Lead poisoning: How lead poisons children in the Global South – and what can be done about it

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Boy in India (symbolic image)

Photo: Ritesh Shukla / Getty Images

Saim is a boy from Mirzapur, a small town in Bangladesh. He used to be a good student, says his mother Shaila Akhtar – until an illegal battery recycling factory settled in the village. "It smelled all the time," she says, and sometimes the family could hardly breathe. "Little by little, he forgot more and more," she says of her son. It was only later that she came up with the idea that it could be due to the lead that is released by recycling. For years, the residents of Mirzapur were exposed to the heavy metal. Since then, many children have been suffering from lead poisoning. Also Saim, who can be seen in a film of the aid organization Pure Earth. When asked which class he goes to, he can't remember.

Caused by an invisible danger, lead poisoning is hardly noticeable at first. But if you absorb lead over a longer period of time, you risk long-term damage to the whole body. Especially for children, the metal is dangerous. Unicef estimated in a 2020 report that 815 million children worldwide have significantly excessive levels of lead in their blood, most of them in the Global South. According to a recent analysis by the World Bank, children under the age of five lost an estimated 2019 million IQ points to lead in 765 alone.

Especially in poorer countries, the heavy metal is widely used: in spices for stronger colors, in cooking utensils made of ceramics, cosmetics, toys, wall paint. So children and adults absorb it through food, through residues on the hands, through breathing when the paint is peeling. For a recent study by the NGO Pure Earth, researchers examined 5000 everyday objects and foods for their lead content in 25 low- to middle-income countries. The results show that the lead content often exceeds the permitted limits and guidelines, for example in the case of toys in 13 percent of the cases examined.

Lead disrupts the brain development of children in the long term, even in supposedly small doses. This leads to cognitive impairments such as learning problems and behavioral disorders, and in some cases it is also associated with crime. This is fatal for children in already disadvantaged contexts: their already low starting chances are further deteriorated. If children are exposed to a lot of lead for a long time, it can also lead to serious health problems such as convulsions, coma or even death.

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The NGO LEEP, in collaboration with the Zimbabwe Environment Agency, is testing paints for their lead content in Harare

Photo: LEEP

The metal is also dangerous for adults: In June, the American Heart Association published a report in which it evaluated, among other things, lead in the body as a "significant risk factor" for cardiovascular diseases such as strokes. A recent World Bank analysis shows that in 2019 alone, an estimated 5.5 million adults died from cardiovascular disease due to exposure to elevated levels of lead. A large part of lead remains in the bones, and cognitive and cardiovascular damage that has already occurred cannot be reversed according to the current state of knowledge.

It is now clear that there is no "safe" level of lead in the blood, at least for children. The problem is huge, especially in the Global South. And it is neglected. Few NGOs focus on this, research on the extent of the damage is scarce; there is a lack of data.

One of the NGOs working on the problem is the Lead Exposure Elimination Project, or LEEP for short. Its co-founder, Lucia Coulter, is a doctor. "The consequences of lead poisoning are not so easily attributable to lead – unless you test the blood of those affected or carry out other research. So it may be that a population is massively affected, and it's just not obvious," she says.

Your organization specializes in one part of the problem: wall paint. In color, the metal is still used in poorer countries as a color pigment or for better drying. Particularly dangerous for children: walls and doors with lead paint are touched. Children often put their hands in their mouths and pick up the substance in the process. In addition, paint particles are inhaled because aging paint gradually releases particles into the air.

There are good alternatives that manufacturers could use instead of lead. However, the problem is simply not clear to many, Coulter reports. She gives an example of a project in Pakistan. "There are already mandatory standards there. Nevertheless, it was not known whether paint with lead was still sold. So, together with the Aga Khan University in Karachi, we conducted a study and tested paints for their lead content. 40 percent of them had very high concentrations of lead." Subsequently, the NGO shared the data with the competent authority. Together, LEEP and the authority held a workshop for manufacturers, where they were informed about the problem and possible solutions. "Ten manufacturers have announced in recent months that they are now switching to lead-free paint," says Coulter.

LEEP works in more than a dozen countries, and according to Coulter, they always proceed in a similar way to Pakistan. A colour expert from the NGO advises manufacturers on how to switch to lead-free paint. In this way, at least dangerous wall paint can gradually be replaced by paint that is safe for health. Coulter calls lead in wall paint a comparatively easy problem to solve.

But there are many other sources: Lead in batteries, for example, is extremely dangerous for many people in poorer countries, where they are not safely recycled. At the same time, the component is not so easy to replace.

In the Global North, lead poisoning is no longer a big problem, actually. A few years ago, the small town of Flint in the US state of Michigan caused a sensation: In 2014, after a change in the water supply, almost 100,000 people were affected by lead from broken pipes, which got into their households and bodies. Later, a study showed that the concentration of lead in the children's blood was greatly increased in Flint. The affected citizens were financially compensated. The incident attracted public attention for years – and shows that even richer countries are not fully protected from the problem by old structures such as pipes.

And yet, the successes in the fight against lead poisoning in rich countries are remarkable – and obvious, for example, at petrol stations: wherever "lead-free" can be read on the petrol pumps. Not so long ago, this was not a matter of course, and leaded gasoline had an impact on the health of entire cities. Since 1996, only unleaded petrol has been available in Germany. In 2021, Algeria was also the last country in the world to ban the heavy metal in gasoline.

Only gradually does the world recognize the danger of the metal for the human body – and continues to process a lot of lead. "We need binding laws that are enforced, and we need to raise awareness of lead poisoning worldwide to a level commensurate with the scale of the problem," says Coulter of the NGO LEEP. The good news is: "You can do something."

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