By Angela BANDEMEHR & Albert PARK
Lead is everywhere, often hiding in plain sight – in the water you drink, the air you breathe, the food you eat, your personal care products, and your children’s toys.
Despite being a useful metal, it is highly toxic and difficult to detect: its fumes and dust are odorless, and exposure to them does not immediately cause overt symptoms in most cases.
This is particularly worrying because exposure to and ingestion of lead can negatively affect almost every part of the body. Recent research finds that exposure contributes significantly 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 behavioral problems.
Today, one in three children worldwide have 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 20% of the learning gap between high- and low-income countries.
Moreover, the annual economic losses from lead poisoning are enormous, amounting to around 6.9% of global GDP. Health care for those sickened by the toxin, coupled with additional financing for special-education services to address the developmental and behavioral 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 45% of ceramic tableware, 52% of metallic cookware, and 41% 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. In some cases, policymakers 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? To answer this question, 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 pXRFs at low cost, training for authorized users, and technical support – both in terms of 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 organizations 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 lead in different sources and for acting 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.
Angela Bandemehr is International Environmental Protection Specialist focusing on Lead Pollution Capacity Building at the US Environmental Protection Agency. Albert Park is Chief Economist at the Asian Development Bank.
