Lead Exposure in Low and Middle-Income Countries: Perspectives and Lessons on Patterns, Injustices, Economics, and Politics

Kordas, Katarzyna; Ravenscroft, Julia; Cao, Ying; McLean, Elena V.

doi:10.3390/ijerph15112351

Cited by 78 publications

(73 citation statements)

References 125 publications

(151 reference statements)

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“…Epidemiological and experimental evidence across a range of exposures indicate that chronic exposure to heavy metals and metalloids, including lead, arsenic, and cadmium, are associated with CVD development [1,55,56], though most evidence is from high-income countries with low-to-moderate levels of exposure. The full extent of heavy metal exposure in LMICs is unknown due to few countries having biomonitoring programs in place, though evidence from individual studies indicates substantially higher exposures than in high-income countries [57][58][59].…”

Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

“…Lead was one of the first pollutants to receive global attention following elucidation of its neuro-cognitive effects in children [58]. Despite remarkable global decreases in blood lead levels following bans on leaded gasoline in many countries [60,61], pockets of high exposure persist among people living near industry and in areas with less environmental regulation [58,62,63]. Studies in high-income countries associate blood lead levels with cardiovascular mortality and clinical outcomes, including coronary heart disease, stroke, and peripheral arterial disease, with associations evident at blood lead levels as low as 5 μg/dL [1,7,64,65].…”

Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

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The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Baumgartner

Bräuer

Ezzati

2020

BMC Med

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Background: As low-and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources. Main text: Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low-and middleincome countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low-and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable. Conclusion: Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.

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Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

Section: Lead Cadmium and Arsenicmentioning

confidence: 99%

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The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Baumgartner

Bräuer

Ezzati

2020

BMC Med

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“…They are exposed to lead from a range of long-standing and emerging sources, emanating from the formal (regulated) and informal sectors [13]. Their elevated levels of lead exposure stymie children's development, as well as the socio-economic prospects for families, communities and nations [12,[14][15][16]. The distribution of elevated blood lead levels is socially stratified, with poorer communities exhibiting significantly elevated burdens of lead exposure, which increases or entrenches social inequalities [16].…”

Section: Discussionmentioning

confidence: 99%

Recycled aluminium cooking pots: a growing public health concern in poorly resourced countries

Mathee

Street

2020

BMC Public Health

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Lead exposure remains a significant public health problem, particularly in the informal sector. Recycling of scrap metal into artisanal pots is a growing concern in poorly resourced countries. Owing to the relatively light weight and low cost of the artisanal pots, as well as good conductivity which equates to lower usage of wood fuel, the pots are widely used. The aim of this article is to describe current insights and emerging evidence of health risks associated with artisanal pot making and usage. This thriving industry, particularly in poorly resourced communities, has multifaceted occupational, environmental and human health impacts. Given the complexity, innovative solutions need to be prioritized, evaluated and scaled up in relevant settings.

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“…Populations with certain sociodemographic and socioeconomic characteristics are more susceptible to lead exposure [29] For example, populations in countries with poor economic development are at highest risk of household exposures [30] as cited in Kordas et al [29]. Several studies in other parts of the world reported associations between sociodemographic characteristics and sources of lead, particularly in developed countries, where BLLs are associated with lower socioeconomic status [31].…”

Section: Association Between Sociodemographic Characteristics and Soumentioning

confidence: 99%

Follow-up of Elevated Blood Lead Levels and Sources in a Cohort of Children in Benin

Ahmadi¹,

Bot²,

Zoumenou³

et al. 2020

Preprint

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Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011-2013) suggested that 58% of one-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at six-years-of-age in 2016-18 and to compare BLLs between age one-year and six-years and study sources of lead at six years. BLLs were analyzed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs >50 µg/L in children was 59.5% [Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1 - 58.7] at six years of age compared to 54.8% [GM 56.5 µg/L, 95% CI: 53.4-59.6] at one year of age. The prevalence of children with BLLs >100 µg/L decreased from 14.4% at one year of age to 8.2% at six years of age. After adjustment for all other covariates, consumption of peanut more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at six years compared with no consumption. Consumption of bushmeat killed by lead bullets at six years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children.

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Lead Exposure in Low and Middle-Income Countries: Perspectives and Lessons on Patterns, Injustices, Economics, and Politics

Cited by 78 publications

References 125 publications

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Recycled aluminium cooking pots: a growing public health concern in poorly resourced countries

Follow-up of Elevated Blood Lead Levels and Sources in a Cohort of Children in Benin

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