Heavy metals screening model in primary care: Experience in the Sierra Minera de Cartagena (Spain)

Abstract

Introduction

Soils contaminated by heavy metals such as lead, cadmium, and arsenic represent a significant health risk. The Sierra Minera of Cartagena (Spain) is an area historically contaminated by mining activities. This study evaluates the exposure to heavy metals and proposes a clinical screening model for its management in primary care.

Method

Descriptive cross-sectional study conducted between 2017 and 2020 with volunteers from the Sierra Minera of Cartagena who provided blood and urine samples. Primary care health professionals were trained in sample collection and analysis, risk communication, and clinical protocols on heavy metals were implemented.

Results

203 participants, 66.5% women and 38 (18.7%) under 16 years old. The majority resided in Zone 0 (contaminated area). Mean blood lead level was 1.78 μg/dl and 2.22 μg/dl in those under 16 years old, with. Metal concentrations, particularly lead, increased with age, male sex, Arab ethnicity, and proximity to contaminated areas. Tobacco smoke was identified as a main source of lead exposure in children under 16 years. The primary care clinical screening model identified 12 (7%) and 22 (11%) participants exceeding 5 μg/dl and 3.5 μg/dl respectively, particularly six children and one pregnant woman, with significant levels that normalized within 2–3 months following PEHSU's clinical guidelines.

Conclusions

The implementation of clinical and analytical screening for heavy metals in primary care, supported by pediatric environmental health units (PEHSU), proved effective in screening and reducing in children blood lead levels in a short period. Training health professionals is crucial to adequately address environmental risks and protect the health of affected populations.