants were from rural area (70.5%) [Table 1].
Table 1: Distribution of subjects according to demographic characteristics

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[Figure 1] shows that half the proportion of the participants (54.50%) had average knowledge, 27.30% had good knowledge, 14.10% had very good knowledge and 4.1% had poor knowledge.
Figure 1: Level of knowledge of mothers on lead poisoning among children.

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[Table 2] reveals that the mean percentage of mothers' knowledge on lead poisoning among children was 51.33%, which in turn shows that they had average knowledge regarding lead poisoning in children.
Table 2: Mean knowledge score of mothers on lead poisoning

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The mean percentage of mothers' knowledge on definition and risk factors was 67.5%, which shows that subjects had good knowledge in this area [Table 3]. Participants had average knowledge in domains 2 and 3 (41.6%and 49.89%, respectively).
Table 3: Domain-wise distribution of mean, standard deviation, and mean percentage of knowledge score (n=99)

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Chi-square test values were computed between knowledge of mothers on lead poisoning among children and selected demographic variables. There was a significant association between knowledge and education level of mothers. No significant association was found between the knowledge of mothers and age, occupation, income, number of children and locality.

  Discussion Top

Most of the mothers in this study were <30-year-old and homemakers. Although there was no significant association found between age or work and knowledge, the opportunities for learning about lead poisoning could have been lower because of this reason leading to an overall lower mean knowledge score. Lead poisoning is also not generally considered by many families in India as much as other poisoning such as with medications or cleaning solutions.

However, the mean knowledge score for mothers in this study was 51.3%, denoting that the knowledge was neither good nor poor. The domain wise computation also showed that mothers had above-average knowledge about definition and risk factors indicating that the concept of lead poisoning was not absolutely new for them and they had some understanding about the poisoning. In a study where knowledge regarding lead poisoning was compared between mothers of children with elevated serum lead levels and those who did not in the USA, it was found both groups did not significantly differ in their knowledge scores. However, the mean score was higher in both groups (72% and 64%) when compared to the current study.[6] In another study conducted to assess 30 mother's knowledge regarding lead poisoning in Karkalla, it was found that most of the mothers (50%) had good knowledge, 10% had poor and 40% had average knowledge.[7]

A significant association between knowledge level and education (χ[2] = 4.473) was found in the present study. A similar association of knowledge with education has been found in a Turkish study on mothers' knowledge on house poisoning.[8] A cross sectional study was conducted to assess mother's knowledge on lead poisoning in Bureghavan. The result reveals that there was a significant association between monthly expenditure and the level of knowledge.

It was estimated that with the raise in income category (from lower to higher), the odds of knowing about lead poisoning increased by 3.4 (P = 0.014).[9] No such association between income and knowledge was found in this study.

  Conclusion Top

Children worldwide today are at risk of exposure to lead from multiple sources and lead poisoning has many adverse developmental outcomes in children. Some countries have robust programme for monitoring levels of lead in blood and the environment, as well as strong program for primary and secondary prevention of childhood lead poisoning. Such programmes are unavailable in the majority of health-care facilities in India. How mothers view lead poisoning enables nurses to plan and implement health education and awareness programmes in the hospital and community setting. This study has explicated that the knowledge of mothers were far from optimal and has strongly indicated the need for educating parents on lead poisoning and its prevention.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Rastogi D. Lead Poisoning; 2017. Available from: https://www.nhp.gov.in/disease/non-communicable-disease/lead-poisoning. [Last accessed on 2018 Oct 05].  Back to cited text no. 1
Agency for Toxic Substances and Disease Registry. Lead (Pb) Toxicity: Where Is Lead Found? 2017. Available from: https://www.atsdr.cdc.gov/csem/csem.asp?csem=34&po=5. [Last accessed on 2018 Oct 02].  Back to cited text no. 2
Mayo Clinic. Lead Poisoning-Symptoms and Causes; 2018. Available from: https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717. [Last accessed on 2018 Oct 30].  Back to cited text no. 3
World Health Organisation. Childhood Lead Poisoning; 2010. Available from: https://www.who.int/ceh/publications/leadguidance.pdf. [Last accessed on 2018 Oct 30].  Back to cited text no. 4
Gordon-Larsen P, Nelson MC, Page P, Popkin BM. Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics 2006;117:417-24.  Back to cited text no. 5
Anderson RL, Whitwell JK, Snyder SA, Besunder JB. Maternal perceptions of lead poisoning in children with normal and elevated lead levels. J Pediatr Health Care 1999;13:62-7.  Back to cited text no. 6
Fernandes ST. A study on knowledge regarding lead poisoning in children among mothers from selected rural community at Karkalla. ZENITH International Journal of Multidisciplinary Research. 2014;4:76-9.  Back to cited text no. 7
Bilgen Sivri B, Ozpulat F. Mothers' knowledge levels related to poisoning. Turk J Emerg Med 2015;15:13-22.  Back to cited text no. 8
Aleksandrian G. Knowledge Assessment of Care–Takers of Children from 2 to 6 Years Old Living in Bureghavan about Lead Exposure and Lead Poisoning (Doctoral dissertation). American University of Armenia; 2014.  Back to cited text no. 9


  [Figure 1]

  [Table 1], [Table 2], [Table 3]


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