Broken Hill Child Lead Testing Relies on Faulty Equipment, Internal Documents Show
In the mining town of Broken Hill, New South Wales, voluntary blood testing is offered to families with children under five years old, where historical and ongoing mining operations have caused significant lead contamination. However, recent revelations indicate that the testing process is compromised by the use of a machine known to produce inaccurate results.
Inaccurate Readings and Health Risks
Ella, a mother whose 16-month-old daughter recently tested at 3.5 micrograms of lead per decilitre (3.5μg/dL), remains deeply concerned. While this reading falls below the Australian investigation threshold of 5μg/dL, she is aware that the World Health Organization states there is no safe level of lead exposure. Internal documents from the NSW Department of Health confirm that even levels as low as 3.5μg/dL may be linked to reduced IQ, attention deficits, learning disabilities, hyperactivity, behavioural issues, impaired growth, and hearing loss in children.
Compounding Ella's worries, her daughter's previous test result was 6.4μg/dL, highlighting inconsistencies. The machine used for both tests, the LeadCare II, provides point-of-care testing with a simple finger prick for immediate results. Yet, this equipment has faced global recalls due to its potential to deliver inaccurately low blood lead readings, raising serious questions about its reliability.
Regulatory Concerns and Continued Use
The Therapeutic Goods Administration (TGA), Australia's medicines regulator, suspended and subsequently removed the LeadCare II system from the Australian Register of Therapeutic Goods in 2020. This action followed a 2018 warning letter to state and territory chief health officers, noting an error margin of +/- 6 μg/dL and a risk of false negative results going undetected.
Despite these concerns, NSW Health continues to employ the machine in Broken Hill under a "special arrangement" with the Far West Local Health District. Dr Jeremy McAnulty of NSW Health explained to budget estimates in December that while the government acknowledges the inaccuracies, it uses the device to screen as many children as possible, offering follow-up care across a broad range of results. However, the Greens party asserts that this follow-up support is frequently not provided to affected families.
Internal Emails Expose Awareness Gaps
Emails released under parliamentary call to Greens MP Cate Faehrmann reveal that stakeholders using the LeadCare II machine in Broken Hill were previously unaware of its accuracy issues. One August 2023 email to an assistant director within NSW Health stated that two stakeholders only recently discovered the product had been revoked, with one expressing concern over the validity of past clinical testing.
In December 2023, Brad Astill, CEO of the Far West Local Health District, described the current screening machine as "considered end of life" in correspondence to McAnulty. He argued that transitioning to conventional blood testing would likely reduce community uptake and that the benefits of point-of-care testing outweigh the inherent risks. Astill proposed continuing to use existing testing strips as an interim measure while exploring alternative screening instruments.
Manufacturer Claims and Regulatory Stance
Meridian Bioscience, parent company of Magellan Diagnostics which manufactures the LeadCare II, claims that a 2021 recall was due to a packaging issue that has been fully mitigated, with the tests now performing as intended. However, a TGA spokesperson countered that no additional data has been provided to demonstrate mitigation, preventing reinstatement on the therapeutic goods register.
Further emails show that Queensland Health expressed nervousness about the machine's continued use in Mount Isa, indicating broader regional concerns. NSW Chief Health Officer Dr Kerry Chant noted that an expert panel was established to address the issue, emphasising that screening tests often trade accuracy for detection capability, with venous blood tests used for validation when needed.
Inadequate Support for Affected Families
Faehrmann criticised NSW Health for applying less rigorous standards in the far west, alleging that children testing above national guideline levels receive minimal support. She reported that families are often given basic advice like using wet wipes, cleaning more, and limiting outdoor play, with home remediation offered only through a lottery system for severe cases.
Alexis, Ella's sister, confirmed that her children tested above the investigation threshold but received no support from NSW Health, calling for enhanced assistance in Broken Hill. A spokesperson for the NSW premier acknowledged the need for ongoing action, highlighting the Broken Hill Environmental Lead Response Group's role in coordinating a long-term, whole-of-government approach to reduce lead impacts, particularly on children.
Slow Progress and Funding Limitations
A recent report by the NSW chief scientist and engineer found that while some progress has been made in reducing environmental lead levels and community exposure in Broken Hill, improvements have slowed in recent years. Issues such as limited access to home remediation due to funding constraints persist, undermining efforts to protect children's health in this contaminated region.
