Child Lead Poisoning
For many people, child lead poisoning can feel similar to a thing of the past, as developed countries have access to resources and information to prevent it. However, lead poisoning is still an all-too-real health concern to millions of people globally.

What is the Situation Surrounding Child Lead Poisoning?

Around the world, more than 800 million children have blood lead concentrations greater than five micrograms per deciliter (μg/dL). To be clear, it is dangerous to have any amount of lead in the bloodstream and five μg/dL is the CDC-established level at which medical intervention is needed. India has one of the highest rates of child lead poisoning, with around 275 million children having a blood lead level (BLL) of more than five μg/dL.

Child lead poisoning in India has many causes, as children can absorb lead almost anywhere in the environment. One can breathe it in, ingest it or absorb it through touch. Water undergoes contamination when it runs through lead pipes. Lead-containing spices and packaging contaminate food. Additionally, toys, paint and traditional Indian cosmetics and medicines can contain lead. Children also undergo exposure when around industries that deal with lead, such as battery recycling plants or mines. Impoverished areas suffer the most from lead poisoning, due to lower levels of awareness, access to medical care and higher amounts of lead in the community infrastructure.

Children’s Exposure to Lead

With so many methods of exposure, it is no wonder that so many Indian children suffer from lead poisoning with consequences that are dire. According to India’s National Health Portal, “Lead is a cumulative toxicant (increasing in quantity in the body over many years) that affects multiple body systems (neurologic, hematologic, gastrointestinal, cardiovascular and renal systems).”

Furthermore, lead poisoning is detrimental to mental health and causes disability. There is a relationship between childhood exposure and increased violence, aggression and criminal behavior. Annually, more than 500,000 new intellectual disability cases can be directly traced to lead poisoning. Data from UNICEF has shown that, on average, Indian children lose four IQ points as a direct result of lead exposure. UNICEF has stated that “A loss of five points across an entire population could result in a 57% increase in the proportion of the population determined to have intellectual disabilities…This has tremendous implications for both the capacity of society to provide remedial or special education programmes, as well as for their future leadership.”

Pure Earth

For this issue, preventative measures are the best solution. Pure Earth is a non-governmental organization (NGO) that focuses entirely on lead and mercury poisoning in low- and middle-income nations. The NGO is the largest organization dealing with international childhood lead poisoning and it solves lead poisoning one project at a time using a “5-Phase Solution.” The five phases include blood testing, source analyses, source-specific interventions, ongoing monitoring of BLLs and public education.

Each Pure Earth project is highly specific to the location it targets. First, the Pure Earth team will gather BLLs in the area, then the Pure Earth team will identify the most probable exposure sources. Once they have determined where the lead is coming from, they will design an intervention that eliminates the lead source. Finally, Pure Earth will continue to monitor BLLs and educate the citizens of the area about lead poisoning and how to avoid it.

One such project that Pure Earth has completed worked with lead poisoning in Vellore, Tamil Nadu, an Indian community in close proximity to a formal lead smelter. When an assessment found large amounts of lead in the yard of the local school and daycare, Pure Earth designed solutions to protect the residents. The solutions involved intensive cleaning, paving of dangerous outdoor areas, installing a drainage system to divert the runoff from the smelter and implementing a citizen education program.

The Toxic Sites Identification Program

Pure Earth works all over the world, but it has completed several projects in India. Additionally, it is currently operating a Toxic Sites Identification Program, which has identified more than 700 attention-needing locations in India since 2015.

Child lead poisoning can seem overwhelming. There are countless methods of exposure, and it causes sombering irreversible damage. Pure Earth has proved that change can happen by addressing the issue one step at a time.

Mia Sharpe
Photo: Flickr

Lead Poisoning in Children
For more than a century, the people of Kabwe, Zambia have lived with devastatingly high levels of lead exposure. In 1994, after 90 years, Kabwe’s lead mine shut down. More than 25 years later, the people of Kabwe still suffer the consequences of decades of unstable mining and nearly nonexistent clean-up efforts by mine owners. Environmental health authorities say Kabwe has unprecedented levels of lead contamination leading to lead poisoning in children.

The EPA “defines a soil lead hazard as 400 parts per million (ppm) in play areas and a 1,200 ppm average for bare soil in the rest of the yard.” Black Mountain, a favorite place for Kabwe’s children to play, measures a staggering 30,000-60,000 ppm. The “mountain” is a massive heap of refuse. Adults often crawl through make-shift tunnels mining for lead, copper, manganese and zinc to sell. With more than half of Zambia’s population living below the poverty line, mineral scavenging provides vital income. Many people who venture beyond the “DANGER KEEP AWAY!” warning outside the mine site, say the risk of lead poisoning is a necessity if they want to feed their families.

Children at Risk

Lead poisoning in children is at a disproportionate rate due to children’s developing bodies and brains. Children absorb four to five times more lead than their parents. Lead exposure can result in skin rashes, poor appetite, weight loss, cough, stunted growth, learning disabilities and death. Often, lead poisoning goes undetected until it is too late. Many families will hide their lead-poisoned children because they fear stigma due to their child’s symptoms. In Zambia, 45.5% of children live in extreme poverty. As a result, they do not often have access to proper healthcare to treat lead poisoning.

The World Bank Project

The World Bank is funding a $65 million project, the Zambia Mining and Environment Remediation and Improvement Project (ZMERIP). The project aims to reduce environmental risks in lead hot spots. It also seeks to assist the Zambian government in addressing the dangers of lead exposure and implementing safety protocols, providing health intervention and engaging mining companies in expanding awareness of their environmental and social responsibilities.

In 2020, the ZMERIP began the largest health intervention to address blood lead levels (BLLs) in children in Zambia. More than 10,000 children received lead poison testing. The CDC recommends a BLL in children of no more than 5 µg/dl. Of the children tested, 2,500 had BLLs of 45 µg/dl or more. Chelation therapy, “which binds the lead into a compound that is filtered out through the kidneys”, is the preferred treatment for children who test 45 µg/dl or higher. Children who test lower, receive vitamin supplements, iron and protein as treatment.

The World Bank attempted another project similar to the ZMERIP in 2011 but achieved little progress. With lessons learned, the World Bank is hopeful this new project will be successful. If the project attains the goals it has set out to complete, more than 70,000 people including 30,000 children will benefit from the information. While some Zambians have yet to realize the risks of lead exposure, the World Bank reports mostly positive responses to their health advocacy.

The Future for Zambia

For the children of Kabwe, the ZMERIP offers hope of reducing lead poisoning in children. It offers hope that play is not a risk and a toddler’s appetite for a fistful of dirt is not a life sentence by lead poisoning. The key to the project’s success is continuing prevention practices, education, remediation and the Zambian government’s obligation to enforce safety regulations after the project’s completion expected in 2022. The ZMERIP’s commitment places focus on improving the lives and futures of Kabwe’s most vulnerable and valuable asset, its children, the country’s future.

Rachel Proctor
Photo: Wikipedia Commons

Lead Paint RegulationsOn October 6, 2020, the Lead Exposure Elimination Project (LEEP) publicly announced its launch online. The startup, which was incubated through Charity Entrepreneurship and identifies as an effective altruist organization, aims to address the absence of potentially high-impact lead paint regulations in countries of low and moderate wealth.

Lead Poisoning

Lead poisoning poses a serious public health hazard to a number of populations around the world, disproportionately impacting children raised in low and middle-income countries. As a toxicant that accumulates over time, the World Health Organization (WHO) reports, human bodies distribute lead to the brain, liver, kidney and bones. Because lead is toxic in any quantity, its ingestion can simultaneously damage multiple systems in a person’s body.

“Lead attacks the brain and central nervous system to cause coma, convulsions and even death,” according to the WHO. “Children who survive severe lead poisoning may be left with mental retardation and behavioral disorders… Lead exposure also causes anemia, hypertension, renal impairment, immunotoxicity and toxicity to the reproductive organs.” All effects of lead poisoning are considered irreversible.

Lead Exposure Elimination Project (LEEP)

As an organization affiliated with the utilitarian “effective altruism” movement, which seeks to maximize the direct impact of modern philanthropy, LEEP describes lead paint regulation as a high-priority issue that addresses “substantial health and economic costs.” Around one in three children globally, almost 800 million, have blood lead levels high enough to cause permanent neurodevelopmental damage, according to a report that UNICEF published on July 30, 2020. Lead poisoning is responsible for one million deaths and 22 million years of healthy life lost each year.

Lead Poisoning and Poverty

LEEP and other sources also link lead poisoning to cyclical poverty. By increasing the rates of mental disability, lead exposure reduces lifetime earning capacity and heightens the prevalence of violent crime, primarily among individuals living in low-income areas. Because mental illness can exacerbate poverty, the Institute for Health Metrics and Evaluation’s (IHME) 2017 Global Burden of Disease Study credits lead poisoning with reducing global GDP by $1.2 trillion each year.

Lead poisoning is considered a neglected issue in effective altruism circles. The only method of avoidance is prevention, yet common sources of lead poisoning like consuming water contaminated by lead pipes and inhaling lead particles generated by burning leaded materials or stripping leaded paint, have still not been regulated against in many areas of the world.

Advocating for Lead Paint Regulation in Developing Countries

To address these risks, LEEP’s primary mission is to advocate for lead paint regulations in countries where lead poisoning imposes large and growing public health burdens. Among the variety of common lead sources, it focuses on lead paint because it “may be the most tractable source of exposure to address and the easiest to regulate.” Among other considerations, eliminating lead paint is a non-partisan issue that is economically feasible for manufacturers and lacks a significant opposition lobby in almost all countries.

Beginning in Malawi, LEEP plans to launch advocacy initiatives in countries where lead paint regulations have the highest potential for impact. Immediate work will consist of testing lead levels in new paints on the market and building political connections in Malawi, with the hope of encouraging anti-lead legislation in the future. LEEP’s broader plan considers similar initiatives in Madagascar, Sierra Leone, Burkina Faso and Guatemala.

As of May 2020, the WHO reports that 39% of countries have regulations in place controlling the production, import, sale and use of lead paints. Africa, South Asia, South America and the Middle East are all regions where a significant proportion of countries do not have such regulations.

The Future of LEEP

LEEP was co-launched by duo Jack Rafferty, founder and director of the Refugee and Policy Institute, and Lucia Coulter, a medical doctor from the University of Cambridge with clinical and research experience. Charity Entrepreneurship provided LEEP with a $60,000 seed grant to jump-start the organization’s work. LEEP is currently seeking donors, in-country staff members and advisors with connections in target countries to reduce the effects of lead poisoning globally.

– Skye Jacobs
Photo: Flickr