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Handbook of Drought
and Water Scarcity
Management of Drought and
Water Scarcity
Handbook of Drought
and Water Scarcity
Management of Drought and
Water Scarcity

Edited by
Saeid Eslamian and Faezeh Eslamian
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742

© 2017 by Taylor & Francis Group, LLC


CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Printed on acid-free paper

International Standard Book Number-13: 978-1-4987-3100-3 (Hardback)

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Library of Congress Cataloging‑in‑Publication Data

Names: Eslamian, Saeid, editor. | Eslamian, Faezeh A., editor.


Title: Handbook of drought and water scarcity : environmental impacts and
analysis of drought and water / edited by Saeid Eslamian and Faezeh A.
Eslamian.
Description: New York : CRC Press, 2017-
Identifiers: LCCN 2016030589| ISBN 9781498731089 (v. 1 : hardback) | ISBN
9781315404226 (v. 1 : e-book)
Subjects: LCSH: Droughts. | Drought forecasting. | Water-supply. |
Environmental impact analysis.
Classification: LCC QC929.24 .H36 2017 | DDC 551.57/73--dc23
LC record available at https://lccn.loc.gov/2016030589

Visit the Taylor & Francis Web site at


http://www.taylorandfrancis.com

and the CRC Press Web site at


http://www.crcpress.com
Contents

Editors����������������������������������������������������������������������������������������������������������������������� ix
Contributors������������������������������������������������������������������������������������������������������������� xi

1 Drought Management: Initiatives and Objectives���������������������������������������������1


Yohannes Yihdego and Saeid Eslamian
2 Impacts of Drought on Social and Agricultural Systems������������������������������� 27
Hussein A. Amery and Christina A. Boyes
3 Capacity Building and Drought Management������������������������������������������������� 51
Shafi Noor Islam, Sandra Reinstädtler, and Albrecht Gnauck
4 Adaption to Droughts�������������������������������������������������������������������������������������� 75
Never Mujere and Sanjay M. Yadav
5 Drought Management Strategies in Water-Stressed/Water-Scarce Regions����� 95
Ismail Kaan Tuncok and Saeid Eslamian
6 Drought Management in an Urban Context�������������������������������������������������� 153
Avanish K. Panikkar
7 Drought Management in Coastal Areas���������������������������������������������������������167
Giovanni Barrocu
8 Drought Management for Landscape and Rural Security����������������������������� 193
Sandra Reinstädtler, Shafi Noor Islam, and Saeid Eslamian
9 Drought Assessment and Management for Heat Waves Monitoring����������� 235
Nicolas R. Dalezios and Saeid Eslamian
10 Drought and Pest Management����������������������������������������������������������������������261
Yohannes Yihdego
11 Groundwater Management in Drought Conditions������������������������������������� 275
Eduardo Kruse and Saeid Eslamian
12 Reservoir Operation during Drought����������������������������������������������������������� 283
Shahab Araghinejad, Seyed-Mohammad Hosseini-Moghari, and Saeid Eslamian
13 Crisis Management Planning and Drought Management Plans������������������� 293
Saeid Eslamian, Behnaz Khosravi, Majedeh Sayahi, and Majedeh Haeri-Hamedani

v
vi Contents

14 Functional Analysis of Regional Drought Management������������������������������ 307


Rares Halbac-Cotoara-Zamfir and Saeid Eslamian
15 Rainfall Management for Sustainable Agriculture���������������������������������������� 331
Never Mujere and Rajendra Kumar Isaac
16 Deficit Irrigation: Farmlands������������������������������������������������������������������������ 345
Ali Zahraei, Sara Saadati, and Saeid Eslamian
17 Deficit Irrigation: Greenhouse����������������������������������������������������������������������� 361
Mohammad Javad Amiri, Saeid Eslamian, Mehdi Bahrami, and Neda Yousefi
18 Deficit Irrigation: Optimization Models�������������������������������������������������������375
Kaveh Ostad-Ali-Askari, Mohammad Shayannejad, Saeid Eslamian, Fereshteh Zamani,
Nasrin Shojaei, Bahareh Navabpour, Zahra Majidifar, Amin Sadri, Zahra Ghasemi-Siani,
Hossein Nourozi, Omid Vafaei, and Seyed-Mohamad-Amir Homayouni
19 Drought Mitigation Practices������������������������������������������������������������������������ 393
Adebayo Oluwole Eludoyin, Oyenike Mary Eludoyin, and Saeid Eslamian
20 Social Impacts of a National Drought Policy in Australia��������������������������� 405
Tamara Sysak and Ruth Beilin
21 History of Drought Management in Australia���������������������������������������������� 423
Kathryn Reardon-Smith, Allyson Williams, Shahbaz Mushtaq, David Cobon,
David McRae, and Louis Kouadio
22 Politics of Drought Management and Water Control in India��������������������� 449
S. Mohammed Irshad and Saeid Eslamian
23 Drought Management for Horticultural Crops in India������������������������������ 463
Ravi Patil and Saeid Eslamian
24 Interbasin Transfers of Water for Southern Africa��������������������������������������� 485
Samir Anwar Al-Gamal
25 Drought Management Planning Resources for Water Suppliers in Pakistan���� 497
Saifullah Khan and Saeid Eslamian
26 Forest Fire Mitigation under Water Shortage����������������������������������������������� 529
Leila Sedaei, Nazila Sedaei, Jonathan Peter Cox, Nicolas R. Dalezios, and Saeid Eslamian
27 Education Program for Drought��������������������������������������������������������������������553
Neda Torabi Farsani, Carlos Neto de Carvalho, and Saeid Eslamian
28 Policy Framework of Drought Risk Mitigation�������������������������������������������� 569
Giuseppe Rossi
29 Drought Law and Policy�������������������������������������������������������������������������������� 589
Bosun Banjoko and Saeid Eslamian
30 Emergency Drought Consequence Plan��������������������������������������������������������641
Sara Nazif, Hamed Tavakolifar, and Saeid Eslamian
31 Coping with Drought�������������������������������������������������������������������������������������661
Mohsen Mohseni Saravi, Reza Shahbazi, and Saeid Eslamian
Contents vii

32 Integrated Water Resources Management under Water Scarcity����������������� 677


Saeid Eslamian, Elham Mohri-Isfahani, Arash Mahdavi, Foroozan Rajaei-Rizi,
Maryam Marzi-Nouhedani, Mahboubeh Ghasemi-Zanyani, Sara Dehghani,
Seyedeh Zahra Hosseini-Teshnizi, Farzad Esmaeili, Nasrin Shojaei, Mohsen Ghane,
and Ali Hasantabar-Amiri
33 Drought and Dust Management�������������������������������������������������������������������� 699
Alireza Aghaei, Saeid Eslamian, Nicolas R. Dalezios, Ali Saeidi-Rizi, and Sivash Bahredar
34 Drought Management: Current Challenges and Future Outlook����������������� 729
Saeid Eslamian, Nicolas R. Dalezios, Vijay P. Singh, Jan Adamowski,
Sheyda Mohammadifard, Ramin Bahmani, Somayeh Eskandari, Mehdi Zomorodian,
Ata Arefeyan, Sara Dehghani, Mina Aghaesmaeili, Meysam Shahbazi,
Mohammad Taghi Amoushahi, Narges Yousefi, and Arya Namdi

Index���������������������������������������������������������������������������������������������������������������������� 765
Editors

Saeid Eslamian is a full professor of hydrology and water resources


engineering in the Department of Water Engineering at Isfahan
University of Technology, where he has been since 1995. His research
focuses mainly on statistical and environmental hydrology in a chang-
ing climate. In recent years, he has worked on modeling natural
hazards, including floods, severe storms, wind, drought, pollution,
water reuses, sustainable development and resiliency, etc. Formerly,
he was a visiting professor at Princeton University, New Jersey, and
the University of ETH Zurich, Switzerland. On the research side, he
started a research partnership in 2014 with McGill University, Canada.
He has contributed to more than 500 publications in journals, books,
and technical reports. He is the founder and chief editor of both the
International Journal of Hydrology Science and Technology (IJHST) and the Journal of Flood Engineering
(JFE). Eslamian is now associate editor of three important publications: Journal of Hydrology (Elsevier),
Eco-Hydrology and Hydrobiology (Elsevier), and Journal of Water Reuse and Desalination (IWA). Professor
Eslamian is the author of approximately 150 book chapters and books.
Dr. Eslamian’s professional experience includes membership on editorial boards, and he is a reviewer
of approximately 50 Web of Science (ISI) journals, including the ASCE Journal of Hydrologic Engineering,
ASCE Journal of Water Resources Planning and Management, ASCE Journal of Irrigation and Drainage
Engineering, Advances in Water Resources, Groundwater, Hydrological Processes, Hydrological Sciences
Journal, Global Planetary Changes, Water Resources Management, Water Science and Technology, Eco-
Hydrology, Journal of American Water Resources Association, American Water Works Association Journal,
etc. UNESCO has also nominated him for a special issue of the Eco-Hydrology and Hydrobiology Journal
in 2015.
Professor Eslamian was selected as an outstanding reviewer for the Journal of Hydrologic Engineering
in 2009 and received the EWRI/ASCE Visiting International Fellowship in Rhode Island (2010). He was
also awarded outstanding prizes from the Iranian Hydraulics Association in 2005 and Iranian Petroleum
and Oil Industry in 2011. Professor Eslamian has been chosen as a distinguished researcher of Isfahan
University of Technology (IUT) and Isfahan Province in 2012 and 2014, respectively. In 2016, he was a
candidate for national distinguished researcher in Iran.
He has also been the referee of many international organizations and universities. Some examples
include the U.S. Civilian Research and Development Foundation (USCRDF), the Swiss Network for
International Studies, the Majesty Research Trust Fund of Sultan Qaboos University of Oman, the
Royal Jordanian Geography Center College, and the Research Department of Swinburne University of
Technology of Australia. He is also a member of the following associations: American Society of Civil
Engineers (ASCE), International Association of Hydrologic Science (IAHS), World Conservation Union

ix
x Editors

(IUCN), GC Network for Drylands Research and Development (NDRD), International Association for
Urban Climate (IAUC), International Society for Agricultural Meteorology (ISAM), Association of Water
and Environment Modeling (AWEM), International Hydrological Association (STAHS), and UK Drought
National Center (UKDNC).
Professor Eslamian finished Hakimsanaei High School in Isfahan in 1979. After the Islamic Revolution,
he was admitted to IUT for a BS in water engineering and graduated in 1986. After graduation, he was
offered a scholarship for a master’s degree program at Tarbiat Modares University, Tehran. He finished his
studies in hydrology and water resources engineering in 1989. In 1991, he was awarded a scholarship for
a PhD in civil engineering at the University of New South Wales, Australia. His supervisor was Professor
David H. Pilgrim, who encouraged him to work on “Regional Flood Frequency Analysis Using a New
Region of Influence Approach.” He earned a PhD in 1995 and returned to his home country and IUT. In
2001, he was promoted to associate professor and in 2014 to full professor. For the past 22 years, he has
been nominated for different positions at IUT, including university president consultant, faculty deputy
of education, and head of department.
Professor Eslamian has made three scientific visits to the United States, Switzerland, and Canada
in 2006, 2008, and 2015, respectively. In the first, he was offered the position of visiting professor by
Princeton University and worked jointly with Professor Eric F. Wood at the School of Engineering and
Applied Sciences for one year. The outcome was a contribution in hydrological and agricultural drought
interaction knowledge by developing multivariate L-moments between soil moisture and low flows for
northeastern U.S. streams.
Recently, Professor Eslamian has completed the editorship of eight handbooks published by Taylor &
Francis (CRC Press): the three-volume Handbook of Engineering Hydrology in 2014, Urban Water Reuse
Handbook in 2015, Underground Aqueducts Handbook (2017), the three-volume Handbook of Drought and
Water Scarcity (2017).

Faezeh A. Eslamian is a PhD candidate of bioresource engineering


and research assistant at McGill University, Montreal, Quebec, Canada.
She is currently working on the fate and transport of ­phosphorus
through subsurface drained farmlands. Dr. Eslamian completed her
bachelor’s and master’s degrees in civil and environmental engineer-
ing from Isfahan University of Technology, Iran, where she evaluated
natural and low-cost absorbents for the removal of pollutants such
as textile dyes and heavy metals. Furthermore, she has conducted
research on the worldwide water quality standards, wastewater reuse,
and drought guidelines.
Contributors

Jan Adamowski Mohammad Taghi Amoushahi


Department of Bioresource Engineering Water Resources Engineering and Management
McGill University Program
Montreal, Quebec, Canada University of Stuttgart
Stuttgart, Germany
Alireza Aghaei
Department of Soil Sciences Shahab Araghinejad
Isfahan University of Technology Department of Irrigation and Reclamation
Isfahan, Iran Engineering
University of Tehran
Mina Aghaesmaeili Karaj, Iran
Department of Material Engineering
Shiraz University and Technology Ata Arefeyan
Shiraz, Iran Department of Civil Engineering
Islamic Azad University, Arak Branch
Samir Anwar Al-Gamal Arak, Iran
Egyptian Atomic Energy Authority
Cairo, Egypt Ramin Bahmani
Faculty of Water Sciences
and
Shahid Chamran University
University of Engineering and Technology Ahwaz, Iran
Lahore, Punjab, Pakistan
Mehdi Bahrami
and
Department of Water Engineering
Sahel and Sahara Observatory College of Agriculture
Tunis, Tunisia Fasa University
Shiraz, Iran
Hussein A. Amery
Colorado School of Mines Sivash Bahredar
Golden, Colorado Department of Civil Engineering
Shahid Bahonar University of Kerman
Mohammad Javad Amiri Kerman, Iran
Department of Water Engineering
College of Agriculture Bosun Banjoko
Fasa University Obafemi Awolowo University
Shiraz, Iran Ile-Ife, Nigeria

xi
xii Contributors

Giovanni Barrocu Adebayo Oluwole Eludoyin


Department of Civil Engineering, Environmental Department of Geography
Engineering and Architecture Obafemi Awolowo University
University of Cagliari Ile-Ife, Nigeria
Cagliari, Italy
Oyenike Mary Eludoyin
Ruth Beilin Department of Geography and Planning Sciences
Faculty of Science Adekunle Ajasin University
School of Ecosystem and Forest Sciences Akungba, Nigeria
University of Melbourne
Melbourne, Victoria, Australia
Somayeh Eskandari
Isfahan Department of Environment
Christina A. Boyes Isfahan, Iran
Independent Scholar
University of Colorado Boulder,
Boulder, Colorado Saeid Eslamian
Department of Water Engineering
Carlos Neto de Carvalho Isfahan University of Technology
Geological Office Isfahan, Iran
Geopark Naturtejo da Meseta Meridional under
UNESCO
Farzad Esmaeili
Idanha-a-Nova, Portugal
Nomads Affairs Organization
David Cobon Ilam, Iran
International Centre for Applied Climate
Sciences Neda Torabi Farsani
Institute for Agriculture and the Environment School of Art Entrepreneurship and Tourism
University of Southern Queensland Art University of Isfahan
Toowoomba, Queensland, Australia Isfahan, Iran

Jonathan Peter Cox Mohsen Ghane


Caribbean Institute for Meteorology and Department of Civil Engineering
Hydrology Islamic Azad University
Bridgetown, Barbados Tehran, Iran
Nicolas R. Dalezios
Department of Civil Engineering Zahra Ghasemi-Siani
University of Thessaly Geograpic Information System Section
Volos, Greece Islamic Azad University
Yazd, Iran
and
Department of Natural Resources and Mahboubeh Ghasemi-Zanyani
Agricultural Engineering Faculty of Water Sciences
Agricultural University of Athens Shahid Chamran University
Athens, Greece Ahvaz, Iran

Sara Dehghani Albrecht Gnauck


Department of Water Engineering Brandenburg University of Technology
Isfahan University of Technology Cottbus-​Senftenberg
Isfahan, Iran Senftenberg, Germany
Contributors xiii

Majedeh Haeri-Hamedani Behnaz Khosravi


Department of Water Engineering Department of Water Engineering
Isfahan University of Technology Isfahan University of Technology
Isfahan, Iran Isfahan, Iran

Louis Kouadio
Rares Halbac-Cotoara-Zamfir International Centre for Applied Climate Sciences
Department of Hydrotechnics Institute for Agriculture and the Environment
Politehnica University of Timisoara University of Southern Queensland
Timisoara, Romania Toowoomba, Queensland, Australia

Eduardo Kruse
Ali Hasantabar-Amiri
National Scientific and Technical Research Council
Department of Civil Engineering
School of Natural Sciences and Museum of the
Islamic Azad University
National University of La Plata
Lenjan, Iran
La Plata, Argentina

Seyed-Mohamad-Amir Homayouni Zahra Majidifar


Bamdad Arg Iranian Company Lorestan University
Isfahan, Iran Khorramābād, Iran

Arash Mahdavi
Seyed-Mohammad Hosseini-Moghari
College of Natural Resources
Department of Irrigation and Reclamation
Isfahan University of Technology
Engineering
Isfahan, Iran
University of Tehran
Karaj, Iran David McRae
International Centre for Applied Climate Sciences
Seyedeh Zahra Hosseini-Teshnizi Institute for Agriculture and the Environment
Department of Water Engineering University of Southern Queensland
Isfahan University of Technology Toowoomba, Queensland, Australia
Isfahan, Iran
Sheyda Mohammadifard
Rajendra Kumar Isaac Department of Water Engineering
Department of Soil Water Land Engineering and Isfahan University of Technology
Management Isfahan, Iran
Sam Higginbottom Institute of Agriculture,
Technology and Sciences S. Mohammed Irshad
Allahabad, Uttar Pradesh, India Jamsetji Tata School of Disaster Studies
Tata Institute of Social Sciences
Mumbai, Maharashtra, India
Shafi Noor Islam
Department of Geography and Elham Mohri-Isfahani
Environmental Studies Department of Water Engineering
University of Brunei Darussalam Isfahan University of Technology
Brunei Isfahan, Iran

Saifullah Khan Never Mujere


Institute of Social Sciences and Directorate of Department of Geography and Environmental
Distance Education Science
Bahaudin Zakariya University University of Zimbabwe
Multan, Punjab, Pakistan Harare, Zimbabwe
xiv Contributors

Shahbaz Mushtaq Foroozan Rajaei-Rizi


International Centre for Applied Climate Sciences Department of Water Engineering
Institute for Agriculture and the Environment Shahrekord University
University of Southern Queensland Shahrekord, Iran
Toowoomba, Queensland, Australia
Kathryn Reardon-Smith
Arya Namdi International Centre for Applied Climate Sciences
Rojyar Consulting Engineer Company Institute for Agriculture and the Environment
Kermanshah, Iran University of Southern Queensland
Toowoomba, Queensland, Australia
Bahareh Navabpour
Sandra Reinstädtler
Faculty of Information Technology Engineering
Darussalam
Payam Noor University
Gadong, Bandar Seri Begawan, Brunei
Tehran, Iran
Darussalam, Brunei
Sara Nazif and
School of Civil Engineering
Brandenburg University of Technology
College of Engineering
Cottbus-Senftenberg
University of Tehran
Senftenberg, Germany
Tehran, Iran
Giuseppe Rossi
Maryam Marzi-Nouhedani
Department of Civil and Environmental
Department of Irrigation and Reclamation
Engineering
Engineering
University of Catania
University of Tehran
Catania, Italy
Tehran, Iran
Sara Saadati
Hossein Nourozi
College of Natural Resources
Department of Civil Engineering
Isfahan University of Technology
Islamic Azad University
Isfahan, Iran
Meybod, Iran
Amin Sadri
Kaveh Ostad-Ali-Askari Relief and Disaster Section
Department of Civil Engineering Water and Wastewater Company
Islamic Azad University Isfahan, Iran
Isfahan, Iran
Ali Saeidi-Rizi
Avanish K. Panikkar Department of Civil Engineering
KMH Environmental Pty Ltd Shahid Bahonar University of Kerman
Chatswood, New South Wales, Australia Kerman, Iran
and
Mohsen Mohseni Saravi
Griffith University Faculty of Natural Resources Engineering
Brisbane Queensland University of Tehran
Australia Tehran, Iran

Ravi Patil Majedeh Sayahi


Department of Environmental Sciences Department of Water Engineering
University of Agricultural Sciences Isfahan University of Technology
Dharwad, Karnataka, India Isfahan, Iran
Contributors xv

Leila Sedaei Ismail Kaan Tuncok


College of Agriculture Solaris Engineering and Consulting
Shahrekord University Ankara, Turkey
Shahrekord, Iran
Omid Vafaei
Nazila Sedaei Department of Mechanical Engineering
Renewable Resources Department Iran University of Science and Technology
University of Alberta Tehran, Iran
Edmonton, Alberta, Canada
Allyson Williams
Meysam Shahbazi International Centre for Applied Climate
Faculty of Architecture and Urban Planning Sciences
Art University of Isfahan Institute for Agriculture and the Environment
Isfahan, Iran University of Southern Queensland
Toowoomba, Queensland, Australia

Reza Shahbazi Sanjay M. Yadav


Natural Resources Engineering Department of Soil Water Land Engineering and
Geological Survey of Iran Management
Tehran, Iran Sam Higginbottom Institute of Agriculture
Technology and Sciences
Mohammad Shayannejad Allahabad, Uttar Pradesh, India
Department of Water Engineering
Yohannes Yihdego
Isfahan University of Technology
Snowy Mountains Engineering Corporation
Isfahan, Iran
Sydney, New South Wales, Australia

Nasrin Shojaei Narges Yousefi


College of Water Sciences Faculty of Water Sciences
Shahid Chamran University Shahid Chamran University
Ahvaz, Iran Ahwaz, Iran

Neda Yousefi
Vijay P. Singh Department of Environmental Sciences
Department of Biological and Agricultural University of Macquarie
Engineering Sydney, New South Wales, Australia
Texas A&M University
College Station, Texas Ali Zahraei
Department of Irrigation and Drainage
University of Tehran
Tamara Sysak Tehran, Iran
Faculty of School of Social Sciences
University of the Sunshine Coast Fereshteh Zamani
Queensland, Australia Information Technology Department
Foulad Institute of Technology
Foulad Shahr, Iran
Hamed Tavakolifar
School of Civil Engineering Mehdi Zomorodian
College of Engineering Department of Civil Engineering
University of Tehran University of Malaya
Tehran, Iran Kuala Lumpur, Malaysia
1
Drought Management:
Initiatives and Objectives

1.1 Introduction ........................................................................................... 1


1.2 Drought Monitoring ............................................................................. 3
1.3 Drought Management ..........................................................................4
Identification of Key Issues • Hazard Assessment and Environmental
Yohannes Yihdego Management • Infrastructure and Risk Characterization
Snowy Mountains 1.4 Response to Drought: Drought Management Initiatives ............... 10
Engineering Corporation Drought Policy • Managing Water Demand
Saeid Eslamian 1.5 Summary and Conclusions ................................................................ 18
Isfahan University Authors............................................................................................................. 21
of Technology References ........................................................................................................ 21

Abstract There are many drought management approaches being used around the world in relation
to drought response. Traditionally, responses to drought throughout the world have been reactive
ones. However, monitoring and identifying the gap between securing water for food production
and managing the demand and reducing risk associated with drought are crucial, and thus, an early
warning system needs to be in place to respond and manage drought effectively. This chapter aims to
identify some of the drought management initiatives in line with a drought policy, including drought
relief programs, water trade, and effective water capture and storage. With a better understanding of
the various drought management options available, a better sense of how drought is being managed
can be realized.

1.1 Introduction
Drought is a regional phenomenon with characteristics differing from one climate regime to another.
Significant changes in weather patterns from normal conditions commonly produce consequential
changes in the natural environment with associated social and economic impacts on affected regions
[12,22,44,66]. The early 1990s saw the scientific and policy viewpoints on drought as a natural disaster
change to one accepting it as a natural cycle. Meteorological drought is a natural event that results from
several causes that are specific to a given region [42,69]. A definition of drought based on standardized
precipitation has been suggested [40]; it is the difference in precipitation from the historical mean for a
specified time period divided by the historical standard deviation. As common as drought occurrences are
around the world, a standard definition of drought is not recognized. Even among the experts who study
droughts, a single standard definition is not easy to agree upon. In the simplest of meanings, drought
can be identified as a deficit in precipitation from an expected average over an established time frame.

1
2 Handbook of Drought and Water Scarcity

To better define drought, one needs to establish the context in which the phenomenon and its associated
impacts are being described. Four main classes of drought are commonly recognized, reflecting the differ-
ent aspects and parameters being considered:
• Meteorological (climatological) drought is defined as a deviation from normal precipitation condi-
tions over a period of time [23].
• Agricultural drought refers to a lack of adequate soil moisture for crops or pasture.
• Hydrological drought reflects reduced precipitation for an extended period, leading to deficient water
resources [72]. It is the deviation of available surface and subsurface water from average conditions.
• Socioeconomic drought recognizes the relationship between supply and demand for water, such as
when low water supplies negatively affect communities in terms of businesses (economies reliant on
crop yield and livestock management) and social behavior.
As their names imply, these diverse drought types impact different sectors, but in most instances, the
impacts related to each type overlap both temporally and spatially. All droughts begin with a deficiency of
precipitation over some time frame. These early stages of accumulating precipitation deficiencies are com-
monly referred to as meteorological drought [60]. A continuation of these dry conditions over a longer
period of time, sometimes in association with above-normal temperatures, high winds, and low relative
humidity, quickly results in impacts on the agricultural and hydrological sectors. Meteorological droughts
are driven by a change in the local meteorological conditions. The geography and climatology of a region
play an important role in what defines meteorological drought since regions have very different precipitation
regimes. Meteorological droughts can develop quickly, but they can also end just as quickly if the precipita-
tion deficits are relatively small. However, these drought may also linger on to become a multiseasonal event
and develop into one of the other types of drought. The identification of the beginning or end of drought
conditions is debatable. Low rainfall in itself does not constitute the commencement of drought, and rain or
flooding over prolonged periods of drought does not necessarily signal the end of drought either [62]. Water
scarcity refers to a shortage in the drinking water supply, whereas drought refers to the lack of water for rain-
fed crops, irrigated crops (mainly food crops), and also for the environment, resulting in desertification. The
poorest section of population is affected most. Villagers who keep the watersheds well managed with soil and
water conservation practices, forestation, and the augmentation of recharge to groundwater do not suffer
from water scarcity [6]. Unfortunately, desertification, land degradation, and drought are contributing to the
global water crisis. As a consequence of desertification, land degradation, and drought, falling water tables
are widespread, resulting in serious water shortages and salt intrusion in coastal areas.
The exacerbation of desertification in Africa and the extended droughts experienced by the continent
have gone unrecognized on many fronts and have been identified as having implications for the imple-
mentation of the Millennium Development Goals. The UNCCD is working to address drought monitor-
ing, preparedness, mitigation, land degradation, and desertification. It has been widely reported in the
Middle East, Africa, Latin America, and Asia that drought causes desertification, falling water tables, and
pollution, forcing communities to abandon their villages and migrate [7]. Drought as an environmental
condition affects a wider geographical area than most other natural disasters. In 1991–1992, sub-Saharan
Africa experienced drought in a region of 6.7 million km2, affecting 110 million people [69]. Similarly,
Fishman [22] highlighted the various water scarcity issues in India, Las Vegas, and the Murray-Darling
river basin in Australia, including recycling wastewater for potable uses. With the growing population and
increasing impacts of land management practices, the situation is expected to worsen in the future, espe-
cially in areas more vulnerable to climate change [29,37]. In areas of low economic development, drought
has considerable impacts on local populations and ecosystems [36], exacerbating the negative effects on
agricultural activities and precipitation deficiency and culminating in socioeconomic drought impacts
such as the degradation of land and other problems with sanitation, health and hygiene, high infant mor-
tality, and low immunity in children.
The most severe social consequences of droughts are found in arid or semiarid regions where the avail-
ability of water is already low under normal conditions. Droughts should not be confused either with
Drought Management 3

aridity, which is a permanent feature of a dry climate, or with water scarcity [6], which implies a long-term
imbalance between available water resources and demand. Drought research and operational applications
have been lagging behind infrastructural in flood-prone areas. There is both an urgent need to address
emerging issues in drought research and management and to interact with the scientific and operational
communities, as well as policy-makers and the general public, to raise awareness of potential drought
hazards. This chapter gives a brief account of the management approaches adopted in drought, including
during drought relief activities, but also toward drought proofing.

1.2 Drought Monitoring
The key to understanding drought is to grasp its natural and social dimensions, with the goal of drought
risk management to focus on society’s coping capacity, resilience, and effective management of drought
assistance [46]. The management of drought takes a risk-based approach in analyzing and adapting to
conditions [49]. In order to effectively manage the risks to water resources and food security via drought
adaptation and sustainable farming practices, a reliable method for monitoring and prediction of drought
is required. Several agencies provide drought monitoring and prediction services around the world, such
as the Global Water Partnership’s Integrated Drought Management Framework, the U.S. Drought Monitor,
and the Experimental African Drought Monitor [34,64]. In keeping with the different characteristics that
are perceived as drought, these services employ different assessment techniques and indices in providing
early warnings. Drought monitoring focuses mainly on observed data and trends using various tech-
niques [39,54]. Drought prediction refers to both an estimate of what might happen over a specified time
period and a degree of certainty about the likelihood and precision of the estimate. Drought monitoring
tasks include the surface water monitoring, catchment management practices, groundwater monitoring,
river management, and assessment of the actual environmental water demand and, potentially, the mul-
tiple forms of water consumption [26,74]. These employ different assessment techniques and indices in
providing early warning. Drought monitoring generally can inform broader policy development for water
management and has been an important planning instrument [4,27,52,55]. Primary producers, insurance
companies, and importers and exporters may benefit from the provision of drought information at sea-
sonal and subseasonal time scales. On a decadal and multidecadal scale, the government and large orga-
nizations would use such information for policy development, infrastructure, and regional development
programs. Drought monitoring and prediction are also useful for resource planning, decision-making,
infrastructure planning, fire risk management, and conservation of biodiversity [47,53,55]. The basis of
human sustenance, agricultural production, is closely linked with the availability of water and actual
crop evapotranspiration, which can be monitored by the water balance during the crop-growing cycle.
Advances in remote sensing and satellite technology have helped in monitoring crop water use and pro-
duction. A drought index [34,59], which assists in the analysis of temporal and spatial variations in vegeta-
tion and crop water use, has long been recognized as an important tool in drought monitoring.
Drought impact monitoring is required to identify interactions between natural characteristics of meteoro-
logical drought and human activities that depend on precipitation to meet societal and environmental demands
and to determine appropriate drought management responses [32,42,69]. Drought has long been recognized to
be increasing in frequency, so monitoring and warning services and the dissemination of meaningful warnings
to the general public thus require a comprehensive and integrated approach to a collaborative process and a
review of the best-available evidences and predictions. As drought is ultimately measured in terms of its impact
and not just rainfall deficiency, no single index is sufficient to measure the impact of drought on a particular
sector or application. The purpose of a drought monitoring index is to coordinate and facilitate the develop-
ment, assessment, and application of drought risk management tools and policies with the goal of improving
drought preparedness and reducing drought impacts [63,65]. Therefore, most such indices will focus on moni-
toring and assessing drought and assessing risks and vulnerability connected to drought.
Drought has been and will continue to have some of the greatest impacts of climate and hence demands
the development of a common framework and new drought-related climate services [60,66] and multiyear
4 Handbook of Drought and Water Scarcity

drought predictions and projections [46]. Drought monitoring relies on the analysis of trends using
­various techniques based on the observed surface water data [14,51,53,76–78,80] and groundwater data
[73–75]. Drought prediction refers to both an estimate of what might happen over a specified time period
[24,25] and a degree of certainty about the likelihood and precision of the estimate. Moreover, the model
can be used to generate maps showing the runoff variation over the basin with the particular chance of
occurrence in the future [1,50,58]. Results indicate that the statistical method is a useful procedure in
probabilistic forecast of future droughts, given the fact that spatiotemporal characteristics of droughts in
the past are suitable for probabilistic drought forecasting [5,11] and have the potential to improve drought
characterization in different applications [21,23,38].

1.3 Drought Management
Socioeconomic definitions of drought associate the supply and demand of some economic good with ele-
ments of meteorological, agricultural, and hydrological drought. It differs from the aforementioned types of
drought because its occurrence depends on the time and space processes of supply and demand to identify or
classify droughts [17,22,27,61,66,67,83]. Drought monitoring and prediction involve the integration of com-
plex series of information, including soil moisture, rainfall, socioeconomic, and industrial conditions, and
the service should be comprehensive to cater for the wide range of user groups [35,41,58]. The drought sever-
ity index and remote sensing information have limitations as the soil type and soil moisture data used would
be more relevant to irrigation needs. Indicators based on inflows to water storages and catchment runoffs to
unregulated rivers are required. Indices that take into account the time scale and spatial scale of a drought
are important, and these are best developed through international cooperation. Users also require drought
predictability with adequate fine-scale resolution and accuracy for application at a local scale. Geographical
information system (GIS) and climate modeling are very useful in terms of historical and future events.
There is a need to improve seasonal forecasting, considering the variability in climate [67,74,81,82].
A 6- to 12-month outlook is noted to be highly desirable. Confidence in data is very important as farmers
and livestock managers need realistic information in the short and long term to manage various aspects of
their business. Such confidence will also serve in planning water storage operations for the water supply
needs of farmers and livestock managers and also assist in policy and planning at the water authority level.
The implications of drought are expected to have a number of important biophysical impacts [16,36], which
could potentially have a significant impact on drought mitigation. These include impacts on the following:
• Climate and water supply
• Vegetation and soil
• Agriculture and forestry
• Human comfort health and disease patterns
• Ecosystem (groundwater dependent and springs will dry up)
These impacts could potentially create social and economic problems in relation to the flooding of
roads, infrastructure capacity, water supply, and human health. This may have particular relevance to the
way policy-makers manage infrastructure (say coastal/harbor facilities), conduct training operations, or
manage water supply in drier areas. Management tools to address drought could include
• Identification of key issues
• Hazard assessment
• Risk characterization
• Preparation of adaptation responses
Droughts have been long seen as a manifestation of scarcity of water due to untimely and inadequate
rainfall. This is further intensified due to human interventions, often on an unsustainable basis. Although
droughts are not a new phenomenon and people in certain parts of India have been coping with drought
on a regular basis, it is certainly not a happy scenario to be in. The effects of drought are felt by almost
Drought Management 5

everyone, though differently and with a time lag depending upon a complex set of factors that are linked
to so-called development indicators. The impact is most felt in rural areas with the poor and those liv-
ing directly off natural resources (such as land and water) bearing the brunt. Similarly, drought is felt
less in urban areas, where the means to basic necessities is available in higher quantity. The efforts of the
administration to address the drinking water crisis in urban areas by having piped water supply schemes
installed at a huge cost and sourcing water from long distances from the countryside prove the point. By
such efforts, the problem is only enhanced or transferred and seldom mitigated, the key reason being that
the resource management is skewed toward supply side. A recent review of the common pool resource
management has thrown up the near absence of demand-side management of groundwater that explains
the ever-depleting water levels and unsustainability, in spite of the widespread watershed development
programs promoted by the government, wherein demand-side management forms an important integral
component [4,48].

1.3.1 Identification of Key Issues


Monitoring and identifying the gap between securing water for food production and managing the
demand and reducing the risk associated with drought are crucial. The current drought prediction ser-
vices need to be compared with drought-specialized early warning services, and gaps in information
available need to be identified. Data collection includes a search for literature and interviews of key stake-
holders. The respondent organizations provide detailed information that will provide considerable insight
into drought monitoring and prediction activities in their relevant jurisdictions. Combined responses
indicate that the requirements and current practices vary widely among nations. Some organizations or
state jurisdictions have developed drought monitoring and prediction services to cater to local situations
and needs. International organizations were seen to share information based on requirements. The spe-
cific requirements of individual states/provinces and agencies in a country resulted in little duplication of
effort in addressing the needs.
A country’s landscape is unique in terms of land management differences, precipitation variability and
rainfall patterns, soil type variability, geography, and population distribution. Therefore, data from over-
seas need to be tailored to specific situations and some solutions would not be practical at all. The indi-
ces used in drought monitoring and prediction by international agencies offer some technical challenges
across varying land management and precipitation patterns. Studies have shown that a country requires
multiple indices, given the diversity of environments and farming systems. There is also a perception that
indices tend to smooth rainfall data while masking extremes.
Currently, there are some gaps in the information available on drought in terms of monitoring
and prediction. The use of GIS and climate modeling with a time domain is valuable in terms of his-
torical and future events. There is a need to improve seasonal forecasting, considering the variability in
­climate and how the information is used locally. Confidence in data at all time scales is required to inform
operational decisions in the agricultural sector in the short term and to guide the development of business
risk profiles in the longer term. Such confidence would also serve in planning water storage operations
for water supply. Multiple drought-monitoring indices are available to describe the different dimensions
of drought and trends over time [56,59,70]. However, these indices are not used consistently for monitor-
ing and reporting [2,3,15,22,27,58]. While drought monitoring services are used in many nations, existing
drought forecasting and prediction services are limited. A potential user of drought prediction services
plays a key role in providing rainfall forecasts and information on temperature and evapotranspiration
over the country to allow local agencies to convert them to indices useable within their area of operation.
For practical purposes, users prefer segmented forecasts into short-term (up to 21 days), medium-term
(up to 6 months), and long-term (years) projections to achieve a comprehensive and accurate service [60].
The conventional focus of meteorological services to present information in the form of spatial
weather maps may contribute to a continued focus on spatial technologies. Focus on spatial information
is likely to grow as spatial technologies, remote sensing, and modeling capabilities continue to develop.
6 Handbook of Drought and Water Scarcity

However, a balance is required to ensure that improvements in spatial technology do not constrain the
development of improved predictive methods for temporal forecasts.
Seasonal drought forecasting is presented within a multivariate probabilistic framework. The stan-
dardized stream flow index is used to characterize hydrological droughts with different severities across
the river basin. Since stream flow and, subsequently, hydrological droughts are autocorrelated variables
in time, a multivariate probabilistic approach is used to perform drought forecasting within a Bayesian
framework, and this probabilistic forecast model can provide insights to water resources managers and
stakeholders to facilitate the decision-making and developing of drought mitigation plans [38,43,79].
Previous studies did not address the fundamental issue of social acceptance of climate data. Members
of the public frequently comment on perceived inaccuracies in short-term weather forecasts. Droughts
should not be confused either with aridity, however, which is a permanent feature of a dry climate, or with
water scarcity [6], which implies a long-term imbalance between available water resources and demand.
Public debate over the existence and causes of climate change continues. Given the level of skepticism in
climate projections in some sectors, it is suggested that drought monitoring and prediction services have
two primary purposes: to guide informed risk assessment and decision-making by the government, the
private sector, and individuals and to educate the wider community and communicate climate informa-
tion. Management initiatives need to be tailored to specific situations and some solutions would not be
practical at all. Due to the differences, the indices used in drought monitoring and prediction by interna-
tional agencies offer some technical challenges. Drought monitoring and prediction involves the integra-
tion of complex series of information. In the past, drought was mainly reported in terms of rainfall and
mapping of other information. Long-term forecasting has been identified as an area for improvement.
Existing long-term predictions provide a level of confidence in climate scenarios. Social acceptance of
climate data is a key point to be considered.
Boundaries often seem slightly blurred in relation to drought. The FAO conducted an excellent study
on the impacts of droughts and mitigation measures in the Limpopo River Basin (Southern Africa).
A point strongly emphasized in this study is that a drought is seldom defined merely in terms of an event
and should rather be defined in terms of the likely impacts that will result from an existing condition
(reduced groundwater recharge, falling water tables levels, etc.). Meanwhile, the underlying condition
that manifests as a drought may not be directly linked to a temporal climatic variation but is likely to
be influenced by water resources management practices and land use. When we do not have rain, we
have no water to produce for drinking. When it is raining, we have too much water and are in danger
of flooding. Also, it is suggested to look at some of the rules and regulations of the water management
district governing water use for public water supply, irrigation, and industrial process. Deeper aqui-
fers (e.g., the Floridan aquifer, the United States) are brackish to salty enough to require high-pressure
reverse osmosis treatment. Florida’s water history has been a struggle between the coastal urban areas
and the internal environmental areas over water supply.
The lack of soil moisture data is seen as a major limitation as remote sensing currently provides limited
information on moisture at the soil surface. Information on soil moisture at greater depths is required for
the monitoring and prediction of agricultural droughts. There is a need to integrate climate data with agri-
cultural and hydrological models to provide better information to monitor and predict drought conditions.
Longer-term forecasting has been identified as an area for improvement. The maximum time frame for
prediction based on current capability is reported as 6 months, because of the predictability of El Niño–La
Niña behavior, and there is a severe lack of peer-reviewed and validated capabilities for short-term forecast-
ing and longer-term projections. Existing longer-term projections provide a level of confidence in climate
scenarios, but these are of limited use in describing the severity and duration of individual events. There
are more dimensions and difficulty in drought prediction than there are in flood prediction, and therefore,
currently available flood prediction methods may provide one option to be expanded and refined to meet
the quantitative and probabilistic requirements for drought information. Longer-term drought assessments
are also complicated by the so-far limited understanding of the interactions between the drivers of El Niño
and La Niña events and other long-term climate features, such as the Indian Ocean dipole [52,57].
Drought Management 7

1.3.2 Hazard Assessment and Environmental Management


A summary of topics related to hazard assessment and environmental management are highlighted as
follows:
• Management of an individual site’s future need to manage floods to build resilience.
• Putting water back to wetlands should be included in management arrangements, as well as shut-
ting down wetlands (closing regulators) in pursuit of different outcomes for different wetlands.
With this type of policy in place, it would be okay to shut wetlands off during drought as a
measure to save water, but this is often subject to argument whether it will become the practice.
The shutting down of wetlands still needs to be monitored, for example, to control the mosquito
population. It remains unclear as to whether there has been permanent environmental damage
caused (including that to wetlands) by drought. There is a risk that wetlands are now perceived
as a water waster because of their closure during the drought at the expense of the availability of
water for human needs.
• Which process decided that the environment did not get any water?
• We describe critical human needs but where are the “environmental needs”?
• Consistent criteria and agreed triggers in advance so that we can have options at the ready.
• Wetland allocations differ during drought and other conditions.
• “No species lost during drought! Is this correct?”
• Timing of water delivery is crucial to the population growth/maintenance of some species.
• Environmental regulators.
• With recovery through increasing flows, it is important to study the outcomes.
• Freshwater needed in lakes.
• Management choices to be made for the communities concerned.
• Toxins from flood plains ending up in rivers.
• Crises over funds for the monitoring of toxins in the water.
• There is so much information and stories need to be told. In times of crises, the community needs
to be kept informed.
• Farmers need to know who to contact in times of crisis.
• The need for an acid sulfate program to learn management techniques from farmers, such as con-
touring to revegetate.
• Resources are required for monitoring.
• Water-critical areas and environment needs.
• Clarify the decision-making process.
• What culture currently exists around the community and the environment and how do we change/
improve?
• Landholder experiences around lower lakes should be documented.
• Drought and flood management to build resilience.
• Wetlands were perceived as a waste of water by the community.
• The dry phase of wetlands was of no benefit.
• It is unclear whether there are examples of irreversible damage.
• Ongoing monitoring will tell if there is any permanent damage.
• Who provides funding for monitoring during crises?
• Ongoing research needs to learn from drought impacts.
• The next drought should not be as extreme.
• We have never extracted as much water out of this system as we did during this drought.
• Reserves need to be stored.
• Government structures for responding to drought are very different.
• Some natural funded management groups are better resourced than others, and the ability to invest
on the ground is very different among different nations.
8 Handbook of Drought and Water Scarcity

• Some species may not be recognized; that is, there may be an absence of pre-existing literature on
some species found in the postdrought assessment.
• The ability to plan for drought during nondrought periods is essential and just responding to
drought is not enough.
• Linkages between the government and natural resources management groups are important and
need to be acknowledged.
• Better integration is needed between departments/states and work out who owns the responsibility
for what in the environment departments.
• Contingency plans for different areas of drought and how they relate to each other.
• The limitations in responding to a major natural resource threat such as drought and planning for
the next drought.
• Significant resources are required for sufficient monitoring to occur and data should be accessible.
• The decision-making process for managing environmental water needs to be clarified for environ-
mental managers.
• It is uncertain as to whether the Basin Plan will address some of the environmental risks experi-
enced during drought.
• There is a need to plan for drought during nondrought periods.

1.3.2.1 Drought Impacts
Droughts are now considered as a process, not a phenomenon, and droughts have severe impacts on
many events, societies, economies, agriculture, and ecosystems. They are complex systems, with impacts
dependent on meteorological, hydrological, and land surface factors as well as on water demand and
management [9,40]. However, in addition to looking at the back-end “impacts”, we should also con-
sider the front-end “causative factors,” which are contributed, in a large measure, by humankind, and
exacerbate the inhomogeneities inherent in the hydrological cycle [61,64]. These factors convert weak,
infrequent disaster events such as droughts into more frequent and stronger episodes. There may be
many other events that are attributable to our “human” actions. People tend to believe that all these
events are no more discreet but continuous, and these events together are now recognized as climate
change [12,17,22,29].
Drought is a natural hazard caused by large-scale climatic variability and thus cannot be prevented
by local water management. Water scarcity refers to the long-term unsustainable use of water resources,
which water managers can influence [42]. Making the distinction between drought and water scarcity
is not trivial, because they often occur simultaneously. An observation-modeling framework is con-
sidered as a preferred choice to separate natural (drought) and human (water scarcity) effects on the
hydrological system, and the basis of the framework is the simulation of the situation that would have
occurred without human influence, the naturalized situation, using a hydrological model. The resulting
time series of naturalized state variables and fluxes are then compared with observed time series. As a
second, more important and novel step, anomalies (i.e., deviations from a threshold) are determined
from both time series and compared. Application of the model shows that the impact of groundwater
abstraction on the hydrological system is, on average, four times as high as the impact of drought.
Water scarcity resulted in the disappearance of the winter high-flow period, even in relatively wet years,
and a nonlinear response of groundwater. The observation-modeling framework helps water managers
in water-stressed regions to quantify the relative impact of drought and water scarcity on a transient
basis and, consequently, to make decisions regarding adapting to drought and combating water scarcity
[33,67,71,72,79].
The past decade saw large areas of the world subjected to the worst drought conditions in living
memory. This drought has come to be known as the Millennium Drought and is widely regarded as
having had a greater impact on communities and the environment than other long-term droughts
[8,20,30,83]. In most areas, reduced rainfall created challenging conditions for dryland farmers
and reduced runoff to major water storages. In addition, there was low rainfall and runoff in
Drought Management 9

important catchments in the headwaters, resulting in the worst inflows to storages on record. The
effects included the following:
1. Most river flows were drastically reduced.
2. Allocations to irrigators were well below historical levels, creating economic hardship for ­irrigation-​
dependent communities.
3. Water levels fell in many places.
4. The environment became severely stressed from an extended period of low flow and a lack of flood-
waters to rejuvenate floodplains and wetlands.
There are seven billion people to feed on the planet today and another two billion are expected by 2050.
It is estimated that every person consumes between 2 and 4 L of water per day. Most of the water that
people consume is embedded in the food they eat. For example, producing 1 kg of beef requires 15,000 L
of water, while producing 1 kg of wheat requires 1,500 L. As populations increase, especially in dryland
areas, more and more people are becoming dependent on freshwater supplies in the land that are becom-
ing degraded. This is not sustainable. Water security, like food security, is becoming a major national and
regional priority in many areas of the world. The implementation of the United Nations Convention to
Combat Desertification (UNCCD) has a significant role in the sustainable availability of clean, adequate,
and safe water for human consumption and economic development.

1.3.3 Infrastructure and Risk Characterization


The complexity of drought over different time scales, geographical regions, and dimensions for different
users has resulted in the development of regionally focused information services within Australia, sepa-
rately, by various agencies [20,28].
Under natural conditions, river flows would produce regular floods, which would flush the system and
provide water to floodplains. Most of the system is now highly regulated with many structures such as that
have altered the natural pattern of flows. After almost a decade of drought, a return to wetter conditions
throughout the basin led to widespread flooding. This widespread flooding was good news for the envi-
ronment and enabled many species to recover from the effects of a long drought. Despite its many benefits,
the flooding caused widespread damage to property and also delayed new and ongoing work scheduled to
be carried out along the river. Issues to consider are
• Business infrastructure
• Community infrastructure (e.g., tourism, education)
• Additional water storages
• Desalination—education on reliance on the amount of river water
• Ecological management
• Water savings from wetland management (wet/dry cycles)
• Selling environment allocations in the market
• Water diversion
• Evaporation
• Dredging
• Policy debate—socioeconomic models
• Flooding
• Water supply shortage
It is important to use the time before the next drought to determine the priority for spending money on
infrastructure. This can be achieved through a fully costed scenario analysis. Salinity of water supply is
a major threat to food production and infrastructure [55]. The natural and man-made rivers and water
storages should not be allowed to drop again below a certain level because significant infrastructure issues
start to arise as a result. Capacity and corporate knowledge are diminishing rapidly due to staff turn-
over. This subsection highlights how approaches used to deal with risks and uncertainties in all areas of
10 Handbook of Drought and Water Scarcity

socioeconomic development can positively or negatively affect water risks and uncertainties, leading to
potential restrictions or an increase in the management choices available to water managers. Risk man-
agement, whether in the form of avoidance, reduction, or mitigation, is integral part of all policy-making.
Moreover, the complexity of the risks and uncertainties now facing society is increasing and accelerat-
ing. Understanding the way choices impact water can help shape decisions that maximize benefits in all
domains, creating safer and more sustainable pathways for long-term development. This also requires a
clear-minded consideration of immediate, medium-term, and long-term trade-offs [71].

1.3.3.1 Learning from Extreme Events


The role of science in responding to drought is to inform policy and management. But to protect ecosys-
tems, given competing demands and uncertainty about future climate, requires robust science (including
economic and social science) to inform the debate on water use and identifies the need for a predictive
capacity regarding climate, hydrology, hydrodynamics, water quality, and ecological response [22,23]. The
realities of drought are that active storage levels are very low and flow is well below average; water levels
fall; and the salinity of water bodies including wetlands, which support irrigated agriculture, tourism, and
fisheries and provide refuge for aquatic birds, rises. The ecological impacts of increasing salinity during
drought became evident with the decrease in the numbers of invertebrate taxa associated with increasing
salinities. Experience from drought has indicated that a target salinity threshold should be set and that
high flow alone has not flushed out the built up salt in the system. The degradation of water quality during
a drought suggests that
• New policies are needed to provide adequate flow to maintain the river flow.
• Mismanaging the past leads to overmanaging the future.
• Running our ecosystems down leaves them vulnerable to further change.
• There is an imperative to conserve now so that ecosystems will be resilient and able to cope with
extremes climate in the future.
• A new investment in new science for tomorrow’s challenges is vital because we cannot just assume
that mining historical data will give us the answers we need.
The experience has provided several key learnings. By and large, a majority of people have self-respect and
would like to be paid appropriately for their work. Our initial apprehension that people may not turn up
for drought work was belied when we saw that the entire village(s) reported for work. Within two weeks,
a majority of those who migrated also returned and resumed the work (except those who committed to
share cropping elsewhere). This indicates that people do not willingly migrate but do so on compulsion.
They have also decided upon appropriate rates for different soil conditions and proved that they are good
decision-makers. That a properly planned and implemented strategy would also address equity and gen-
der issues most satisfactorily is proved by this approach. Thinking and installing systems is very essential
for both efficient implementation and transparency. Procedures need to be developed for all activities as
part of the control and monitoring mechanism that helped avoid confusion and duplicity, while increas-
ing transparency. The systems that were established and the procedures devised have helped in proper
accounting, whose significance was highlighted at the time of auditing by the donor agencies. It is perti-
nent to mention how a village-level institution has resolved a potential conflict all by itself.

1.4 Response to Drought: Drought Management Initiatives


Humans survive change via adaptation. Strengthening the adaptive capacity of populations at all levels is
among the most important challenges facing development and human society in the broad context, encom-
passing climate change and other change processes, among other things, and the critical importance of
transboundary flows of information, funds, goods, services, ideas, and often people in determining the
adaptive capacity of local populations. The ability to adapt to local problems such as floods and droughts
often depends on systems and flows that connect to the regional and global levels. More specifically,
Drought Management 11

understanding this and addressing its inherent implications for trade, migration, and other sensitive global
policy arenas are among the most significant challenges facing society in the coming century. Adaptive
strategies are the result of collaboration that attempts to understand and disaggregate the factors that enable
communities to adapt to floods, droughts, and climatic variability by examining the courses of action house-
holds actually take during these events and by gathering the insights generated in a wider review of regional
trends, government programs, and systems theory. Although focused on floods and droughts, many of
the insights generated through research, including factors that heavily influence vulnerability and adaptive
capacity, have potential relevance for other situations where livelihood systems are disrupted and adaptation
is essential [45]. This section provides a summary of the information and opinions shared to document and
establish the key learnings from government responses to drought as part of drought management initia-
tives. There are also additional learnings that can be garnered from considering the basin-wide response to
the Murray–Darling basin drought, which may warrant the future involvement of other jurisdictions [13].

1.4.1 Drought Policy
Policy responses that concentrated on food needs, on access, and entitlements to food [7,9,19,68] too have
made impressive figures of food production at the macroeconomic (national) level but did not make much
difference to the communities, owing to a host of distribution-related issues and more importantly, due to
the lack of sustainability of such an approach. People recognize the value of water, especially the farmers
in agricultural regions of India. Ensuring some sort of “empowerment” where people take water manage-
ment decisions will alone address drought. One of the main requirements for people to remain in their
villages and often the first problem faced is not access to food, but rather the availability of water [13]. In
securing water for domestic or industrial uses, it is important to
• Generate and document innovations and lessons learned.
• Offer incentives to researchers and water managers, from policy to implementation.
• Build the evidence base to inform policy development and implementation.
Review of the drought is considered important because
• The recent drought resulted in one of the largest ever collection of government responses to a natu-
ral resource management event in history, making it a significant living laboratory.
• It provided an opportunity to review an adaptive management approach on a large scale, recogniz-
ing that the lessons learned would be particularly valuable given future predictions of increased
frequency and severity of drought due to climate change.
• The response to the drought is of significant international interest and the workshop provided an
opportunity to better understand common learnings from across government and research com-
munities and to communicate the messages more widely. The goals of this chapter are therefore to
• Identify common learnings from across organizations and determine the keys to successful
collaboration in responding to drought.
• Determine effective means for the government to engage with the community during periods
of high, collective community stress.
• Identify outstandingly high priorities for new research and/or policy to help respond to drought
or equivalent natural resource stresses in the future.
• Record the lessons learned that may be of interest to other public administrators and research-
ers to consider issues regarding the decision-making process and the collective government
response that was put in place to direct government actions and facilitate in the initiation of
discussions on four themes (legislative change, policy, and community engagement; the role of
science; environmental management; and risk and infrastructure management).
Water resources management and other water-related decisions and policies are frequently guided
by economic dimensions [18]. Economic considerations, including efficiency, equity, production,
12 Handbook of Drought and Water Scarcity

allocation, and pollution, have expanded as water resources have become scarcer both in terms of
quantity and quality. While economic analyses applied to the water sector are useful and educational,
their policy implications are less obvious for guiding policy-makers. Water Economics and Policy will
address the economics–policy interaction by publishing highly technical water economics research
with clear relevance for policy. Water Economics and Policy will aim to target a wide range of economic
questions at the local, regional, national, and international levels. It will accommodate work that is
focused on specific sectors (such as the urban, hydropower, irrigation, and environmental sectors)
as well as work that is inter-sectoral in nature. Science provides knowledge that can act as a guide for
management. While science contains uncertainty this should not be a reason to marginalize it in the
decision-making process. Instead, the uncertainty needs to be noted as is the case for other informa-
tion types (e.g., financial, social). Science interpretation is critical to political decisions and there is a
need for scientists to become more proactive in communicating the results of their work. Scientists
need to invest in building trust with decision-makers and the community. There is a need to systemati-
cally decide what is required of science and how to get the most out of it. Lessons can be learned from
the management of the recent drought in a river/catchment basin that demonstrate the value of taking
a truly adaptive approach to scientific investigations to support management and not waiting until a
crisis occurs. This is further demonstrated by the operation and management of drainage infrastruc-
ture in some countries.
As drought conditions worsened, the department in charge of disaster management instructs to
• Coordinate a series of government responses
• Deliver evidence-based and innovative support
• Be responsive to regional needs and be consistent with national exceptional circumstances policy
and programs
This leads to the adoption of a step-by-step and adaptive approach, progressing through phases from crisis
to recovery to preparedness, with cross-agency action and collaboration providing ready access to services
and support. Holistic support is provided by combining farm business support, family and community
support, and employment and workforce support. As a result of this support, a number of corridor pro-
grams and actions can be initiated, including
• Interest rate subsidies
• Relief payments
• Exit grants
• Professional advice and planning grants
• Irrigation management grants
• Financial counseling
• Health and well-being counseling and support
• Alternative employment assistance
• Critical water allocations
• Information and decision support
These programs and actions supported the potential for rural communities to recover and build
regional capacity. The programs were regarded as successful as they helped to mitigate impacts on the
state’s agricultural food production, economy, the fabric of rural communities and environment, and
landscape.

1.4.1.1 Legislative Change, Policy, and Community Engagement


The importance of community engagement in informing policy was reenforced. Focused community
engagement should be done at the same time as developing communications material. Community
engagement became a positive mechanism during the drought for conveying information about how
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method is therefore not applicable in such cases, but is useful in
water examination.
Electrolytic Reactions.—Solutions of lead are easily
electrolyzed, and give a precipitate of lead at the cathode;
simultaneously the peroxide is produced at the anode, and the
reaction is acid. In nitric acid solutions Riche pointed out that the
whole of the lead is carried to the anode, and this is the reaction
made use of in the determination of lead present in the urine (see p.
172).
The presence of copper in an electrolyte regulates the
precipitation of lead oxide, copper alone being deposited at the
cathode, and at the same time the presence of a small quantity of
copper promotes the destruction of organic materials.

REFERENCES.
[1] Pliny: lxxxiii., 11, N.c.v.
[2] Stockhusen: De Litharg. Fumo, etc. Goslar, 1656.
[3] Tronchin: De Colica Pictonum. 1758.
[4] John Hunter: Observations of Diseases of the Army in Jamaica.
London, 1788.
[5] Meillère, G.: Le Saturnisme. Paris, 1903.
[6] Bisserie: Bull. Soc. Pharmacol. May, 1900.
[7] Houston: Local Government Board Annual Report, 1901-02,
supplement, vol. ii.
CHAPTER II
ÆTIOLOGY
Lead poisoning of industrial origin rarely occurs in the acute form.
Practically all cases coming under the notice of either appointed surgeons,
certifying surgeons, or even in the wards of general hospitals, are of the
subacute or chronic type. There is no reason to suppose that lead
compounds are used more frequently by the workers in lead industries as
abortifacients than by other persons.
The compounds of lead which are responsible for poisoning in industrial
processes are for the most part the hydrated carbonate, or white lead, and
the oxides of lead, whilst a comparatively small number of cases owe their
origin to compounds, such as chromates and chlorides.
The poisonous nature of any lead compound from an industrial point of
view is proportional to (1) the size of the ultimate particles of the substance
manufactured, and therefore the ease with which such particles are capable
of dissemination in the air; and (2) the solubility of the particles in the normal
fluids of the body, such as the saliva, pharyngeal and tracheal and bronchial
mucus, etc., and the fluids of the stomach and intestine. An instance of the
variation in size of the particles of lead compounds used industrially is the
difference between ground lead silicate (fritted lead) used in the potteries,
and the size of the particles of ordinary white or “raw” lead. By micrometric
measurements one of us [K. W. G.[1]] found the average size of the particles
of fritt to be ten times that of the white lead particles. Further, direct
experiment made with equal masses of the two compounds in such a manner
that the rate of settling of the dust arising could be directly compared in a
beam of parallel light showed presence of dust in the white lead chamber
fifteen minutes after the fritt chamber was entirely clear. It is found as a matter
of practice that where dust is especially created, and where it is difficult to
remove such dust by exhaust fans, the greatest incidence of lead poisoning
occurs. The association of dusty processes and incidence of lead poisoning is
discussed in relation to the various trades in Chapters XV. to XVII. Fume and
vapour given off from the molten metal or compounds, such as chlorides
(tinning), are only a special case of dust.
The channels through which lead or its compounds may gain entrance to
the animal body are theoretically three in number:
1. Respiratory tract.
2. Gastro-intestinal.
3. Cutaneous.
For many years most authorities have held that industrial poisoning by
means of compounds of lead takes place directly through the alimentary
canal, and that the poison is conveyed to the mouth mainly by unwashed
hands, by food contaminated with lead dust, and by lead dust suspended in
the air becoming deposited upon the mucous membrane of the mouth and
pharynx, and then swallowed. As evidence that lead dust is swallowed, the
classical symptom of colic in lead poisoning has been adduced, on the
supposition, in the absence of any experimental proof, that the lead
swallowed acted as an irritant on the gastro-intestinal canal, thus causing
colic, and, on absorption from the canal, setting up other general symptoms.
Much of the early treatment of lead poisoning is based upon this assumption,
and the administration of sulphuric acid lemonade and the exhibition of
sulphate of magnesia and other similar compounds as treatment is further
evidence of the view that the poisoning was considered primarily intestinal.
One of the chief objections to this view, apart from the experimental
evidence, is that in those trades where metallic lead is handled, particularly
lead rolling, very few hygienic precautions have ever been taken in regard to
washing before meals, smoking, etc. Although in these trades the hands
become coated with a lead compound (oleate), and the workers frequently
eat their food with unwashed hands, thus affording every opportunity for the
ingestion of lead, the incidence of poisoning is by no means as high or so
pronounced in these occupations as in those giving rise to lead dust, such as
the white lead industry, where special precautions are taken, and where the
incidence of poisoning is always related to the dust breathed.
Respiratory Tract.—In a report on the incidence of lead poisoning in the
manufacture of paints and colours, one of us [T. M. L.[2]] in 1902 laid stress on
the marked incidence of poisoning in the specially dusty lead processes.
Following on that report special attention was given to the removal of dust by
means of exhaust ventilation. With the introduction of precautionary
measures, the incidence of poisoning underwent a marked decrease, this
decrease being most definite in those industries where efficient exhaust
ventilation could be maintained (see p. 47). Experience shows that cases of
poisoning in any given trade or manufacturing process are always referable to
the operations which cause the greatest amount of dust, and where,
therefore, the opportunity of inhaling lead dust is greatest.
The investigations of Duckering[3], referred to on p. 203, show the amount
of dust present in the air in certain dangerous processes. His results clinch
the deductions made from general observation, that dusty processes are
those especially related to incidence of industrial poisoning. Ætiologically,
therefore, the relationship of dust-contaminated air and poisoning is
undeniable, and in not a few instances on record persons residing at a
distance from a lead factory have developed poisoning, although not
employed in any occupation involving contact with lead, aerial infection
through dust remaining the only explanation. The actual channel through
which the lead dust suspended in the air gains entrance to the body is,
therefore, of especial importance; one of two channels is open—gastro-
intestinal and respiratory.
The investigations of one of us (K. W. G.) on the experimental production of
lead poisoning in animals has shown conclusively that the dust inhaled was
far more dangerous, and produced symptoms far earlier than did the direct
ingestion of a very much larger quantity of the same compound by way of the
mouth and gastro-intestinal canal. There is no doubt whatever that the chief
agent in causing lead poisoning is dust or fume suspended in the air. That a
certain amount finds its way into the stomach direct is not denied, but from
experimental evidence we consider the lung rather than the stomach to be
the chief channel through which absorption takes place (see p. 81).
The following table gives a specific instance of the incidence of lead
poisoning in a white lead factory, and demonstrates clearly the ætiological
importance of dust. The increase in reported cases, as well as in symptoms
of lead absorption not sufficiently severe to prevent the individual from
following his usual occupation, was associated with the rebuilding of a portion
of the factory in which the packing of dry white lead had been carried on for a
large number of years. The alterations necessitated the removal of several
floors, all of which were thoroughly impregnated with lead dust. Before the
alterations were undertaken it was recognized that considerable danger
would arise; stringent precautions were therefore taken, and the hands
engaged in the alterations kept under special observation. Notwithstanding
this there was an increase in the number of reported cases, which were all
mild cases of colic; all recovered, and were able to return to their work in a
short time.
Table I.—Lead Poisoning in a White Lead Factory.
The figures refer to the weekly examination of the whole of the men. For example, if a man
was returned as suffering from anæmia on three occasions, he appears as three cases in
Column 7.

Year Total Total Cases Cases Cases of Cases of Cases of Blue Line
Number Cases of in Dusty in Other Suspen- Anæmia Tremor
of Poisoning Processes Processes sion
Exami-
nations
(1) (2) (3) (4) (5) (6) (7) (8) (9)
1905 5,464 9 8 1 20 78[B] 249[B] 311[B]
1906 [A] 5,096 18 16 2 9 256 215 532
1907 4,303 4 3 1 6 62 81 38
1908 3,965 4 3 1 5 40 25 11

[A] Structural alterations in progress, including cutting up “lead floor,” saturated with
white lead dust.
[B] These numbers for the half-year only, the inspection being taken over in June,
1905.

Meillère[4] goes to considerable trouble to show that absorption of lead dust


by the lung is hypothetical; that it may take place, but that it is not a channel
of absorption of practical importance. He cites a number of opinions and
experiments by various observers on the absorption of lead through the
mucous membrane of the mouth, alimentary canal, conjunctiva, etc., and he
regards the absorption of lead as one peculiarly confined, in the majority of
instances, to the intestinal canal.
The usual view is that, in the passage of the respired dust-laden air through
the nose, the larger particles of dust are deposited first of all upon the
mucous membrane in the interior chambers of the nose; further, a second
deposit takes place on the posterior wall of the pharynx and in the throat,
where the eddies produced by the current of air inhaled through the nostrils
allow the finer particles to become more easily deposited. Finally, should a
small trace gain access to the larynx, it is said to be deposited there upon the
mucous membrane, to be subsequently ejected, and only a very small
proportion of the total may ever find its way into the lung.
In all arduous labour, directly the respiration rate rises through extra calls
made upon the muscles of the body, an increase in the depth of respiration
takes place; yet even under these circumstances Meillère and others incline
to the view that the dust is deposited on the mucous surfaces of the mouth
and swallowed. Experimental evidence is entirely opposed to these
suppositions. In the first place, unless particles of dust readily find their way
into the lung, it is difficult to understand how the lung itself becomes the site
of so much deposit of carbon, and of flinty material in stonegrinder’s
pneumokoniosis. The staining of the lung by means of carbon particles,
particularly in dwellers in cities, is too well known to warrant more than a
passing reference. Moreover, experimental work has shown that fine powders
suspended in the air easily reach the lung. Armit[5] has shown that the nickel
in nickel carbonyl poisoning gains direct access to the lung, and becomes
deposited there, the metallic particles being readily demonstrated in the lung
tissue itself. Further, the experiments (see p. 84) demonstrate that white lead
dust and other forms of lead dust definitely gain access to the lung, and thus
inhaled produce all the symptoms of lead poisoning in animals subjected to
the inhalation. White lead, litharge, or red lead, are not easily suspended in
water, and long-continued mixing is necessary to make a suspension. Great
difficulty is found in “laying” lead dust by water, as the following experiment
demonstrates: Five wash-bottles are arranged in series; in the first ground dry
white lead is placed, and the other three bottles are filled with water, and a
tube laid under the surface of the water in such a way that the air from the
first bottle must pass the whole of the water seals in each subsequent bottle.
In the last bottle is dilute nitric acid saturated with sulphuretted hydrogen. If
the series is now attached to an aspirating jar, and air drawn slowly over at
the rate of ordinary respiration, the white lead powder in the first bottle being
at the same time shaken so that the air is fully charged with finely powdered
dust, lead is quickly detected in the air passing through the last bottle of the
series, by the darkening of the solution. In this way the presence of lead dust
has been demonstrated after passing through four 2-inch water seals and 8
feet of ¹⁄₄-inch wet rubber tubing. Such an experiment negatives the theory
that all, or even a large quantity, of a finely divided powder becomes
deposited on the upper portion of the respiratory tract.
Particles of lead present in the air in industrial processes are exceedingly
minute, and even in ground white lead the average size of the particle is
under 1 μ. Finally, Tanquerel[6] and Stanski[7] succeeded in producing lead
poisoning experimentally by blowing lead dust through a tube inserted in a
tracheotomy opening. There remains, therefore, no room for doubt that the
lung is the pre-eminent portal for lead absorption, particularly in industrial
processes; from which it follows, as has been extensively shown in actual
practice, that the diminution of dust in workshops and factories by means of
exhaust ventilation is invariably followed by a diminution in the number of
cases of plumbism.
Gastro-Intestinal.—We have dealt with absorption by way of the lung,
and have insisted that such inhalation of dust is of greater importance in
giving rise to industrial lead poisoning than gastro-intestinal absorption.
Gastro-intestinal absorption can take place, and is by no means negligible, in
ordinary industrial conditions. One of the most interesting and important
confirmatory evidences of the absorption of lead by the gastro-intestinal canal
is to be found in the large outbreaks of poisoning in which water-supplies
have been contaminated, either at their source or locally. We have already
seen that electrolysis may play an important part in the solution of lead in
water, and also learnt from Gautier[8] that the carbon dioxide content of water
is not necessarily the sole predisposing element in the solution of lead. In this
connection an important case is described by Thresh[9], where water by no
means soft, but holding some 30 degrees of hardness, produced lead
poisoning in an isolated family. The water in question was distinctly acid to
litmus-paper, and contained a very high percentage of nitrates; the compound
or salt of lead present was therefore one easily absorbed from the alimentary
canal (see p. 86).
In all instances of water-borne lead poisoning the amount of lead present in
the water was small; but as such lead would not be removed by boiling, the
amount of water consumed per person from the contaminated source was
probably large. As the signs of poisoning did not appear until a considerable
time had elapsed, a much larger quantity of lead was probably absorbed than
would appear from the simple statement that the water contained ¹⁄₁₀ grain
per gallon.
A number of cases have been reported from use of diachylon as an
abortifacient, and the symptoms in these cases are invariably those which
occur in other severe forms of poisoning such as are met with in industrial
processes. In nearly every case colic was the first symptom, followed later by
paresis of various types—amaurosis, albuminuria, albuminuric retinitis,
melancholia, encephalopathy—and not a few of the persons succumbed. In
most of the reported cases abortion was produced, but in some, particularly in
one[10], three dozen pills containing diachylon were taken in a month,
producing acute lead poisoning, colic, and paresis, but not abortion.
In fifteen recorded cases of the use of diachylon, fourteen showed a lead
line, in many cases distinct and broad. This point has considerable interest,
as such a line cannot have been produced by oral contact. The drug in the
form of pills would be rapidly swallowed, and little opportunity afforded for
particles to remain in the mouth. Its presence, therefore, suggests excretion
from circulating blood of lead which has been absorbed in the intestine. The
blue line will be referred to again later (see p. 122).
Practically all cases of water poisoning and of swallowing of lead
compounds have developed colic. Further, colic is cited in all the early
recorded cases, even in the very earliest cases referred to in the historical
note, of lead poisoning; and as poisoning in those cases had invariably taken
place by swallowing the drug, it may be presumed from this association has
arisen the belief that lead must be swallowed to produce gastro-intestinal
symptoms. No attention has been paid to the fact that a few cases of definite
cutaneous absorption of lead from the use of hair lotions have been followed
by colic. Gastro-intestinal symptoms, therefore, can be produced without the
direct ingestion of the drug, and colic is a symptom of generalized blood-
infection rather than a localized irritative action on the intestinal mucosa. This
question, again, is more related to pathology than ætiology, and is dealt with
in that section. But mention may be made here of the fact that a number of
observers, more lately Meillère, have laid it down as an axiom that
experimental production of lead poisoning in animals gives no criterion or
evidence of lead poisoning produced in man industrially. Very grave exception
must be taken at once to such a statement. In the majority of experiments
quoted by Meillère the quantity of lead given for experimental purposes has
been large—much larger, indeed, than is necessary to produce small and
characteristic effects—and instead of chronic poisoning an acute lead
poisoning has generally been set up; and even where chronic poisoning has
supervened, the condition has as a rule been masked by the severer initial
symptoms. On the other hand, the evidence to be derived from comparison of
the various observations from animal experiments brings out with remarkable
unanimity the similarity of the symptoms to those produced in man, and, as
will be seen later in the section devoted to Pathology, experiments by one of
us (K. W. G.) have so far confirmed this surmise; in fact, a description of a
case of encephalopathy coming on after lead poisoning of a chronic nature,
described by Mott, agrees in practically every particular with the train of
symptoms as observed in these experimental animals. Certain slight
differences as to the muscles first affected are observed, but it is practically
always the homologous muscle (the physiological action of which more nearly
resembles the human muscle) which is the one to be affected in the animal,
not the anatomical homologue. Thus, for instance, in the cat the spinal
muscles, and particularly the quadriceps extensor, is the muscle which is first
affected through the medium of the anterior crural nerve. This extensor
muscle is one which only performs a slight amount of work in extending the
knee-joint, the amount of work being, however, disproportionate to the size of
the muscle. The extensors of the fore-feet ultimately do become weakened,
but it is the hind-limb upon which the stress first falls.
Attention has been given to the solubility of lead salts in gastric juices, the
majority of such experiments having been performed with artificial gastric
juice. The method at present in use, prescribed by the amended rules of
August, 1900, for earthenware and china factories, is based on some, if
slight, consideration of the physiology of digestion. The method described by
Rule II. states that the estimation of the quantity of lead present in the lead
fritt shall be performed as follows:
A weighed quantity of dry material is to be continuously shaken for one
hour at room temperature with one thousand times its weight of an aqueous
solution of hydrochloric acid, containing 0·25 per cent. of HCl. This solution is
thereafter to be allowed to stand for one hour, and to be passed through a
filter. The lead salt contained in a portion of the clear filter is then to be
precipitated as lead sulphide, and weighed as lead sulphate.
This method has been adopted on the supposition that the solubility of a
lead salt in the gastric juices is the chief source of the lead poisoning in the
Potteries, and that the hydrochloric acid content of the solution determines,
for practical purposes, the quantity of lead dissolved out of a given sample.
The temperature, however, at which this estimation is made—namely, room
temperature—is one considerably lower than that of the body, and the
quantity of lead taken up into solution at this temperature is less than that
which occurs at the ordinary temperature of the body—37° C. Practically
twice as much lead is dissolved out of fritt at 37° C. for an hour as is rendered
soluble at the ordinary temperature of the room—about 15° C. Thomason[11],
who made some experiments in this direction, gives a figure of 2·35 lead
oxide dissolved at 15° C. and 4·54 at 37° C. In another estimation—a matter,
too, of some considerable importance—it was found that acetic acid dissolved
1·97 per cent, at 15° C., and 3·27 at 37° C. In lactic acid the figure was 2·28
at 15° C., and 3·53 at 37° C. It is therefore a low estimation of the solubility of
any substance by the gastric juices if the substance is operated on at a
temperature below that of the body.
The question of the solubility of a lead salt in the gastric contents is
important in view of the small quantities of dust swallowed; and in addition to
hydrochloric acid, other substances are also present in the gastric juice,
which is by no means a simple aqueous solution of the mineral acid. Further,
the gastric juice, except in cases of pathological type, is not acid in periods of
gastric rest, unless such acidity may be represented by the presence of
fermentative acids—acetic, lactic, and butyric.
The activity of the gastric juice on lead is directly caused by the quantity of
organic acids present in addition to the hydrochloric acid, and by the
presence of foodstuffs—(1) in the undigested and (2) in the semidigested
condition. In considering the absorption of lead products from the gastro-
intestinal canal, the normal digestive processes should not be lost sight of—
that is, the sequence of events which occur during digestion of food. On
swallowing food, no definite acidity is present in the stomach for fifteen to
twenty minutes, and even after that time the hydrochloric acid is only
commencing to be secreted. As digestion proceeds, and the whole mass
becomes partially dissolved, such portions as are in a soluble condition are
passed through the pyloric opening at intervals, and the whole contents of the
stomach do not pass straight through the pyloric opening as through an
ordinary straight drain-pipe. As each mass of food passes onwards through
the pylorus, it comes into contact in the duodenum with pancreatic juice, and
with the bile, these alkaline fluids rapidly change the reaction, and allow the
other ferments, trypsin, etc., to become active. As the mass proceeds
onwards through the intestine, the succus entericus also exerts its function.
Finally the fluid contents of the intestine are passed onwards through the ileo-
cæcal valve. During the passage from the pylorus to the ileo-cæcal valve, the
reaction of the intestinal contents undergoes variations, from an alkaline in
the duodenum or upper parts of the jejunum, to acid at the ileo-cæcal valve.
Practically no absorption takes place from the stomach itself; a small quantity
of water and such highly volatile fluids as alcohol may be absorbed, but the
main absorption is not commenced until the food has left the stomach; in fact,
the stomach contains no mechanism for food absorption. The work of
absorption of the products of digestion is carried on actively through the small
intestine until finally the materials have reached the large intestine through
the ileo-cæcal valve; water is then mainly absorbed, and albuminous fluids
and substances in solution to some extent, but the amount of absorption
which takes place is infinitesimal as compared with that of the small intestine.
These points in the physiology of digestion require to be taken into account
when discussing the absorption of lead salts in the gastro-intestinal canal.
When human gastric juice is obtained direct from the stomach in man, and
lead is submitted to its action, definite quantities of lead pass into solution;
and, curiously enough, in the normal gastric juice lead sulphate is as soluble
as both white lead and litharge. The following two tables give the results of
the estimation of the direct action of human gastric juice upon lead. The
particular point is that the juice was obtained by the stomach tube from
persons who had been given a simple test meal preceded by a twelve hours’
fast; the juice was therefore in a normal condition. The tests gave the
following results in the normal stomach:
Lead sulphate 0·080 per cent.
White lead 0·048 „
Litharge 0·040 „

In the second digestion, in which the analysis of the contents showed the
patient to be suffering from the condition known as “hyperhydrochloridia,” the
results were—
Lead sulphate 0·046 per cent.
White lead 0·042 „
Litharge 0·340 „

A very large number of experiments have also been performed for the
purpose of determining the solubility of raw lead glaze, and white lead, in
artificial digestions, the digestions having been made up in such a way that
they resembled as far as possible in every particular the ordinary stomach
contents. The type of digestion used was as follows:
Dry breadcrumbs 140 grammes.
Hydrochloric acid 5 c.c.
Lactic acid 0·1 c.c.
Acetic acid 0·1 c.c.
Pepsin 1·2 grammes.
Milk 1,200 c.c.

Digestions were performed with this mixture, and in every case the digest
was divided into two portions; each portion was retained at body temperature,
with agitation for a couple of hours, and at the end of that time one portion
was submitted to analysis. The second portion was neutralized, sodium
carbonate and pancreatic ferment added, and digestion carried on for another
two and a half hours at body temperature. At the end of this time the
pancreatic digest was examined.
Thirty-five digestions were performed. When 1 gramme of white lead was
used—that is, 0·01 per cent., containing 0·75 per cent. of lead oxide—the
quantity of lead found as lead oxide in the acid digest varied from 2 to 3 per
cent., whilst the amount found in the pancreatic digest varied from 4 to 6·5
per cent. of the added salt. On increasing the amount to 12 grammes—that
is, 1 per cent.—the quantity returned in the digest only increased from 1·5 to
2 per cent. In other words, in the addition of larger quantities of material the
ratio of solubility did not rise in proportion to the quantity added. Where a
direct pancreatic digestion was performed without the preliminary digest of
the gastric contents, the amount of lead present in the digest was only about
0·2 per cent. of the quantity added; indeed, it was very much smaller than the
amount dissolved out after preliminary acid digestion—that is, if the normal
sequence of digestion is followed, the solubility progresses after the gastric
digest has been neutralized and pancreatic ferment has been added,
whereas very slow action indeed occurs as the result of action of the
pancreatic digest alone. Some experiments described by Thomason[12],
although carried out without special regard to the physiological question of
the progressive nature of digestion, distinctly confirm the point raised. Thus,
in a digest of gastric juice, milk, and bread, 5·0 per cent. of lead was
dissolved, whereas when pancreatic juice alone was used only 0·4 per cent.
was found to be dissolved, a remarkable confirmation of the point under
discussion.
The difficulty of estimating lead present in these gastric digestions is a very
real one, as, owing to the precipitation of lead by various fluids of an
albuminoid nature, it is difficult to determine the amount of lead present in a
given quantity of digest; moreover, in making such a digest, much of the
material may become entangled among the clot of the milk in a purely
mechanical fashion, and, in attempting to separate the fluid from the other
portion of the digest, filtration no doubt removes any lead which has been
rendered soluble first of all, and reprecipitated as an albuminate. An
albuminate of lead may be formed with great ease in the following way: A 5
per cent. solution of albumin in normal saline is taken, 0·02 per cent. of
hydrochloric acid is added, and 10 per cent. solution of lead chloride added
as long as a precipitate is formed. The precipitate is then filtered off, and
washed in a dialyser with acidulated water until no further trace of lead is
found in the washings. A portion of this substance taken up in distilled water
forms a solution of an opalescent nature, which readily passes through the
filter and gives the reaction of protein with Millon’s reagent, and the lead
reaction by means of caustic potash and sulphuretted hydrogen, but very
large quantities of mineral acid are required to produce any colour with
hydrogen sulphide. Lead which gains access to the stomach, either dissolved
in water or swallowed as fine dust, becomes in all probability converted first
into a soluble substance, chloride, acetate, or lactate, which compound is
then precipitated either by the mucin present in the stomach, or by the protein
constituents of the food, or by the partially digested food (peptonate of lead
may be formed in the same way as the albuminate described above). In this
form, or as an albuminate or other organic compound, it passes the pylorus,
and becomes reprecipitated and redigested through the action of the
pancreatic juice. A consideration of the action of artificial gastric juices and
the properly combined experiments of gastric and pancreatic digestions
suggest that the form in which lead becomes absorbed is not a chloride, but
an organic compound first formed and gradually decomposed during the
normal process of digestion, and absorbed in this manner from the intestine
along with the ordinary constituents of food. Dixon Mann[13] has shown that
about two-thirds of the lead administered by the mouth is discharged in the
fæces, and that the remaining one-third is also slowly but only partially
eliminated. This point is of very considerable importance in relation to
industrial poisoning of presumably gastro-intestinal origin, and consideration
of the experiments quoted suggests that the digestion of albuminate or
peptonate may to some extent be the basis which determines the excretion of
so much of the lead via the fæces. This alteration of solubility has no doubt a
bearing on the immunity exhibited by many animals when fed with lead, and
probably explains the fact that many of the experimental animals fed with lead
over long periods exhibited no symptoms of poisoning (see p. 85), whereas
control animals, given a far smaller quantity of lead by other means and
through the lung, rapidly developed symptoms of poisoning. A diversity of
opinion exists as to the effect of pepsin upon the solubility of lead. Oliver[14]
considers that the pepsin has a retarding influence on the solubility of lead in
the gastric juice, and Thomason’s experiments also support this view,
although it is difficult to see why the action of pepsin alone should be of such
extreme importance. There is also the complicating fact that other added
substances in the food may mask any direct pepsin factor that may be
present. Albumose and peptone rather than pepsin are to be regarded as the
more important substance physiologically in their reaction with lead, and it is
interesting to note that Schicksal[15] found that by exposing lead in the form of
white lead in a 1 per mille solution of hydrochloric acid in the presence of
peptone produced a greater solvent effect on white lead than did the diluted
acid alone, and the same effect was also seen on metallic lead.
Table II.—Schicksal’s Table.
Amount
dissolved
returned
as
Metallic
Solution. Substance. Time. Lead.

(a) 1·0 per cent. peptone 100 White lead, 10 3 days at 37°
- 0·1471 grm.
0·1 per cent. HCl c.c. grms. C.

(b) 1·0 per cent. peptone 100 Metallic lead, 4


- „ 0·0330 „
0·1 per cent. HCl c.c. grms.
(c) 0·1 per cent. HCl, 100 White lead, 10
0·0983 „
c.c. grms.
(d) 0·1 per cent. HCl, 100 Metallic lead, 4
0·0194 „
c.c. grms.
(e) Metallic lead, 4
0·3 per cent. Na2CO3 None
grms.
(f) 0·3 per cent. Na2CO3 White lead „
(g) 0·3 per cent. Na2CO3
- White lead „
0·5 per cent. NaCl

(h) 0·3 per cent. Na2CO3


- Metallic lead „
0·5 per cent. NaCl

The experiments referred to on p. 18 undoubtedly agree with those of


Schicksal. In addition to the presence of peptones, the effect of carbonic acid
must be also considered, as increase in solubility in gastric and pancreatic
digestions was produced when carbonic acid gas was bubbled through the
digest during the period of action. The whole question of solubility of many
materials in the fluids of the stomach and intestinal canal requires entire
revision, not only as regards lead, but as regards a number of other metals,
including arsenic.
The Mechanism of Lead Absorption.
—The final method of absorption of lead particles or lead solution into the
animal body remains to be considered. Experimental phagocytosis of lead
particles—as, indeed, of any minute particles of substance—suspended in an
isotonic solution, may be observed directly under the microscope. Lead
particles show no exception to the rule, and white blood-corpuscles in a
hanging-drop preparation, made by suspending them in an isotonic salt
solution and serum, may be watched englobing particles of lead, and by
appropriate means the ingested lead may be afterwards demonstrated. In
such an experiment, much of the lead absorbed by the individual corpuscles
rapidly loses its property of giving a black precipitate with sulphuretted
hydrogen, and has apparently become converted into an organic compound,
peptonate or albuminate.
In the section devoted to the Chemistry of Lead, it has been noted that the
colloidal solutions of lead are not precipitated by sulphuretted hydrogen, and
that albuminates and peptonates of lead are presumably of colloidal form.
There seems evidence, therefore, that the direct absorption of lead takes
place by means of the phagocytes of the body, and that in them it becomes
converted into a colloidal form, in which it is probably eliminated through the
kidney and intestine, mainly the latter.
Further evidence of the englobement of lead particles by amœbic cells may
be gained if sections of the intestines of experimental animals are examined;
in the lymphoid glands particles of lead may be seen situated in the interior of
the walls, and even in the cells. It does not by any means follow that these
particles of lead sulphide present in the cells have been formed in situ; more
probably the lead has been converted into a sulphide in the intestinal lumen
itself, and subsequently taken up by the amœbic cells situated in its
periphery.
Another solution is possible—namely, that the particles seen in the
intestinal wall are particles of lead in process of excretion into the intestine
itself, and that the pigmentation of the vessel walls and cells is caused by the
staining of the particles of lead passing from the blood into the lumen of the
tube, which have been converted into a sulphide during their passage.
The localization of the staining in the large intestine, especially in the region
of the appendix in animals (cats), tends to support this theory. The large
bowel near the ileo-cæcal valve, the appendix, and even the glands in the
immediate neighbourhood, are found to be discoloured, and to contain lead in
larger quantities than any other portion of the intestine. In extreme cases the
whole of the large intestine may be stained a greyish-blue. The bloodvessels
in the mesentery in this region are also engorged. When, however, a salt of
lead, such as lead carbonate or lead oxide, gains access to the stomach, it
may be easily converted into chloride by the free hydrochloric acid present in
the stomach; and, in addition, should there be any chronic acid-dyspepsia
(hyperchlorhydria), particularly of the fermentative type, in which free lactic
acid and other organic acids are to be found within the viscus, small
quantities of lead swallowed as dust undergo solution and conversion into
chloride or lactate. The pouring out of acid gastric juice from the stomach
glands does not take place immediately after the first bolus of food is
swallowed, and it may be twenty minutes or half an hour before the gastric
contents have an acid reaction. During this time any lead salts previously
swallowed may become incorporated with the bolus of food and escape
absorption.
Lead in solution or suspension in the stomach which becomes mixed up
with the food, and at the same time subjected to the action of various
albuminous constituents of the food in addition to acids, causes an
albuminate or peptonate of lead to be easily formed, and as such can never
be absorbed from the stomach direct; practically no absorption takes place in
the stomach, and the presence of food containing albuminate precipitates any
lead in solution as an organic insoluble salt. The bolus of food impregnated
with small quantities of lead passes onwards to the intestine, where further
digestion takes place. As the mass passes through the intestine the action
gradually results in the reappearance of acidity, but at the same time a certain
quantity of sulphuretted hydrogen is produced, some of it from the
degradation of the sulphur-containing moiety of the protein molecule by
ordinary hydrolytic process and intestinal ferments, quite apart from any
bacterial action. A portion of the lead present in the chyme may be set free
again for absorption. The bile is said to assist in the solution of lead in vitro.
In experiments made by one of us, which are quoted later, it has been
shown that an isolated loop of intestine allows the absorption of a soluble
lead salt (chloride) when there is no food present in the loop. As the food
mass proceeds through the length of the intestine more and more sulphur is
set free, and an opportunity arises for the fixation of the lead as a sulphide,
but even as a sulphide it is slightly soluble. Probably, however, most of the
lead becomes absorbed long before it reaches the stage at which free
sulphur or sulphuretted hydrogen exists for the formation of sulphide. It is
highly probable that lead, in common with a number of other heavy metals,
including arsenic, is absorbed gradually in the upper part of the intestine, and
re-excreted in the lower. Such an hypothesis is undoubtedly strongly
supported by the remarkable staining of the large intestine and the ileo-cæcal
valve.
The exact mechanism of the absorption of lead from its compound with
albumin or peptone as a lead peptonate or albuminate is very difficult to state
at present; lead albuminate is undoubtedly insoluble in water or normal saline
and in albumin. The process of absorption, then, of the metal lead from the
gastro-intestinal canal is very closely related to the absorption of other heavy
metals, and the fact that animals after very large doses of lead salts
administered via the mouth show hæmorrhages in the intestinal wall, in
addition to hæmorrhages in other parts of the body, with occasional distinct
ulceration, suggests a localized coagulative action on the vessels in the wall
of the intestine as the probable origin of the ulceration. A consideration of this
problem of lead absorption from the intestine—probably only the minutest
quantity of lead, if any, is absorbed from the stomach direct—is one of
considerable importance in the prevention of such lead poisoning as is
attributable to swallowing lead. No work in a lead factory should be
commenced in the morning without partaking of food, because if food be
present the opportunities for absorption of lead are greatly diminished, and of
all foods the one to be recommended as the most efficient is milk, or cocoa
made with milk.
The absorption of dust through the lung is probably an exceedingly
complicated reaction, and Armit’s experiments with nickel carbonyl probably
give the clue. He found that in nickel carbonyl poisoning the volatile product
was split up on the surface of the lung cells, the metallic portion passing
onwards into the lung itself, to be eventually absorbed by the serum.
From the pathological and histological investigations described on p. 81,
and from the fact that particles of lead are very readily taken up by white
blood-corpuscles, we can conclude that absorption of the finer lead particles
gaining access to the lung takes place through the medium of these
phagocyte cells, as such cells are well known to exist within the alveoli of the
lung. The stored-up carbon particles found in the lungs in dwellers in cities
show that such transference of particles from the alveoli to the inner portions
of the lung trabeculæ is a constant phenomenon, and it is therefore easily
understood how rapidly any fine particles not of themselves irritant may be
easily taken up by the tissues. Once having gained access to the interior of
the cells, the particles subjected to the action of the serum of the blood in the
ordinary process of bathing the tissues by the exuding lymph—nay, more,
actual particles of lead—may thus be actually transferred bodily into the finer
blood-spaces, and so be carried forward to the general circulation. Such
particles as remain fixed in the lung will undergo gradual absorption, and the
constant presence of carbonic acid in the circulating blood brought to the lung
undoubtedly largely contributes to their solution, and there is no need to
presuppose the necessity of some recondite interaction of organic acid for the
solution of the inhaled lead in the lungs.
In the absorption of the substance from the intestine, it may go direct into
the blood-stream in a similar fashion through the lacteals along the lymph
channels, and so into the thoracic duct, and finally into the general circulation.
On the other hand, a certain amount, probably not an inconsiderable portion,
is taken up by the portal circulation and transferred direct to the liver itself.
Chemical analysis of the liver supports this view, as does also the
considerable amount of stress thrown upon the liver when poisoning has
taken place from the intestinal canal on administration of massive doses of a
highly soluble lead compound. According to Steinberg[16], excretion of lead
takes place partly from the liver by the bile. This is probable, but there is no
experimental evidence at the present time to support the view. If such an
excretion does take place, the form in which the lead is excreted is probably
one in which it is no longer soluble by digestive action. On the other hand, it
may be in so soluble a form as to become reabsorbed from the intestine, thus
setting up a constant cycle. But such a theory is one that would require a
considerable amount of experimental evidence to support it before it could be
relied on.
There is no doubt that, however absorbed, lead remains stored up in the
body in minute quantities in many places, and the close analogy to arsenic is
met with in the curious elimination of the metal by the fæces. Cloetta[17],
quoted by Dixon Mann, discovered that, although dogs were unable to take a
larger dose of arsenic than 0·0035 gramme per day without exhibiting toxic
results, they could nevertheless take arsenic in much larger doses if it were
given in the solid form, and he was able to increase the dose to as much as 2
grammes per diem without showing any toxic symptoms. Examination of the
urine and fæces showed that as the amount of urinary excretion of arsenic
diminished, so that in the fæces increased, and in lead poisoning, even in
massive doses swallowed in error, the amount of lead excreted by the urine
rapidly diminishes in quantity, although the patient may be still suffering from
the effects of lead poisoning. The experiments, also, quoted on p. 100
constantly pointed to the elimination of lead by way of the intestine, and in
practically all the animals that had suffered from chronic poisoning well-
marked dark staining of the upper part of the cæcum due to lead was
invariably present. This staining and excretion of lead of the large intestine
undoubtedly takes place in man. In a case described by Little[18], where
diachylon had been administered, the administration of a large enema
containing sulphate of magnesium came away black. A more detailed result
of the experiments and a consideration of the elimination of lead are reserved
for another chapter, but it is impossible to consider the ætiology of the
disease without some reference to the general histological channels of
absorption and excretion.
Cutaneous Absorption of Lead.—A considerable amount of
controversy has centred on the question of the absorption of lead through the
unbroken skin. It has been shown that such drugs as belladonna applied to
the skin alone may produce dilatation of the pupil; an ointment containing
salicylic acid spread upon the skin and thoroughly rubbed in is followed by the
appearance of derivatives of salicylic acid in the urine; mercury may be
applied to the skin, and rubbed in, in sufficient quantities to produce
salivation; and a very large number of other drugs may be cited, all of which
when applied to the unbroken epidermis with friction produce the
physiological action of the drug.
There is no reason to exclude lead from the category of drugs which may
be absorbed through the medium of the skin, and, as several observers have
shown, animals may be poisoned by lead on applying a plaster of lead
acetate to the skin. Amongst these experiments may be quoted those of
Canuet[19] and Drouet[20] on rabbits. Some observers, among whom may be
mentioned Manouvrier[21], have attempted to prove that paralysis of the
hands occurs more often in the right hand in right-handed people, in the left
hand with left-handed people, and from the various experiments showing
absorption of lead through the unbroken skin they seek to connect the lesion
of the nerve with absorption direct through the skin of the hands.
Many objections can be urged against acceptance of this theory. Lead
workers who are constantly manipulating lead in a state of solution with bare
hands do not appear as a class to be more subject to wrist-drop than do
persons who are exposed to inhalation of fumes or dust of lead; in fact,
incidence of paralysis and of nerve lesions generally is more severe among
persons exposed to prolonged inhalation of minute quantities of lead through
the respiratory tract. The greater the exposure to dust, the greater the number
of cases of anæmia and colic, whilst in other industries, as has already been
stated, where lead exists as an oleate on the hands of the workers day in and
day out for many years, paralysis and even colic are of rare occurrence; in
other words, persons especially exposed to the absorption of lead through
their hands show a much smaller incidence of lead poisoning of all types than
do those exposed to lead dust. Further, the pathology of wrist-drop and
similar forms of paresis tends to show that the nerve supplying the affected
muscles is not affected primarily, but that the initial cause is hæmorrhage into
the sheath of the nerve, producing ultimate degenerative change. The
hæmorrhage, however, is the primary lesion.

REFERENCES.
[1] Goadby, K. W.: A Note on Experimental Lead Poisoning. Journal of Hygiene, vol.
ix., No. 1, April, 1909.
[2] Legge, T. M.: Report on the Manufacture of Paints and Colours containing Lead
(Cd. 2466). 1905.
[3] Duckering, G. E.: Journal of Hygiene, vol. viii., No. 4, September.
[4] Meillère, G.: Le Saturnisme, chap. iv. Paris, 1903.
[5] Armit, H. W.: Journal of Hygiene, vol. viii., No. 5, November, 1908.
[6] Tanquerel des Planches: Traité des Maladies de Plomb, ou Saturnines. Paris,
1839.
[7] Stanski: Loc. cit.
[8] Gautier: Intoxication Saturnine, etc. Académie de Médecine, viii., November,
1883.
[9] Thresh, J. C.: The Lancet, p. 1033, October 7, 1905.
[10] Ibid., January 5, 1909.
[11] Thomason: Report of the Departmental Committee on Lead Manufacture:
Earthenware, China, vol. ii., appendices, p. 61. 1910.
[12] Ibid.
[13] Dixon Mann: Forensic Medicine and Toxicology, p. 495. 1908.
[14] Oliver, Sir T.: Lead Poisoning (Goulstonian lectures). 1891.
[15] Schicksal: Die Bekämpfung der Bleigefahr in der Industrie, p. 38. 1908.
[16] Steinberg: International Congress of Industrial Hygiene. Brussels, 1910.
[17] Cloetta: Dixon Mann’s Forensic Medicine and Toxicology, p. 463.
[18] Little: The Lancet, March 3, 1906.
[19] Canuet, T.: Thèse, Paris, 1825, No. 202. Essai sur le Plomb.
[20] Drouet: Thèse, Paris, 1875. Recherches Experimentales sur le Rôle de
l’Absorption Cutanée dans la Paralysie Saturnine.
[21] Manouvrier, A.: Thèse, Paris, 1873, No. 471. Intoxication par Absorption
Cutanée.
CHAPTER III
SUSCEPTIBILITY AND IMMUNITY
A large number of poisonous substances, among which lead may
be included, are not equally poisonous in the same dose for all
persons. It is customary to speak of those persons who show a
diminished resistance, or whose tissues show little power of resisting
the poisonous effects of such substances, as susceptible. On the
other hand, it is possible, but not scientifically correct, to speak of
immunity to such poisonous substances. Persons, particularly, who
resist lead poisoning to a greater degree than their fellows are better
spoken of as tolerant of the poisonous effects than as being partially
immune.
The degree of resistance exhibited by any given population
towards the poisonous influence of lead shows considerable
variation. Thus, in a community using a water-supply contaminated
with lead, only a small proportion of the persons drinking the water
becomes poisoned. There are, of course, other factors than that of
individual idiosyncrasy which may determine the effect of the poison,
as, for example, the drawing of the water first thing in the morning
which has been standing in a particular pipe. But even if all
disturbing factors are eliminated in water-borne lead poisoning,
differing degrees of susceptibility are always to be observed among
the persons using the water.
Lead does not differ, therefore, from any other drugs to which
persons show marked idiosyncrasies. Thus, very small doses of
arsenic may produce symptoms of colic in susceptible persons; a
limited number of individuals are highly susceptible to some drugs,
such as cannabis indica, while others are able to ingest large doses
without exhibiting any sign of poisoning; and it is well known that
even in susceptible persons the quantity of a particular drug which
first produces symptoms of poisoning may be gradually increased, if
the dosage be continued over long periods in quantities insufficient

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