Advancing Knowledge to Reduce Lead Exposure of Children in Data-Poor Low- and Middle-Income Countries
Wyatt M. Champion, Mahmooda Khaliq, James R. Mihelcic
Abstract
Though age-standardized disability-adjusted life-years rates due to lead exposure are declining globally, lead continues to harm global populations and, in particular, young people in low- and middle-income countries (LMICs). Legacy pollution and unregulated informal activities here contribute to markedly high exposures. Malnutrition amplifies lead’s deleterious effects, as does a lack of access to healthcare and education/awareness. Children are the most vulnerable subpopulation, owing to their relatively high lead intake and rapidly developing organ systems. As such, a majority of the 800 million children estimated with blood lead levels (BLLs) of >5 μg/dL reside in LMICs, and recent data suggest both higher and more variable BLLs in lower- versus high-income economies. Interestingly, urbanization (and development itself) can drive increased lead exposures as these countries progress toward a high-income classification, wherein regulatory efforts then reduce exposures. To help address this continuing health concern and to provide insight for researchers and practitioners, this Global Perspective aims to explore recent trends in global childhood BLL data and to elucidate potential and established contributors to lead exposures unique to LMICs. This work highlights the need for opportunities to advance knowledge in data-poor locations that address the unique, local, and complex aspects of a global environmental health concern.