Around one in every three children are exposed to dangerous concentrations of lead, with the vast majority living in poor countries, according to new research, which has warned about long-term health damage.

The Toxic Truth report published by UNICEF said that around 800 million children and young people under the age of 19 are likely to have levels of lead at or above 5 micrograms per decilitre (5μg/dl) in their blood.

There’s no safe level of exposure to lead, according to the World Health Organization, as even at low concentrations it acts as a dangerous toxin. But levels above 5μg/dl are considered by the US Centers for Disease Control as a cause for action.

“This is an absolutely shocking figure,” Nicholas Rees, a policy specialist at Unicef and author of the report, told The Guardian. “We have known for so long about the toxic nature of lead, but we have not known how widespread it is, and how many children are affected.”

Lead is a potent neurotoxin and high exposure to it can kill, while lower levels can cause symptoms that lead to lower IQ scores, shortened attention spans and even violent and criminal behavior later in life. Children can even be born prematurely when exposed to lower levels in the womb.

Children under the age of 5 years are at the greatest risk of suffering lifelong neurological, cognitive and physical damage and even death from lead poisoning. Older children and adults, as well, suffer severe consequences from prolonged exposure to lead in food, water and the air they breathe, including kidney damage and cardiovascular disease.

The role of lead

Richard Fuller of Pure Earth, an NGO that collaborated with Unicef on the report, told The Guardian that people were less aware of the damage caused by lead, after campaigns to remove the toxin from many common uses in developed countries decades ago. “We did a terrific job of taking lead out of petrol but the use of lead has plateaued after falling in the 1970s and 80s,” he said.

Scientists now have more extensive knowledge of the damage caused by lead even at low concentrations than they did previously. For example, the US used to consider levels above 10μg/dl a cause for concern, but changed this to 5μg/dl in 2012 as more evidence became available.

One of the most concerning sources of lead exposure is the unsound recycling of used lead-acid batteries, most of which are found in cars, trucks and other vehicles. Recycling activities are often conducted in informal, unlicensed, and frequently illegal open-air operations close to homes and schools.

Lead is recyclable. It can be reused safely and cleanly through practices consistent with the circular economy and closed-loop supply chain principles, as is the case in countries with appropriate environmental regulations and monitoring. However, many countries lack sufficient formal recycling infrastructure and capacity.

Another cause of lead poisoning is the use of lead compounds, such as lead oxide and lead chromate, as a food additive to make spices appear more vivid in color. The compounds are frequently used with paprika and to make turmeric appear bright yellow. This has been found to happen in India, Africa and Bangladesh.

The risk is also present in developed countries but from other sources, including lead paint, contaminated soil and old water pipes. In the US, for example, children living in poorer households and dilapidated accommodation have been found to be at higher risk from lead exposure, the report showed.

A six-step approach

Addressing lead pollution and exposure among children requires a coordinated and concerted six-pronged approach, according to the report.

• Monitoring and reporting. Building capacity for blood lead level testing; strengthening the role of the health sector in prevention, diagnosis and management of childhood lead exposure and introducing blood lead level monitoring in the household survey.
• Prevention and control measures. Preventing children’s exposure to high-risk sites; preventing pregnant women and children’s exposure to products that contain lead and ensuring that children, pregnant women and lactating mothers are receiving adequate health services and nutrition.
• Management, treatment and remediation. Strengthening primary health care, including providing training for healthcare workers about how to identify, manage and treat lead exposure in children and pregnant women; providing children with improved nutrition and health services.
• Public awareness and behavior change. Creating continual public education campaigns about the dangers and sources of lead exposure with direct appeals to parents and caregivers, schools, youth associations, community leaders and healthcare workers
• Legislation and policy. Developing, implementing and enforcing environmental, health and safety standards for manufacturing and recycling of lead-acid batteries, e-waste and other substances that contain lead.
• Global and regional action. Creating global standard units of measure to verify and track the results of pollution intervention on public health, the environment and local economies and creating international standards and norms around recycling and transportation of used lead-acid batteries.