Leads Lethal Legacy, a Poison We Choose to Ignore

Jan 18 , 2025
By Angela Bandemehr , Albert Park

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The economic losses from lead poisoning are consequential, amounting to around 6.9pc of global GDP. In this commentary provided by Project Syndicate (PS), Angela Bandemehr, an international environmental protection specialist focusing on lead pollution capacity building at the US Environmental Protection Agency, and Albert Park, chief economist at the Asian Development Bank, write the costs of healthcare and special education services for those affected by lead poisoning are a major financial burden, particularly in low- and middle-income countries (LMICs).

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Lead is everywhere, often hiding in plain sight, in the water we drink, the air we breathe, the food we eat, our personal care products, and our children's toys. Despite being a useful metal, it is highly toxic and difficult to detect. Its fumes and dust are odourless, and exposure to them does not immediately cause overt symptoms in most cases.

This is particularly worrying because exposure to and ingesting lead can negatively affect almost every part of the body. Recent research finds that exposure contributes to cardiovascular disease, killing millions worldwide. But while lead poisoning is responsible for more deaths annually than HIV/Aids and malaria combined, and more than tuberculosis, it receives a small fraction of the funding allocated to these better-known diseases.

The health effects are often irreversible and unequally distributed. For example, lead is especially harmful to children's cognitive development, leading to lower IQs and behavioural problems. Today, one in three children worldwide has dangerous levels of the metal in their blood, and nearly all of them live in low- and middle-income countries (LMICs). This inequality in exposure accounts for more than 20pc of the learning gap between high- and low-income countries.

The annual economic losses from lead poisoning are enormous, amounting to around 6.9pc of global GDP. Healthcare for those sickened by the toxin, coupled with additional financing for special-education services to address the developmental and behavioural issues caused by lead poisoning, costs millions of dollars each year in the United States alone. Lead poisoning also reduces an individual's lifetime earning potential, leading to lost tax revenue.

This makes it all the more important to reduce and eliminate lead exposure. The good news is that it is possible to detect lead in soil, spices, food, paint, cookware, and other solid materials using a portable X-ray fluorescence analyzer (pXRF), which provides near-instantaneous results and has already proven effective in many settings.

In Nigeria, health officials used pXRFs to help identify and clean up the source of a lead poisoning epidemic that killed more than 400 children, ultimately saving thousands of lives. An assessment of lead levels in consumer goods and foods used the devices to test samples in 25 LMICs, finding that 45pc of ceramic tableware, 52pc of metallic cookware, and 41pc of paint exceeded regulatory limits. The technology has enabled some governments to test the safety of toys and playgrounds, enforce lead-paint regulations in houses, and investigate whether lead exposure is the cause of health incidents.

Researchers using pXRFs identified dangerous levels of lead paint – which is still sold in many LMICs – in schools and playgrounds in Guyana.

But, very few LMICs currently use pXRFs to determine the sources of lead poisoning. Policymakers sometimes lack awareness that lead exposure is a major public health issue. Perhaps most importantly, these devices are expensive to buy and maintain, and training on how to interpret the data they produce remains limited.

What would it take to improve access to this valuable technology, so that LMICs can identify and eliminate the sources of lead poisoning that put their populations – especially their young people – at risk?

A working group comprising global lead-poisoning experts, practitioners, policymakers, and funders gathered in "Room 3" – linked to Sustainable Development Goal 3 for Good Health and Wellbeing – within the 17 Rooms Initiative. In our discussions about how to make pXRFs universally available by 2030, we agreed that the recently launched Partnership for a Lead-Free Future (PLF), supported by the United Nations Children's Fund (UNICEF), is best positioned to bring together stakeholders to support such an initiative.

Regional hubs, centrally coordinated by the PLF, could be established to provide low-cost pXRFs, training for authorised users, and technical support – both in maintenance and data analysis – for governments, NGOs, and academic partners. With sufficient demand, the proposed hubs can negotiate directly with pXRF manufacturers to lower prices and tailor device design to ensure cost-effective and accurate screening for lead in different sources.

The PLF could thus roll out this technology on a global scale, a breakthrough that would serve as a mechanism for international and local organisations to work together to raise awareness among LMIC governments about the importance of lead poisoning. This could include setting clear protocols and guidelines for using pXRFs to screen for leads in different sources and to act upon the results.

When it comes to lead exposure, prevention is the only option, because there is no cure. Increased access to pXRFs could help us win the fight against lead poisoning, safeguard the health and future potential of millions of children and young people, and unlock billions of dollars in economic benefits.

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PUBLISHED ON Jan 18,2025 [ VOL 25 , NO 1290]

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