Lead Poisoning Still Causes 900,000 Deaths Per Year
Geneva Health Forum panel tackles “the effects of pollution on health: Current risk and possible solutions” on May 5, 2022.
Geneva Health Forum panel tackles “the effects of pollution on health: Current risk and possible solutions” on May 5, 2022.

Pollution is responsible for the premature deaths of approximately 9 million people each year; more than the number of deaths attributable to war and terrorism, malaria, AIDS, tuberculosis, drugs, alcohol or even smoking.

Chemical pollution severely undercounted in premature deaths from pollution

That’s also the equivalent of one in six premature deaths worldwide, pointed out Rachael Kupka, of the Global Alliance on Health and Pollution (GAHP) at a panel on the effects of pollution on health on Thursday, the final day of the Geneva Health Forum.

That estimate, originally published in 2017 by the Lancet Commission on Pollution and Health, is likely even higher now, insofar as an updated Lancet report is expected to be published on May 18, she noted.

While the conference this year has focused heavily on a emerging knowledge about the complex relationship between climate change, biodiversity loss, and pandemic risks – the panel on the GHF’s closing day, drove home the point that pollution of the air, waterways and soils is a fundamental driver of all of these trends. And despite half a century of environmental action, health risks from pollution remain as acute as ever.

Types of pollution

Types of pollution

Lead poisoning – one in three children worldwide have elevated blood lead levels

Lead pollution in the Amazons

While there are many sources of pollution – from traditional ones such as biomass burning and water contamination to ‘modern’ sources like vehicles, one important risk that still needs more attention is lead pollution, Kupka and other panelists pointed out.

Despite the worldwide phase out in leaded gasoline, environmental lead remains pervasive, causing some 900,000 deaths a year, according to the 2017 Lancet report.

“We have not eradicated lead poisoning,” stressed Kupka , citing a recent report by UNICEF and Pure Earth that showed one in three children have elevated lead levels of at least 5 micrograms per decilitre of blood – the level at which the World Health Organization recommends intervention. That’s 800 million children and 90% of them live in low-and-middle-income countries, often least equipped to handle the health impacts.

“Lead poisoning causes irreversible neurological damage,” Kupka said.

It also caused up to a 2% drain on LMIC’s Gross Domestic Product (GDP) from loss of productivity, and accounts for 7% of healthcare costs in middle incomes countries.

According to Kupka, primary sources of lead exposure today are not always the expected ones.

They include spices, cookware and lead acid car and truck batteries – as well as areas tainted by oil extraction and other industries.

She explained that in some countries, especially in South Asia, Eastern Europe, the Middle East and North Africa, lead salts are added to spices like turmeric and paprika to make them more colourful.

“Due to climate change, sometimes the turmeric roots become a dull yellow. People use turmeric for colouring – they want to make their rice and other foods colourful – so they are adulterating the spice,” Kupka said.

In countries ranging from Mexico, Turkey and Morocco some artisans still glaze their ceramic cookware with lead glazes.

And in most of the developing world, lead acid batteries are not properly disposed of, but rather dropped into landfills; lead and sulphuric acid seep into the soil contaminating the earth and underground fresh water supplies.

The effects of lead poisoning can be seen in the Peruvian Amazon, where oil extraction started mainly in indigenous areas in the 1960s, according to Cristina O’Callaghan.
The effects of lead poisoning can be seen in the Peruvian Amazon, where oil extraction started mainly in indigenous areas in the 1960s, according to Cristina O’Callaghan.

The effects are acute and chronic

Extractive industries, such as oil, are another source of lead poisoning, including for communities living around mining sites, where the gradual contamination of land and waterways may receive little notice or attention.

The Peruvian Amazon is one example, said another panelist, Cristina O’Callaghan of the Universitat Oberta de Catalunya and Barcelona Institute for Global Health.  Oil extraction began there in the 1960s. In recent years, she lead research efforts looking at the health effects of exposure on the area’s indigenous residents to lead, present in the crude oil spills that dot the areas forests and waterways – also contaminating local wildlife.

A 2021 study of some 1047 people in 39 indigenous communities of the northern Peruvian Amazon found that 49% of children and 60% of adults had blood lead levels (BLLs) above the WHO Guideline of 5 micrograms per decilitre of blood. The study, published in Environment International, found mean blood levels in some areas as high as 8.1 µg/dL among children under the age of 12, and 8.8 µg/dL among older participants.

Mean blood lead levels (BLL) in the study population was higher than 5 μg/dL
49% of children and 60% of adults had BLL above this threshold

“There are several routes of exposure: skin absorption and inhalation, but also ingestion,” O’Callaghan said, citing another study that observed that 50% of hunted biomass in the area had been affected by oil pollution. Displaying images of animals with faces covered in oil, she described how animals often seek out oil slicks to lick up the salts that their bodies require – but in this case are toxic lead salts.

“It turned out consumption of wild game was also a factor,” she said. “From the animals, it was getting into humans.”

Health effects are both acute and long-term. One cross-sectional study published in 2016 by BMC that looked at communities living around oil fields in the Ecuadorian and Peruvian Amazon, as well as the Nigeria’s contaminated Delta region, catalogued health effects as ranging from respiratory, eye and skin symptoms, headache, nausea, dizziness and fatigue, to neurological and psychological disorders; reduction of lung function, genotoxicity and alterations in hormonal status.

“It is very important to have valid data on environmental exposures and conditions of life of understudied populations,” she continued. At the same time, since there is already overwhelming data about the health effects of lead, even at very low levels of exposure, “we should not wait. We do not need these complex studies to act.”

Air pollution in Mashhad, Iran

More than six million people die each year from air pollution

Pollution is the largest cause of death globally.

Even more pervasive than lead, is air pollution from ambient air and household air pollution sources – which accounts for some 7 million deaths annually, according to the World Health Organization’s latest report.

“It is estimated that 99% of the entire world’s population breathes air with unhealthy levels of fine particulate matter (PM2.5) and nitrogen dioxide (NO2)that threatens their health,” said Liz Arnanz Daugan of the NCD Alliance.

Daugan said that air pollution ranks up with unhealthy diets, physical inactivity and tobacco use as a leading but modifiable cause of noncommunicable disease.

While many people associate air pollution with respiratory diseases and lung cancer, air pollution at low levels of chronic exposures also is responsible for a significant proportion of deaths globally from heart disease, hypertension and cancers as well as having impacts on almost every other organ of the body somehow.

People are exposed to higher levels of air pollutants in Asia, Africa and the Middle East in their homes and on the streets – and they may also be exposed to higher levels of dust and chemical air pollutants in workplaces, particularly informal workplaces where enforcement of occupational health rules is poor or non-existent.

The case of Madagascar

Health impacts of pollution in Madagascar

Madagascar is a country whose air quality is considered “moderately unsafe,” according to WHO standards. Some 28,280 people died as a result of air pollution in the country in 2016, according to Tatiana Eddie Razafindravao, chargé d’affaires of the country’s UN Mission to Geneva and the UN, who also spoke during the GHF session.

Considering all forms of air, water and chemical pollution together, some 31% of all premature deaths in Madagascar are due to pollution, shared Razafindravao during the session, citing data from 2016. “That’s a loss of 3.3 million healthy life years in 2016 through exposure to pollution.”

The air pollution in Madagascar is a result mainly of emissions from vehicles, bushfires, brick making, use of fossil fuels, charcoal consumption and waste that is incinerated in urban spaces.

A few years ago, with the support of GAHP, the country decided to take action.

In 2018, it ratified a “Health and Pollution Action Plan” and established a pollution control taskforce. The Health and Environmental ministries started evaluating their pollution policies and made a national plan for health security and air pollution control.

“But we are not without challenges,” said Razafindravao, noting that the country lacks technical and financial support to move as quickly as it wants to against pollution. It is also sometimes difficult to convince the public to adopt new behaviours that are conducive to preserving the environment and protecting their health, she said.

“We are working on developing a 10-year roadmap for pollution management in collaboration with GAHP,” Razafindravao explained.

She said Madagascar also hoped to establish an independent institute for pollution and chemical management that will bring together state entities, academicians, the private sectors, NGOs and international organizations around solving the crisis.

But she added that national and international legal frameworks are also important – because those in turn compel more investments and enforcement.

Practical steps

Daugan called on countries to adopt, and more strictly enforce, tougher emission standards for key pollutants.  Those should include air quality standards that correspond to WHO guideline levels for PM2.5 and NO2.

More sustainable urban planning, particularly in cleaner transport systems can also make physical activity more feasible – for a double “co-benefit” to health.

Other measures include the removal of fossil fuel subsidies that amount to hundreds of billions of dollars a year in G-20 countries alone – and wreak trillions of dollars in health damage, she said.

Removal of such subsidies also would clear the way for redirecting more development investments toward health-promoting renewable energy; cleaner public transport, walking and cycling; and improved housing with access to clean energy sources.

“We must make addressing pollution a national and international priority,” Kupka concluded.

Image Credits: ISGlobal – Barcelona Institute of Global Health , Maayan Hoffman, GAHP , Screenshot of PowerPoint presented by Rachael Kupka on May 5, 2022 at the Geneva Health Forum, Screenshot, PowerPoint Slide, Cristina O’Callaghan on May 5, 2022, O'Callaghan-Gordo, C, et al. Environment International 2021, Mohammad Hossein Taaghi, GAHP.

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