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The health and economic impacts of lead poisoning are staggering: Lead poisoning affects 1 in 3 children worldwide. 90% of these children are in low- and middle-income countries. The global cost of lead exposure is US$6 trillion.

Why Focus on Lead Poisoning in Low- and Middle-Income Countries

As many as one third of the world’s children, about 800 million globally, have blood lead levels at or above 5 micrograms per deciliter (µg/dL), the level at which requires action. 90% of children with high lead levels are in low- and middle-income countries (LMICs) according to the 2020 Toxic Truth report from UNICEF and Pure Earth.

In 2019, 5.5 million adults died from cardiovascular disease (CVD) from lead exposure. Children under five years old worldwide lost 765 million IQ points from lead exposure. About 90% of CVD deaths and 95% of IQ point loss due to lead exposure were in LMICs.

To explore more data related to lead exposures around the world, visit Pure Earth’s interactive map LeadPollution.org.

Understanding the Impacts of Lead Poisoning

Health Impacts

Lead is a cumulative toxicant that affects multiple body systems, including the neurological, hematological, gastrointestinal, cardiovascular and renal systems. Children are particularly vulnerable to lead poisoning due to their smaller size and higher rates of lead absorption. Lead poisoning has been associated with brain damage, reduced IQ, decreased intelligence, learning difficulties, lower lifetime earnings, increased incidence of heart and kidney disease later in life, and increased tendency for violence. In 2019, children under five years old worldwide lost 765 million IQ points from lead exposure. Those living in LMICs lost 729 million IQ points, an average loss of 5.9 IQ points per child.

In adults, lead exposure causes a significant burden of disease as well. In 2019, 5.5 million adults died from cardiovascular disease from lead exposure. About 90% of CVD deaths and 95% of IQ point loss due to lead exposure were in LMICs. In pregnant women, lead exposure can cause miscarriage, stillbirth, premature birth and low birth weight.

    Economic Impacts

    The global financial cost of lead exposure is US$6 trillion (2019), equivalent to 7% of global GDP. In low- and middle-income countries (LMICs), these costs accounted for more than 10% of GDP, or twice as high as in high income countries (HICs). More than three-fourths of the economic cost (77%) was due to cardiovascular disease deaths and associated income loss from premature mortality; nearly one-fourth of the economic cost (23%) was due to estimates of lower future income caused by IQ loss.

    Top Sources of Lead Exposure in Low- and Middle-Income Countries

    Informal used lead-acid battery recycling
    Informal used lead-acid battery recycling

    A leading source of lead poisoning of children in low- and middle-income countries is the informal and substandard recycling of lead-acid batteries. In these countries, up to 50% of lead-acid batteries are processed informally.  This process, conducted with little to no environmental controls, often in residential areas, results in severe pollution and lead poisoning of local children.

    Lead-glazed pottery and metal cookware
    Lead-glazed pottery and metal cookware

    Lead-glazed pottery crafted by traditional artisans is commonly used to cook and serve food in  homes across Mexico, causing lead to leach into the food.

    Our researchers have recently uncovered that lead is being added to low-cost, locally made aluminum cooking pots in over a dozen low and middle-income countries, resulting in another source of lead exposure.

    Spices and Household Products
    Spices and Household Products

    The practice of adding lead-based pigments to enhance the color and weight of spices is occurring in several countries. Some of these contaminated spices find their way into kitchens worldwide through the global food supply chain. 

    Other household products such as toys, traditional medicines, and cosmetics such as eyeliners (kohl, kajal, and surma) have been found contaminated with lead.

    Paint
    Paint

    Only 35% of countries have limits on lead in paint that are legally binding. Young children are exposed to lead from peeling paint chips and from lead dust.

    Program Highlights: Lead Poisoning Solutions

    Health Surveillance
    Health Surveillance

    Blood lead level testing and analysis is crucial to understanding the prevalence, severity and location of exposure. Pure Earth has developed a model to launch national childhood lead monitoring programs using a country’s existing health survey infrastructure to collect lead exposure data. To date this model has been used in the Philippines, Mexico and the Republic of Georgia. In 2023,  Pure Earth launched Strengthening Health Systems to Reduce Lead Exposure, partnership between Pure Earth and the Ministries of Health in Colombia, Indonesia, Kyrgyzstan, Maharashtra, India, and Peru to strengthen each country’s national healthcare system to better prevent lead poisoning.

    Source Analysis
    Source Analysis

    Pure Earth assesses consumer products, environmental media, and homes to identify the primary sources and exposure pathways that likely contribute most significantly to lead poisoning.

    In 2021, Pure Earth launched the Rapid Market Screening project in 25 countries. Supported by a grant from GiveWell, the Rapid Market Screening (RMS) program is a novel, wide-reaching assessment of lead (Pb) contamination in more than 5,000 samples of consumer goods and foods from markets across 25 low- and middle-income countries.

    Source-Specific Interventions
    Source-Specific Interventions

    Pure Earth designs and implements interventions to reduce the use and/or release of lead in products and industrial processes.

    In addition, Pure Earth remediates polluted communities, supports countries in developing and implementing strategies and programmatic approaches, and integrates communications such as education and awareness-raising training to inform stakeholders.