Focus on Research in Developing World: “We are missing the full picture”


(NOTE:  Deadline Jan. 12, 2015 to apply for research grants.  See below)

haz matOver the past few years, Blacksmith Institute for a Pure Earth has embarked on a broad effort to expand research and understanding about the issue of toxic pollution, especially its damaging impact in low and middle-income countries, where pollution is the largest killer. Without data and information, one of the world’s biggest global problems will remain invisible.


“Although toxic pollution is one of the biggest global threats, cleanup has been slow partly because there has been a lack of data to chronicle the scope and reach of problem. And this void of knowledge is greatest in poor and middle-income countries. Without proper data and studies, the toxic pollution problems plaguing these nations cannot be solved.”

— Richard Fuller, president of Blacksmith Institute for a Pure Earth.

“Some scientists are at a disadvantage – they have no funds to support the write up of their research… As a result, not enough is written and published about the effects of toxic pollution in low and middle income countries.”

“… we are missing the full picture, missing local information. Research is going on but it is not known among funders of the world.”

— Sandy Page-Cook, Managing Editor of the Journal of Health and Pollution, in Teaching Scientists in Developing Countries to WriteHuffington Post, Dec. 2014

Crucial Pipeline

Blacksmith/Pure Earth is creating a crucial pipeline for this information to reach organizations like the World Bank, European aid agencies and others who have the vast funding needed to deal with threats to human health from pollution.

Our efforts have allowed us to paint the clearest picture to date of pollution’s devastating hold on the poisoned poorMore than one in seven deaths in the world are pollution-related. Here’s a snapshot of pollution’s global toll.

Here are three ways we are continuing to close this knowledge gap:

1) Small Research Grants 2015: Call for Proposals, Deadline Jan. 12, 2015

Calling all researchers and scientists, there is still time to apply for these grants – deadline January 12, 205.  The grants are intended mainly to support researchers in their effort to write up their findings for publication in an international, peer-reviewed journal. Research work should focus on the scope, effects and remediation of toxic pollution in poor countries.  Click on the link above to get details.

2) Teaching Scientists in Developing Countries to Write for International Journals

To date, over 100 researchers, including Kenyan scientist Faridah Hussein Were, have taken the free online course developed by Blacksmith/Pure Earth in collaboration with AuthorAID, to help researchers and scientists from low and middle-income countries improve their technical writing and editing skills with an eye to getting their views and findings in major international journals. The course will increase from five to ten weeks next year.

3) Journal of Health and Pollution Gives Voice to Researchers from Underrepresented Countries

Published by Blacksmith/Pure Earth, the Journal of Health and Pollution (JH&P) is the only journal focused exclusively on low and middle-income countries. The online journal of peer reviewed research and news is an important pipeline of crucial data and analysis of this global problem in countries that are often underrepresented in major studies. In 2015, the journal will enter its fifth year.


Three Papers Published in Prestigious Journal

Richard Fuller, Blacksmith Institute for a Pure Earth President with a  Mexican potter

Richard Fuller, Blacksmith Institute for a Pure Earth President with a Mexican potter

Our effort to expand research and understanding about toxic pollution continues this month with three papers published in the prestigious Annals of Global Health, formerly known as The Mount Sinai Journal of Medicine (Volume 80, Issue 4, p245-344, e1-e11 July–August 2014). 

Environmental pollution is the main cause of disease and death in the developing world. In 2012, exposures to polluted soil, water, and air resulted in an estimated 8.4 million deaths worldwide. By comparison, HIV/AIDS is responsible for 1.5 million deaths annually and malaria and tuberculosis less than 1 million each. More than 1 in 7 deaths globally are the result of environmental pollution.

This key paper is available in English and Spanish. It is an extensive historical review and analysis of 83 published articles from 1978 to 2010 containing available data on blood lead levels from more than 50,000 participants.  Using this data, researchers calculated a  geometric mean to evaluate the effect of lead on the pediatric burden of disease.

The results indicate that more than 15% of the population will experience a decrement of more than 5 IQ points from lead exposure. The analysis also leads researchers to believe that lead is responsible for 820,000 disability-adjusted life-years for lead-induced mild mental retardation for children aged 0 to 4 years.

In low- and middle-income countries (LMICs), chemical exposures in the environment due to hazardous waste sites and toxic pollutants are typically poorly documented and their health impacts insufficiently quantified. Furthermore, there often is only limited understanding of the health and environmental consequences of point source pollution problems, and little consensus on how to assess and rank them. The contributions of toxic environmental exposures to the global burden of disease are not well characterized.

This study describes the simple but effective approach taken by Blacksmith Institute’s Toxic Sites Identification Program to quantify and rank toxic exposures in LMICs. This system is already in use at more than 3000 sites in 48 countries such as India, Indonesia, China, Ghana, Kenya, Tanzania, Peru, Bolivia, Argentina, Uruguay, Armenia, Azerbaijan, and Ukraine.


CDC’s MMWR Features Our Findings on Lead in Kabwe’s Children

Fact Sheet: What is the #1 Childhood Environmental Health Threat Globally?


“Lead Poisoning from improper automotive battery recycling activities is the number one childhood environmental health threat globally”.

—  Dr. Jack Caravanos, CUNY professor and research lead at Blacksmith Institute for a Pure Earth

While lead pollution can result from a number of activities, the improper recycling of used lead-acid batteries (ULABs) is the leading source. Lead exposure is estimated to account for 143, 000 deaths per year, or 0.6% of the global burden of disease, with the highest burden in developing regions. Children are most at risk. Read the story of Seynabou Mbengue and the five children she lost

Here are some FACTS ABOUT LEAD:

  • There is no known safe level of lead exposure.
  • The CDC has adopted 5 µg/dL (micrograms /deciliter) as the point at which to trigger public health actions.
  • In the U.S., about 500,000 U.S. children are estimated to have a blood lead level of at least 5 µg/dL.  Average blood lead level in the U.S. is 1.8 µg/dL. In some of the world’s worst polluted places, we have found levels as high as 234 µg/dL in children.
  • Lead exposure is entirely preventable.


  • Childhood lead exposure is estimated to contribute to 600,000 new cases globally of children with intellectual disabilities every year.
  • Lead exposure is estimated to account for 143, 000 deaths per year, or 0.6% of the global burden of disease, with the highest burden in developing regions.
  • In a review of 242 studies of known chemically contaminated sites, lead was the primary contaminant in 57 (25%) studies, representing 8,345 exposed children.

Health Effects:

  • Lead is a potent neurotoxin, causing lower intellectual capacity, neurological damage, and cardiovascular disease, amongst other problems.
  • Children are the most vulnerable. Lead can affect nearly every system in a young developing body, in particular the brain and nervous system, with devastating and sometimes permanent health consequences.
  • The presence of lead in children lowers I.Q. by an estimated 4-7 points for each increase of 10 μg/dL.
  • In adults, lead poisoning can lead to increased risk of high blood pressure and kidney damage. In pregnant women, lead poisoning can cause miscarriage and stillbirths.
  • Lead exposure often occurs with no obvious symptoms as lead accumulates in the body over time.  Lead poisoning therefore frequently goes unrecognized.


  • The improper recycling of used lead-acid batteries is arguably the #1 childhood environmental health threat globally.
  • Of the six million tons of lead that are used annually, approximately three quarters go into the production of lead-acid batteries. Of these batteries, 97% are eventually recycled to retrieve the lead.
  • The improper recycling of ULABs happens in every city in the developing world.  These are small mom-and-pop operations. Batteries are often broken up by hand, often in backyards, and smelted in kitchens.
  • Lead pollution can also be a result of mining, smelting, manufacturing and other activities, including the continued use of leaded paint and leaded gasoline in some countries.

Examples of the Lead Problem:

  • In Nigeria, the high price of gold prompted a mini gold rush in 2010, and villagers took to mining the lead-rich ore. This resulted in the world’s worst outbreak of lead poisoning.  Over  400 children were killed.  Lead levels as high as 150µg/dL were recorded. (see Photos)

Sources/Learn More:

The Mystery of Mining Waste Dumped In An Armenian School

Beyond Akhtala, the site of our very first cleanup project in Armenia (read more in Armenia’s Toxic 10th-Century Monastery), our team came across various other polluted sites including a school, which apparently had been used as an informal dumping ground by a mining company.

We found mounds of highly toxic waste all around the school grounds (see photos below). We were shocked and very concerned to see children playing around the exposed piles of poison, unaware of the dangers. Obviously, this called for immediate action, and we began planning on a mode of action.

Shortly after, however, to our surprise, we found that the toxic materials had suddenly vanished. Someone had come and removed the toxic waste away from the school in the middle of the night! We can only guess where it has been re-dumped.

We found the contamination at the school and identified 29 pollution sites as threats to the health of Armenians following two years of field research conducted through a partnership between Blacksmith Institute for a Pure Earth and the American University of Armenia. This was the first independent, comprehensive assessment of toxic pollution in Armenia.

By spotlighting pollution in Armenia, we are making the threat more visible to prompt cleanup and raise awareness. Dumping toxic waste at a school should not be tolerated anywhere in the world.

While the immediate danger to children at the school we assessed is reduced, there is no guarantee that more toxic materials will not be dumped there in the future. As to what happened to the dangerous waste that was mysteriously moved in the middle of the night? Did it end up in another school or neighborhood? For now, there is no way to know.

Toxic dump at school

Red arrows mark where the highly toxic piles of mining waste had been dumped on the school grounds.

Toxic dump at school

Red arrows show the close proximity of the school buildings to the mounds of toxic waste dumped on the school grounds.

CDC’s MMWR Features Our Findings on Lead in Kabwe’s Children

The latest issue of Morbidity and Mortality Weekly Report (MMWR), the main resource for key public health information and recommendations from the CDC, features field notes from our July trip to Kabwe, where we found devastating levels of lead poisoning in children.

kid in tub IMG_5293 copy

With a population of approximately 203,000, Kabwe is located in Zambia’s Copperbelt.

For nearly 100 years, lead mining and smelting operations contaminated the soil in the community.

Our Blacksmith/Pure Earth team, which included Dr. Jack Caravanos from the City University of New York School of Public Health, and Green Cross Switzerland, conducted extensive surface soil testing across 12 neighborhoods, and blood lead testing of 196 children aged two to eight years in six communities adjacent to the now-closed Kabwe mines and smelters.

Testing the playground for toxins.

Testing the playground for toxins.

We found that 26.5% of the children recorded blood lead levels higher than 65.0 µg/dL. The reference level at which CDC recommends public health actions be initiated is 5 µg/dL. The CDC recommends that lead chelation therapy be considered when a child has a blood lead level ≥45 µg /dL.

Read the full article in MMWR.


Armenia’s Toxic 10th-Century Monastery (PHOTOS)

The modern world has finally caught up with Akhtala, a historic town with a 10th-century monastery and church in Armenia.

Years of mining and metals processing have provided jobs to the community, but at a grave cost.  The grounds of the historic building, a community focal point where children play and residents picnic, is contaminated with toxic levels of arsenic and heavy metals that is poisoning residents.


The polluted site is one of 29 in the country that were recently identified as threats to the health of Armenians, following two years of field research conducted through a partnership between Blacksmith Institute for a Pure Earth and the American University of Armenia.

This was the first independent, comprehensive assessment of toxic pollution in Armenia.

[Related: The Mystery of Mining Waste Dumped In An Armenian School]

“When you think of Armenia, you don’t immediately think of pollution. In fact, not many people within the country grasped the scope of the threat partly because they did not have any way to assess, identify and measure the levels of contamination,” explained Andrew McCartor, Blacksmith’s program director for Eastern Europe and Central Asia.

“So one of the first things we did was to bring over two piece of equipment to Armenia.  One to measure lead levels in blood, and the other to analyze heavy metals in soil. That proved groundbreaking.  The deadly pollution, which they could not see before, was suddenly visible.”

Toxic Ravine

Toxic Ravine: The area on the left, which looks like a bare field, is the location of a deep V-shaped ravine that has now been filled nearly to the top with toxic mining tailings dumped there.

Blacksmith/Pure Earth experts found toxic pollutants such as heavy metals and banned pesticides.

Over the past few months, we have conducted various educational campaigns to alert residents to the dangers.  Now, we are moving that effort to the U.S. to raise awareness among Armenians here in support of the cleanup.

Last week we invited Armenians in the New York and New Jersey area to the latest edition of our popular toxic cocktail event, where guests learn about global pollution while drinking custom-made concoctions given a lethal look.

The event, generously hosted by Diana and Charles Mkhitarian, moved us closer to our $25,000 goal to fund the first cleanup project in Armenia to remove or contain the contaminated soil at Akhtala.  The project will serve as a model for cleaning up the rest of the country.  Please donate to help complete funding for this effort so that we can begin life-saving remediation next year.

To learn more about global pollution and what you can do to support crucial cleanup work in poor countries, contact us about hosting a toxic cocktail party.


Kabwe’s Children’s Silent Struggles

This guest post is from Ben Barber, who visited Kabwe with the Blacksmith for a Pure Earth team in July.


We arrived last July in one of the world’s most toxic hotspots — Kabwe, a city of about 200,000 just two hours drive north of Zambia’s capita Lusaka.

We checked into the Elephant Head Hotel, most likely built during British rule when Zambia was known as Northern Rhodesia. At first, during a quick walk around the center of the city, it was hard to notice anything really out of the normal.

Shoppers wound their way through the markets and past sidewalk vendors of everything from newspapers to fruits and vegetables to cellphone cards. A friendly and active buzz of activity made me forget that the city contains a huge lead smelter and mine. They have been shut down for more than 10 years, but their legacy slowly became clear as we walked the sandy streets of the neighborhoods near the closed mine.

I went with a small team of three colleagues from the Blacksmith Institute, also known as Pure Earth, a New York-based non-profit that identifies and then helps clean up toxic waste sites in developing countries that contain lead, mercury, chromium, pesticides and other dangerous substances. We quickly made contact with local health and environment officials who arranged for us to test the blood of around 200 small children – to determine if the lead from the mine had been accumulating in the bodies of the most vulnerable residents.

The next morning we arrived at a tidy little cinderblock clinic. Dozens of anxious and friendly parents held their children close at hand, eager to get their blood tested for lead.

A Zambian health worker and a Blacksmith health expert pricked the tiny fingers. Some screaming ensued but tears dried up quickly when each kid got a piece of candy.  The team quickly drew blood samples into sterile containers. I was assigned the task of wiping away excess blood and applying band aids.

After two or three hours in the packed and noisy clinic we found we had to turn away the mothers with their children who continued to arrive seeking a blood test.

In the afternoon, we began using a hand-held x-ray machine that tested soil for lead as well as other toxic substances. Following a pattern monitored by continuous geo spatial readings we prepared a list of readings. The soil readings were off the charts – hundreds of time above what health officials in Zambia and the U.S. consider acceptable and safe.

A local teacher in Kabwe, Wisdom Kuanda, wrote in a letter to the Zambia Daily Mail July 23 that “Kabwe is indeed one of the 10 most polluted towns in the world.”

“As a teacher I have observed poor memory retention in most of the pupils who were born in Kabwe as compared to those who just come on transfer. I have personally linked this problem to lead poisoning.

We saw the tailings – highly toxic piles of lead-rich ore that had been dumped over the nearly 100 years when the smelter was operation. These small hills of stone and gravel up to 50 feet high are the legacy that is getting into the children’s blood.

Just 50 feet from those tailing piles dozens of school children raced barefoot over a sandy football pitch, most likely unaware that they are picking up high lead from the dust all around them. Although 400 parts per million is the safe limit in Zambia, we found 10,000 to 15,000 parts per million.

We had been prepared to see the damage caused by lead poisoning but it was not easy to spot anything unusual. It was when we talked to nurses, teachers and parents that we learned how lead affects children there: it damages the developing neurological system, making it hard for children to learn and behave in a classroom.

Lead poisoning is often a silent disease – symptoms can be subtle such as degraded ability to learn, stomach upsets and other less-than- catastrophic effects.

So people continue to build houses near the mine, literally in the shadow of the towering slag piles. In Makalulu and other neighborhoods where thousands of children and adults lack resources to relocate, health teams told parents to prevent the children from playing outside. This has been inadequate and ineffective.

“This is a public health crisis – these are the highest blood lead readings I have ever seen,” said team member Dr. Jack Caravanos, Blacksmith/Pure Earth technical advisor and CUNY professor.

“Part of the population has acute lead poisoning, above the level that causes mental impairment.”

Lackson Mwanza , head teacher at the David Ramusho School, told me “dealing with lead will help improve mental capacity of the children.”

When we asked the parents if they knew about the danger from lead, most said they knew something but not enough to prevent their kids from getting lead into their bodies.

People are so poor in Kabwe that they had resorted to taking the lead tailings into their houses to try and extract some lead for sale.

And the government is considering reopening the smelter for a new run at lead production.

Gibson Chileshe, 62, was walking past the mine and told me “some of us are against reopening production at the mine, but people want jobs.” Many have registered to get a job if it reopens.



(PHOTOS) Transforming Agbogbloshie: From Toxic E-Waste Dump Into Model Recycling Center

DSC03046On October 9, Agbogbloshie, Ghana – one of the world’s largest e-waste dumpsites – got something new.

The sense of excitement grew when residents saw a group of about a dozen men carrying a towering sign through town before planting it in the ground and raising it up in a Herculean effort, with six men on each side pushing and pulling.

The 20-foot tall sign announced the launch of a pilot project – the opening of a new e-waste recycling facility that could transform the way recyclers work in one of the worst polluted places on earth.

“Everyone is talking about how this is just the beginning,” said Kira Traore, the program director for Africa at Blacksmith Institute for a Pure Earth.

“I think we are seeing a real commitment to changing the e-waste recycling industry.”

The new e-waste facility is equipped with four automated machines that can strip or pull apart plastic coated cables and wires of various sizes scavenged from the e-waste dump to extract copper and other valuable materials within without burning.

Stripping e-waste can save lives by reducing the vast amount of toxic fumes that are released by burning, poisoning thousands (an estimated 250,000 people are at risk) and contaminating the community’s land, water and food.

With the opening of this new facility, recyclers all over Agbogbloshie now have a safer option.

“Burning e-waste was and still is, to many, the established way of working here. That is why we are grateful to see so much support from the recyclers and residents of Agbogbloshie for this new recycling facility,” said Yaw Amoyaw-Osei, Founder/Executive Director of GreenAd, one of Blacksmith/Pure Earth’s partners on the project.

“There was a lot of distrust initially. We had to convince the recyclers that we did not want to take away their livelihoods. We just want to find a non-toxic way for them to do their jobs. This is the first step towards stopping the mass poisoning of Agbogbloshie residents.”

Dromo-naa Folkloric dance ensemble at the ceremony

Drummers celebrate the opening of the new e-waste recycling facility.

It is difficult to miss the new facility.  Consisting of three low-cost shipping containers that are painted a bright and cheery blue, the recycling center stands out against the scorched and burnt landscape.

Bright balloons formed an archway welcoming all into the new center during the grand opening.

There was drumming and dancing, and school children, who put on a play about the dangers of e-waste.


The team – Blacksmith Institute/Pure Earth and local partners Green Advocacy Ghana (GreenAd) and the Greater Accra Scrap Dealers Association (GASDA) – was there along with local VIPS and stakeholders including the Deputy Minister of the Environment, the Director of the EPA, and representatives from the World Bank, UNDP, GIZ, GRATIS Institute, ProLink, the  National Youth Authority, the Ministry of Energy, the national Ghana electric company, the Customs Department, and EcoBank.

The recycling facility went up in much the same way as the sign that announced its opening – it was a collaborative effort.

“It was amazing to see so many of our supporters and stakeholders coming together for the opening,” said Yaw.

“We are receiving offers to help us bring in more machines, install sanitation equipment like a washing station and bathroom facility for the workers, provide business training, additional funding, and other means of support that will help ensure the success of this recycling facility.”

DSC03228 (smaller)

The crowd streams in to check out the new e-waste recycling facility after the grand opening.


Not far away, evidence of toxic burning.

Blacksmith/Pure Earth and partners have been piloting various technologies to aid recyclers in replacing the burning process since 2008. Hand wire-stripping tools introduced in 2010 were met with a small-degree of success. With the new automated machines, the team has high hopes of starting a mini “revolution” in the way recyclers work.


Workers at the new e-waste recycling facility demonstrate how the machines work to strip wires without burning.

“This time, the recyclers are asking more questions about the machines and are offering more feedback and insights about the way they work,” said Kira.

“They are open about their needs because they know that we rely on their expertise. And we are very open about this being a pilot project, that we are trying to figure out what works and what doesn’t.”

This pilot is a project of the Global Alliance of Health and Pollution

See more PHOTOS of the opening and Agbogbloshie

Support for the project comes from the European Commission and the United Nations Industrial Development Organization (UNIDO) through the Global Alliance for Health and Pollution (GAHP),with additional funding for scaling up the project from Addax and Oryx Foundation. The National Youth Authority donated use of the land for the recycling center, with additional support from theMinistry of Environment and Ghana’s EPA, Ghana Health Services, and the Comic Relief Fund.

Press release: Change and hope comes to Agbogbloshie, Oct 22, 2014

Learn more:

Agbogbloshie has been called one of the world’s worst polluted places. The burning of e-waste releases copious amounts of toxic fumes, which then spreads throughout the community.  An estimated 40,000 to as many as 250,000 people are at risk.

“Everywhere you look you see pieces of circuit boards, televisions, refrigerators, irons, etc. The toxic chemicals released are spread throughout the area when it rains and of course spread to the homes each evening. What especially troubled me was the path of the toxic smoke that floats right into the food market. So whatever doesn’t get into your lungs can now settle onto the food supply of Accra.”

— Dr. Jack Caravanos. Read more of his first-hand account in Report from Ghana’s Agbogbloshie E-Wasteland.

On previous visits, the Blacksmith/Pure Earth team has documented the vast amount of contamination. Samples taken around the perimeter of Agbogbloshie, found a presence of lead levels as high as 18,125 ppm in soil. The US EPA standard for lead in soil is 400 ppm. Another set of samples taken from five workers on the site found aluminum, copper, iron, and lead levels above ACGIH TLV guidelines. For instance, it was found that one volunteer had aluminum exposure levels of 17 mg/m3 compared with the ACGIH TLV guideline of 1.0 mg/m(read more).

Businessweek Chronicles Dangerous Cleanup, Blacksmith/Pure Earth’s Global Successes

Ukraine pic










“Fuller and Pure Earth (Blacksmith) have amassed an impressive record of success. But nothing could have prepared them for a situation like the decrepit Soviet dynamite* factory.”  [*Note:  We want to clarify an error in the article.  It was not a “dynamite” factory.  The facility housed TNT.]

– The Chemical Weapons Ukrainian Separatists Didn’t Get, Businessweek, Sept. 2014

Businessweek spoke with Richard Fuller recently about one of our most dangerous cleanups, and chronicled the advances Blacksmith Institute/Pure Earth has made in the fight to spotlight and deal with the world’s growing toxic pollution problem. 

Note: This project was supported in part by the EU Delegation of Ukraine, and the Swedish International Development Agency (SIDA).  Dow Chemicals was also a donor.


About Blacksmith’s Toxic Sites Identification Program:

“Until now, it’s not really been possible to evaluate how many people are exposed to hazardous waste and pollution and to calculate the human cost of that each year. And that’s something remarkable that Blacksmith’s done.”

– Dr. Philip Landigran, chairman of the Department of Preventive Medicine at New York’s Mount Sinai Medical Center.

About Pollution – A Fixable Problem:

“And this is why Fuller gets so passionate, Landigran says, “because it’s finite—it can be fixed. It’s not like a disease we don’t have a cure for. He can look at the levels in the environment or in people’s blood and see the progress.”

About the “toxic dump on top of a bomb” site in the Ukraine:

“If the site where we were operating were shelled today, it’s likely that a dozen people might still be killed, but it wouldn’t be the calamity it could have been… It’s just awful that the place is under such siege, but we managed to truck off and destroy about 10,000 tons of truly lethal materials. I’m really grateful we were able to complete the work when we did.”

— Richard Fuller, President, Blacksmith Institute/Pure Earth

Read the full article in Businessweek – The Chemical Weapons Ukrainian Separatists Didn’t Get, Businessweek, Sept. 2014


To Environmental Journalists: Address Underreported Issue of Toxic Pollution


When an airliner disappears into the Indian ocean and hundreds of people are assumed dead, it’s huge news and millions are spent to find it and understand what went wrong. But in Zamfara, Nigeria, in 2010, over 200 children died from lead exposure from local mining and hundreds more fell ill. It wasn’t big news. There was no worldwide interest or outrage.

— Dr. Jack Caravanos, Associate Professor of Environmental Health, City University of New York, School of Public Health, NY; Advisor to Blacksmith Institute for a Pure Earth.

Photo: Courtesy Waste Management. Moderator: Abrahm Lustgarten, Energy Reporter, ProPublica Speakers: Jack Caravanos, Associate Professor, School of Public Health, Hunter College, City University of New York and Senior Science Advisor, Blacksmith Institute Tom Carpenter, Director of Sustainability Services, Waste Management, Inc. Kate Sinding, Senior Attorney, Natural Resources Defense Council

Photo: Courtesy Waste Management.

Blacksmith Institute for a Pure Earth advisor Dr. Jack Caravanos recently addressed the Society of Environmental Journalists (SEJ) at their annual conference in New Orleans about the far reaching, yet underreported global health impacts of toxic pollution.

The panel, Waste in the 21st Century, was moderated by ProPublica Energy reporter Abraham Lustgarten, and included Dr. Caravanos as well as Tom Carpenter (Waste Management, Inc.) and  Kate Sinding (Natural Resources Defense Council). 

If you missed it, listen to the audio of the discussion, or read Dr. Caravanos’ presentation notes below:

Today,  I will be talking about the global burden of disease from toxic waste sites. The extent of the problem, how it’s measured and why is it’s important.

Let me start by explaining a reporting problem we have with environmental health disasters:

When an airliner disappears into the Indian ocean and hundreds of people are assumed dead, it is huge news and millions are spent to find it and understand what went wrong. But in Zamfara, Nigeria in 2010, over 200 children died from lead exposure from local mining and hundreds more ill.  It was not big news. There was no worldwide interest or outrage.

When a strange odor wafts across the river in NYC and hundreds call to complain, it becomes major news and there are calls for action (even though no one was hospitalized.) But when dozens of villagers who use mercury to extract gold from ore in Bolivia are poisoned, few people write about it.

I can go on and on, but the delayed health response from exposure to toxic agents in the community or workplace, work against us when it comes to reporting the problem.

Rarely does environmental contamination kill dozens of people in one place at one time. It is a slow and steady effect.

So my message today is simple and I’ll state it up front : Toxic chemicals from industry and mining affect the health of hundreds of millions of people in low- and middle-income countries.

How do we know this?

Well about eight years ago, a group called Blacksmith Institute for a Pure Earth, founded by Richard Fuller (read this recent profile in Businessweek) started to make a list of the worst polluted places on the planet.  By the way, Blacksmith/Pure Earth and the affiliated group the Global Alliance on Health and Pollution (GAHP) coordinate cleanup activities using a collaborative model.

So, I was starting a sabbatical at that time and Richard asked me to help out. Well our Toxic Sites Identification Program is now operating in 49 low-middle income countries and has assessed over 3,000 sites.

In the U.S. we would call these “Superfund sites” but the Blacksmith/Pure Earth list focuses more on human health impacts. If a site doesn’t present a real human health threat, we don’t include it. The superfund program doesn’t work quite the same way.

So what have we found is hundreds of sites contaminated with lead, mercury and chromium and the disease burden rivals that of many common diseases.

Before I elaborate on this statement, I need to explain the term “burden of disease.”

Years back, Christopher Murray and Allan Lopez developed a health metric while working with the WHO.  The Disability Adjusted Life Years or DALY measures the years of life lost from a disease or exposure.

For example, my uncle Gus was a three-pack-a-day smoker and died of lung cancer at the age of 45. According to the life tables, he should have live to 80, so smoking took 35 years from his life or 35 DALYs. But this metric also measures illness and converts it into equivalent years lost. For example, living 40 years with untreated asthma equals about two years of life lost. I encourage you to read more on DALYs and the Wiki page is quite good. In analyzing our data, we learned that:

  • In India, hexavalent chromium exposure causes more DALYs than multiple sclerosis, more than Parkinson’s disease and more than various cancers.
  • In Indonesia, exposure to chromium and lead presented higher DALYs than conditions such as upper respiratory infections.
  • In the Philippines, lead had more DALYs than malaria or HIV/AIDS. And those pictures of children with clef-palates that are used to solicit money? Well lead poisoning from these sites often generates much higher DALYs than that health condition.

So whether it is processing e-wastes, scavenging a landfill for recyclables or attempting to put a health number on fracking, more and more people using DALYs as the comparison health metric.

We published several papers on this and they are available online – read the GAHP Poisoned Poor report and the position paper “Pollution:  The Largest Cause of Death in the Developing World.”

So, why you should care?

Well as you know, many of our products are manufactured oversees in countries with practically no pollution controls and few safety standards.

The large corporations that we all read about are easy targets for improvement, but our experience is that there are thousands of small-scale manufactures that are collectively a bigger problem.

So the moral question becomes, what is our role? Both as a society and as individuals, in preventing environmental health disease in countries that supply our shirts, shoes, jewelry and cosmetics?

We, in the U.S., have the technology to properly recycle batteries, to safely extract gold from ore, to ensure that lead does not leach out of pottery, to properly dispose of obsolete pesticides, to ensure materials are recycled without causing harm.

In NYC it is safe to swim in the harbor (if you are crazy enough to do that), our air has never been cleaner, our workplaces are safer, and our food supply is free of the pesticides Rachel Carson wrote about years ago.

The U.S. has some environmental health issues… but I’m concerned as we get cleaner, the rest of the world is getting dirtier.

Especially the low income countries. And who suffers the most?  It is the poorest of the poor. So I do believe it is our obligation to transfer that technology and knowledge to others. So as I see it, not helping, is just not right.

And the solutions are simple and cost effective.

We have cleaned up old lead battery sites in Indonesia and the Dominican Republic for a fraction of what a U.S. Superfund cleanup costs. And now the environmental ministries in those countries know how it’s done.

So to reiterate, the health impact from exposure to toxic waste sites rivals that of other well-known and well-funded diseases.

As a matter of fact, the U.N.’s draft of the Sustainable Developmental Goals, recently omitted language addressing “toxics in the environment”. Fortunately, it looks like Blacksmith/Pure Earth was able to get the language reinstated.


  • Tanneries in Bangladesh
  • Lead mining in Zamfara
  • Gold mining in Bolivia
  • Battery breaking in Indonesia
  • Obsolete pesticides in Armenia

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