Final Rapid Market Screening Report Released September 12, 2023
Lead in Consumer Goods: A 25 Country Analysis of Lead (Pb) Levels in 5,000+ Products and Foods
While prior studies have identified lead in a variety of consumer goods, the geographic variations in lead exposure sources have been poorly understood. This assessment improves our understanding of which products are more likely to be contaminated, and how contamination levels vary across a diverse set of low- and middle-income countries.
The product types that most frequently exceeded relevant public health guidelines or regulatory limits were: metal foodware (52% of samples exceeded the relevant threshold), ceramic foodware (45%), paints intended for walls and large surfaces (41%), toys (13%), and cosmetics (12%).
Pure Earth recommends the RMS data be used to identify possible trends and products that warrant further attention and assessment. The data should be viewed as suggestive, not conclusive or representative of all similar products in these countries.
You can explore the findings via leadpollution.org, a repository of high-quality data related to lead (Pb) exposures around the world.
In 2021, Pure Earth launched an ambitious project to analyze the lead (Pb) content in thousands of products and food samples in markets across 25 low- and middle-income countries. The Rapid Market Screening (RMS) project is the first analysis of its kind that we are aware of. Support for this work comes from GiveWell, the Effective Altruism Global Health and Development Fund, and Open Philanthropy.
The scale of childhood lead poisoning is staggering, and due to a lack of research in the most impacted countries, the sources of exposure affecting the majority of the world’s children have been poorly understood. The 2020 report titled The Toxic Truth, by Pure Earth and UNICEF, revealed that an estimated 800 million children globally, or one in every three, have levels of lead in their blood that indicate lead poisoning. This prevalence suggests that children are continually exposed to lead in their daily lives. The vast majority of these children live in low- and middle-income countries, where research into exposure sources has been limited. Pure Earth’s Rapid Market Screening program (RMS) aims to improve our understanding of these exposure sources and advance the ability of all actors to implement solutions.
The RMS was implemented in the following 25 countries and states:
Armenia; Azerbaijan; Bangladesh; Bolivia; Colombia; Egypt; Georgia; Ghana; the Indian states of Maharashtra, Tamil Nadu, and Uttar Pradesh; Indonesia; Kazakhstan; Kenya; Kyrgyzstan; Mexico; Nepal; Nigeria; Pakistan; Peru; the Philippines; Tajikistan; Tanzania; Tunisia; Türkiye; Uganda; and Vietnam.
Results by Product Type
Results by Country (organized by regional groups)
The table below is organized by country and shows percentages of samples of each product and food category that exceeded the relevant reference level.
Pure Earth’s seven-point action plan to address lead contamination in countries with high levels of contaminated products.
Blood lead level testing
Few low- and middle-income countries conduct large surveys or ongoing monitoring of children’s blood lead levels. The result is that we have little visibility into the prevalence, severity, and geographic distribution of lead poisoning for most countries. This is one of the largest impediments to solutions. Governments and their development partners should explore and invest in ways to generate primary data on children’s blood lead levels so resources can be allocated appropriately, and so progress can be measured. The importance of blood lead level surveillance testing is highlighted by the identification of widespread lead exposure sources in low- and middle income-countries as part of the RMS.
Home-Based Source Assessments
Blood lead level surveys should be conducted in conjunction with in-home source analyses to establish connections between contaminated products and actual incidents of lead poisoning. During home-based source assessments, investigators asses a variety of products and environmental media in and around the homes of children with elevated blood lead levels. This combination of blood lead level testing with in-home source analysis can point to correlations between elevated blood lead levels and the presence of contaminated products like those highlighted in the RMS to help identify potentially significant local contributors to lead poisoning.
Research into foodware leachability and use
The high prevalence and wide geographic distribution of contaminated metallic and ceramic foodware was a surprise to Pure Earth’s team. However, total lead levels in foodware, as measured in the RMS, provide only limited insights into the potential dangers from use. Total lead levels cannot yet tell us concretely what lead dose a person is likely to receive from each use of a pot or pan. While Pure Earth is conducting ongoing leachate testing of more than 100 aluminum pots to help answer these questions, field research is also needed to determine if lead contaminated foodware is used in settings where high concentrations of children could be exposed (e.g., schools, daycares, hospitals) and if the food prepared in such foodware is being contaminated. If contaminated foodware is used in settings with high concentrations of children and the food prepared in that foodware is becoming contaminated, interventions to replace contaminated foodware at these locations could be highly impactful at a relatively low cost.Given the extraordinary prevalence of contaminated metal foodware, research is needed to determine if there are ways to reduce the leachability of lead from metallic pots during or after production through the introduction of an additive, coating, or other means.
Establishing recommended limits for total lead in foodware
The RMS team did not find public health guidelines or regulatory standards for total lead concentrations in foodware from which to set reference levels. Instead, the RMS team created the reference level of 100 parts per million for foodware based on guidelines for other products and on Pure Earth’s ongoing research into foodware leachability. While some countries have limits for leachable lead in foodware, assessing the leachability of lead in a product generally requires a lab, which makes screening expensive and time consuming. Instead of establishing leachability limits, regulators should consider setting a maximum allowable concentration for total lead at the lowest achievable level. If exceptions are needed, regulations should force producers to demonstrate that products exceeding the allowable level would not leach lead into food under any condition.
Track cosmetics to production sources
There is a need to track commonly contaminated cosmetics to their production facilities and then work with governments and producers to eliminate lead use. Contaminated eyeliners, for example, can be bought through e-commerce retailers worldwide. Efforts to eliminate lead in such products could have global impacts.
Enact and enforce lead paint laws
All governments should enact and enforce regulations limiting lead in paint and consider guidance provided in the UNEP Model Law And Guidance for Regulating Lead Paint developed by the Global Alliance to Eliminate Lead Paint. Additionally, countries and their development partners should invest in monitoring and enforcement capacities to ensure strict regulatory compliance, taking into consideration the UNEP Lead Paint Law Compliance and Enforcement Guidance.
Replicate programs to eradicate spice adulteration
Successful efforts to stop the adulteration of spices with lead-based pigments in Bangladesh and Georgia should be adapted to other countries with similar challenges, particularly Northern India and Pakistan, where recent assessments suggest a pattern of adulteration.
New research published in The Lancet Planetary Health serves as an urgent call to action
Lancet Planetary Health article: Global health burden and cost of lead exposure in children and adults: A health impact and economic modeling analysis
New World Bank research published in The Lancet Planetary Health reveals a dramatically greater burden and cost of lead exposure on IQ loss in children and on cardiovascular deaths in adults, six-fold greater than previously thought, and an estimated global cost of US$6 trillion.
Published on September 12, 2023, The Lancet Planetary Health paper showed the level of harm due to lead exposure is greater than previously thought. Specifically, based on data from 2019, the report showed:
- Children under five years old worldwide lost 765 million IQ points. Those living in LMICs lost 729 million IQ points, an average loss of 5.9 IQ points per child. This IQ point loss is 80% greater than previously estimated.
- 5 million adults died from cardiovascular disease (CVD) due to lead exposure; this is six times greater than the 2019 estimate by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD).
- Previous estimates included CVD deaths only from lead-mediated high blood pressure
- The new mortality calculation is based on the lead’s estimated effects on CVD deaths caused by factors other than high blood pressure, e.g., damage to the heart and arteries due to atherosclerosis and increased incidence of stroke
- About 90% of CVD deaths and 95% of IQ point loss due to lead exposure were in LMICs
- The global financial cost of lead exposure was US$6 trillion, equivalent to 7% of global GDP. In 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 CVD 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
Pure Earth President Richard Fuller, who served as an advisor for the World Bank report, said, “Pure Earth’s RMS study and The Lancet Planetary Health report demonstrate that lead pollution knows no boundaries. While severe lead contamination is well documented in toxic hotspots that poison local communities in many LMICs, our research indicates that hundreds of millions of people have elevated blood lead levels due to continuous, long-term exposure to household lead sources increasing serious health risks across lifespans. More people are dying from cardiovascular disease caused by lead exposure than by cholesterol.”
To request access to country data charts, please reach out to Sarah Berg at [email protected].