Pure Earth, USC and Macquarie University Publish Landmark Lead Study in The Lancet Planetary Health Journal

Students at a school in Bangladesh

The March 2021 issue of The Lancet Planetary Health journal includes an important paper that supports Pure Earth’s previous publications asserting the extent of the childhood lead poisoning crisis in low- and middle-income countries (LMICs).

The paper, Blood lead levels in low-income and middle-income countries: a systematic review, concludes that an estimated 632 million children in 34 LMICs have elevated blood lead levels suggestive of lead poisoning.

The study, a collaborative effort by researchers from Macquarie University in Sydney, Australia, University of Southern California and Pure Earth, considerably expands the existing knowledge about blood lead levels in low and middle-income countries (LMICs) and underscores the danger for children living in those countries.

“Lead is one of these major environmental issues that is hiding in plain sight,” says Bret Ericson, PhD., the lead author of the study. “Lead poisoning remains a significant issue in low- and middle-income countries. For the countries that we were able to include, the numbers are pretty staggering.”

While blood lead levels in high-income countries have declined dramatically with the phase-out of leaded gasoline — dropping from a geometric mean blood lead level of 12.8 µg/dL in the United States in 1976 to one of less than 1 µg/dL by 2016 * — blood lead levels in millions of children living in some LMICs remain persistently elevated, even in the absence of leaded gasoline. These children face exposures to lead from industrial sources, including informal used-lead acid battery recycling, smelting and mining; adulterated foods and spices; ceramics used for cooking; and to a lesser extent, deteriorating lead-based paints, the study finds.

“High-income countries, recognizing lead’s impact on IQ and the importance of intelligence to their knowledge-based economies, have continued to reduce lead exposure. This study’s finding of continued elevated lead exposure among children in low- and middle-income countries underscores a growing global disparity that requires policy makers to take action,” says co-author Howard Hu, M.D., Ph.D., Sc.D., professor and Flora L. Thornton Chair in the Department of Preventive Medicine, Keck School of Medicine, University of Southern California.

The Toxic Truth: Children’s Exposure to Lead Pollution Undermines a Generation of Future Potential,Pure Earth’s joint publication with UNICEF, using modeling estimates from The Institute for Health Metrics and Evaluation (IHME), revealed 800 million children globally have elevated blood lead levels. When examining IHME’s data from the same 34 countries included in this new research, both studies arrived at similar numbers of children harmed using different methodologies.

“This research adds to the scientific evidence that a previously unknown wave of lead poisoning has been sweeping through low- and middle-income countries, resulting in a staggering loss of human and economic potential for these children over their lifetimes,” says Richard Fuller, Pure Earth CEO. “What makes this especially urgent is this problem is growing, and the cycle will continue for generations until the sources of lead exposure are removed and no longer poisoning children.”

The good news is that an initiative to solve this problem at scale has been established.

Pure Earth, the Clarios Foundation, and UNICEF launched Protecting Every Child’s Potential (PECP) in October 2020 to directly tackle this challenge. PECP draws upon the expertise of its three founding organizations in toxic-site assessment and remediation; sustainable, environmentally sound battery recycling; and children’s health and welfare to raise awareness about the dangers of lead exposure from informal and sub-standard used lead-acid battery recycling, adulterated spices, cookware and other products. The PECP initiative is focusing its efforts in the first three years in Bangladesh, Georgia, Ghana, and Indonesia, while the Clarios Foundation and Pure Earth are integrating their work already underway in Mexico.

Two of the Guiding Principles of the PECP are:

  • We commit to a multi-stakeholder approach to work collaboratively with local and national governments, businesses, the United Nations system, academia and civil society to share best practices and model policies.
  • We recognize that the task of addressing this global crisis poses a formidable challenge that will not be met overnight. Actions and interventions may need to occur incrementally, and always with the awareness of local conditions and concern for livelihoods.

The three founding partners recognize the enormity of this task and invite actors from all sectors to join the initiative and contribute the diverse experience, talent and resources urgently needed to ensure that future generations are no longer subject to this preventable burden of lead poisoning.

Read the press release.


*Dignam, Timothy, Rachel B. Kaufmann, Lauren LeStourgeon, and Mary Jean Brown. “Control of Lead Sources in the United States, 1970-2017: Public Health Progress and Current Challenges to Eliminating Lead Exposure.” (Journal of Public Health Management and Practice: JPHMP 25, no. Suppl 1 LEAD POISONING PREVENTION, 2019): S13. DOI: 10.1097/PHH.0000000000000889

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