Eradication of child and adult mortality from lead poisoning following community resettlement: Mitrovica, Kosovo
Submitting Institution
Aberystwyth UniversityUnit of Assessment
Geography, Environmental Studies and ArchaeologySummary Impact Type
SocietalResearch Subject Area(s)
Earth Sciences: Geochemistry
Environmental Sciences: Environmental Science and Management, Soil Sciences
Summary of the impact
The results of commissioned research by Aberystwyth University (AU) have
shaped decision-making that led to the relocation of refugee Roma,
Ashkali and Egyptian (RAE) communities in Mitrovica, northern Kosovo. In
2009/2010 AU research unequivocally identified the source of elevated lead
(Pb) levels in soils that had been blamed for high infant and adult
mortality rates in RAE refugee camps, and established that Roma Mahalla
had sufficiently low soil Pb levels to permit the construction of a
purpose-built housing development for the RAE communities. Following the
relocation of the RAE families to Roma Mahalla in 2010/2011 there has been
a significant reduction in blood Pb levels in children with no reported
deaths attributable to Pb poisoning. This AU research project has had a
demonstrable positive impact on life quality and human health of the
resettled RAE communities living in Mitrovica.
Underpinning research
For more than 20 years Macklin (MGM) and Brewer (PAB) have led UK
geomorphological-geochemical research into the impacts of modern and
historical metal mining on river systems worldwide. They have an
internationally recognised track-record of research into the sources,
transport pathways and sinks of sediment associated contaminant metals
(especially lead [Pb], zinc [Zn], copper [Cu] and cadmium [Cd]) in the
fluvial environment as well as their impacts on human and ecosystem health3.1-3.3.
Since 1993 their research in these fields at AU (Brewer, 1993-, Macklin,
1999-) has led to the publication of 43 peer-reviewed articles, 23
commissioned scientific reports and the award of 18 research grants and
consultancy projects worth £1.37 million.
Pioneering research by MGM identified that the dispersal, storage and
remobilization of sediment-associated metals in the fluvial system can be
directly related to sediment transport processes and flooding regimes.
Furthermore, the realisation that more than 90% of metal contaminants in
rivers are transported in a particulate-associated form and, therefore,
follow the same transport pathways as the natural sediment load of a
river, led to the development of the `geomorphological-geochemical
approach' for assessing the environmental impacts of metal mining in river
basins3.2. This fundamental research has subsequently been
applied to the identification and solving of environmental problems
arising from the legacy of historical metal mining in the UK (funded by
DEFRA3.4, EPSRC3.5 and the EA3.6), Europe
(e.g. Bulgaria funded by the Royal Society) and South America (funded by
NATO and National Geographic3.7).
In the last decade or so, development of geomorphological-geochemical
research tools and the application of Pb-isotope analysis has enabled the
specific impacts of mine tailings dam failures in South America3.7,
Spain (by MGM, PAB and their co-workers and funded by NERC and Boliden
Apirsa) and Romania (funded by the Royal Society, Rosia Montana Gold
Corporation, and Maramureş/Satu Mare County Councils) to be investigated
and effectively managed. Sediment mixing models have been used to
establish the geochemical/pollution `footprint' of the Rosia Montana gold
mine in Romania. The model outputs were incorporated within the mining
company's application to exploit and develop Europe's largest gold reserve
in the Apuseni Mountains.
As a result of their research on metal contamination following the 2000
Yorkshire Ouse floods, MGM and PAB were commissioned by DEFRA3.4,
EA3.5 and Lloyd's of London3.8 to produce a series
of policy and emerging risks guidance reports to steer environmental
assessment and regulation. It was as a direct consequence of this work
that MGM and PAB were asked by the Foreign and Commonwealth Office in
Kosovo to help resolve the problem of relocating the refugee RAE
communities to an environmentally `safe' site within Mitrovica, Kosovo.
From 2000, concerns had been raised about the health of RAE communities
who were displaced during the 1999 Yugoslav conflict, and who were living
in two refugee camps (Cesmin Lug and Osterode) on former industrial land
around Mitrovica in northern Kosovo. These communities were subject to
abnormally high adult and infant mortality rates, prompting the WHO to
recommend immediate closure of the refugee camps. In December 2009 PAB and
MGM (under the aegis of Fluvio, the brand-name for applied research by the
River Basin Dynamics and Hydrology Research Group at Aberystwyth
University), were commissioned by the Foreign and Commonwealth Office in
Kosovo3.1, Post Telecommunications Kosovo (PTK) and NGOs
(Norwegian Church Aid, Danish Refugee Council, Mercy Corps) to (i)
establish if Roma Mahalla (a suburb of Mitrovica) was an environmentally
`safe' location to build a new housing development for the relocation of
the displaced RAE communities, and (ii) identify the source(s) of soil Pb
in the Mitrovica region and recommend appropriate remediation strategies.
Although funding and planning permission were in place for the Roma
Mahalla development, the principal barriers to initiating the scheme were
concerns regarding possible soil contamination at the site and the lack of
data confirming the Pb-source(s) responsible for the high mortality rates
in the camps; the RAE communities were reluctant to move unless assurances
could be given that Roma Mahalla would be a `safe' place to live. Fluvio's
commissioned research project was specifically designed to provide an
independent and objective evidence base that would result in the removal
of these barriers to the Roma Mahalla development.
The results of a detailed field-based sampling programme identified
severe Pb contamination in the soils underlying the occupied Cesmin Lug
and Osterode refugee camps. Pb concentrations in soils (5,100 mg kg-1)
and house dust (5,900 mg kg-1) exceeded the UK CLEA Soil
Guideline Value for residential use/allotments (450 mg kg-1) by
more than tenfold, rendering the camps wholly unsuitable for human
habitation. However, the data also demonstrated that land quality at Roma
Mahalla was significantly better, with mean Pb concentrations in surface
soils (513 mg kg-1) only marginally exceeding the 450 mg kg-1
threshold CLEA value.3.9,3.10
References to the research
3.1 Peer-reviewed paper: Macklin, M.G., Brewer, P.A., Balteanu,
D., Coulthard, T.J., Driga, B., Howard, A.J. and Zaharia, S. (2003): The
long term fate and environmental significance of contaminant metals
released by the January and March 2000 mining tailings dam failures in
Maramureş County, upper Tisa Basin, Romania. Applied Geochemistry
18, 241-257. http://dx.doi.org/10.1016/S0883-2927(02)00123-3.
3.2 Peer-reviewed paper: Macklin, M.G., Brewer, P.A.,
Hudson-Edwards, K.A., Bird, G., Coulthard, T.J., Dennis, I.A., Lechler,
P.J., Miller, J.R., and Turner, J.N. (2006): A geomorphological approach
to the management of rivers contaminated by metal mining. Geomorphology
79, 423-447. http://dx.doi.org/10.1016/j.geomorph.2006.06.024.
3.3 Peer-reviewed paper: Miller, J.R., Hudson-Edwards, K.A.,
Lechler, P.J., Preston, D. and Macklin, M.G. (2004): Heavy metal
contamination of water, soil and produce within riverine communities of
the Rio Pilcomayo basin, Bolivia. Science of the Total Environment
320, 189-209. http://dx.doi.org/10.1016/j.scitotenv.2003.08.011.
3.4 Research grant: Macklin, M.G., Brewer, P.A. and Coulthard,
T.J. `The use of geomorphological mapping and modelling for identifying
land affected by heavy metal contamination on river floodplains'. DEFRA
(SP 0525), £20,012. 01.03.2003 - 30.06.2003 Peer-reviewed commissioned
report. Brewer, P.A., Dennis, I.A., Macklin, M.G. (2005): The use of
geomorphological mapping and modelling for identifying land affected by
metal contamination on river floodplains. DEFRA Research and Development
Report SP 0525, 58 pp. http://sciencesearch.defra.gov.uk/Default.aspx?Menu=Menu&Module=More&Location=None&Completed=0&ProjectID=10969.
3.6 Research grant: Macklin, M.G., Coulthard, T.J. and Brewer,
P.A. `Contaminated Sediments: Assessing Environmental and Public Health
Risks'. EPSRC (GR/S76304/01), £154,388. 01.09.2004 - 31.08.2008.
3.7 Peer-reviewed paper: Hudson-Edwards, K.A., Macklin, M.G.,
Miller, J.R. and Lechler, P.J. (2001): Sources, distribution and storage
of heavy metals in the Rio Pilcomayo Bolivia. Journal of Geochemical
Exploration 72, 229-250. http://dx.doi.org/10.1016/S0375-6742(01)00164-9.
3.9 Commissioned research report: Brewer, P.A., Bird, G, Macklin,
M.G. and Swain, C.H. (2010): Geochemical assessment of soils in Roma
Mahalla, Mitrovica, Kosovo: implications for the proposed resettlement of
families presently living in the Osterode and Cesmin Lug Camps.
Commissioned by the Foreign and Commonwealth Office (Kosovo) and Post
Telecommunications Kosovo. Fluvio report 2010/02/66, 44 pp.
3.10 Commissioned research report: Brewer, P.A., Bird, G, and
Macklin, M.G. (2010): Pb levels and Pb isotopic signatures determined in
samples of scalp hair from residents of the Osterode and Cesmin Lug camps,
Mitrovica, Kosovo. Commissioned by the Foreign and Commonwealth Office
(Kosovo) and Post Telecommunications Kosovo. Fluvio report 2010/03/67, 10
pp.
Details of the impact
The research undertaken by MGM and PAB in Kosovo provided the evidence
base for the relocation of residents of the Osterode and Cesmin Lug
refugee camps to a new site at Roma Mahalla, and as a result, to sharp
reductions in blood lead levels and consequently to the eradication of
child and adult mortality from lead poisoning among the RAE refugee
community. Recommendations from the commissioned research reports were
presented at meetings in Mitrovica (March 2010) attended by the British
Ambassador to Kosovo, the Mayor of Mitrovica, the Kosovan Minister for
Communities and Returns, the Chief Executive Officer of PTK, various NGOs,
the press and leaders from the Roma Mahalla, Osterode and Cesmin Lug
refugee camps.
The reports/presentations triggered widespread media coverage in Kosovo
(newspapers5.1,5.2, television and radio interviews) and the
research was also referred to in a question and answer exchange in the
House of Lords between Lord Avebury and Baroness Kinnock5.3.
The profile gained by such high-level political interest in the UK
provided the momentum for the British Embassy in the UK to press for our
recommendations to be implemented5.4: "In response to
Baroness Kinnock's letter ...... the Kosovo Emergency Medical Group told
UKAGW that they are pleased that the UK Embassy in Pristina has been
working hard to try and get matters moving, and the recent Fluvio lead
testing programme at the camps and Roma Mahalla is a testament both to
their efforts, and that of the scientists involved".
The published
recommendations led directly to the following quantifiable actions and
impacts:
1) In August 2010 construction began on the Roma Mahalla site and by
September 2011 the first phase of the development was complete5.5
— report recommendation 2. The two air photographs in Figure 1
show the Roma Mahalla site before (March 2005) and after (September 2011)
housing construction.
2) By September 2010 the Pb-contaminated Cesmin Lug camp had been closed
and this was followed by the closure of Osterode in December 2012 — report
recommendation 1.
3) Improved knowledge and management of the risks posed by Pb in the
Mitrovica region. In particular, Fluvio's research-informed recommendation
was to deep-plough and resurface the site to reduce near-surface Pb
levels. Mercy Corps, the NGO responsible for liaison with the RAE
community, has confirmed that, "your recommendation to deep plough the
site was implemented before construction at a depth of 90 cm and gravel,
from outside Mitrovica, was laid on top of the newly tilled soil for the
123 row houses that were constructed"5.6 — report
recommendation 3.
4) Improved health and welfare outcomes, especially for children who are
disproportionately susceptible to Pb poisoning. As reported by Mercy
Corps: "Shortly after their resettlement, more than 200 children, aged
0 to 6 years, had their blood lead levels tested at the local health
clinic working with Mercy Corps. The results indicated that 82 percent
of these children had elevated blood lead levels above 10 micro-grammes
per decilitre. Such elevated blood lead levels impair
neuropsychological functions and in particular, those of young children
whose brains are developing. Treatments are available for the highest
lead levels and diet and hygiene play a role in mitigating
contamination. However, moving to the lead safe area of Roma Mahalla was
the most important factor in reducing their blood lead level. Children
resettled for 18 months or more had a median drop in blood lead levels
of 36 percent."5.6
5) Following the demonstrable impact of the Roma Mahalla study, Brewer
and Macklin were invited back to Kosovo by Mercy Corps to undertake a
second land contamination assessment. The aim of this follow-up project
was to identify an environmentally safe site for the relocation of some
RAE families who, for ethnic reasons, could not move to the Roma Mahalla
site3.9.
MGM's and PAB's research was responsible for resolving in Mitrovica,
Kosovo, what has been described by Dorit Nitzan, head of the World Health
Organisation office in Belgrade, as "the worst ever Pb poisoning that we
know of in Europe"5.7. Their scientific assessments and health
guidance resulted in the lives of more than 160 families, including over
400 children and adults, being saved and protected, and it represents a
benchmark study in the field of environmental toxicology.
Sources to corroborate the impact
5.1 Marzouk, L. (2010): Experts call for pollution probe in North Kosovo.
Pristina Insight, March 27 — April 8, p. 6.
5.2 Experts Call for Pollution Probe in North Kosovo. Balkan Insight
March 15 (2010). http://www.balkaninsight.com/en/article/experts-call-for-pollution-probe-in-north-kosovo.
5.3 Citation in Hansard record of House of Lords (04/03/2010): question
asked by Lord Avebury [HL2372] with response from Baroness Kinnock (http://www.publications.parliament.uk/pa/ld200910/ldhansrd/text/100304w0004.htm).
5.4 Direct quotation from Roma Files: (http://groups.google.com/group/Roma_Files/browse_thread/thread/87ecbeeed5addf6f/22c7153272009b59?lnk=raot).
5.5 EU starts building 38 houses in Roma Mahalla for Roma, Ashkali and
Egyptian families living in Cesmin Lug and Osterode camps. European
Commission Liaison Office to Kosovo press release. http://www.mercycorps.org.uk/articles/kosovo/new-homes-after-more-decade-displacement.
5.6 Letter from Mercy Corps, the main NGO charged with RAE liaison and
humanitarian assistance.
5.7 BBC News (2009) Kosovo's poisoned generation, BBC News website, 14
January 2009, http://news.bbc.co.uk/1/hi/7827031.stm