Health experts urge elimination of ‘remarkably harmful poison’

The Biden administration recently announced this plan to replace all lead pipes in the US is a reminder that the toxic metal remains a threat, even in a country that has largely banned its use. The smallest exposure to lead can cause a range of health damage over time, especially to children’s brain development.

Stanford researchers Stephen Luby and Jenna Forsyth have spent years investigating the widespread presence of lead in low-income countries, including in some commonly used products.

They led a perspective published on November 5 The Lancet Public Health that identifies the global health and economic costs of lead, and a study in the November issue of Science of the total environment which highlights the urgent challenge of lead contamination in South Asian turmeric.

“Lead is a remarkably harmful poison,” says Luby. “Even within the context of limited resources, we must find ways to focus on reducing exposure to it.”

Below, Luby, the Lucy Becker Professor of Medicine at the Stanford School of Medicine, and Forsyth, a research scientist at the School of Medicine, discuss the prevalence of lead-contaminated produce, and share insights on how food safety policies, education and lead-free alternatives can reduce the risks reduce.

You call for a complete phase-out of lead by 2035. What do you see as the main obstacles to achieving this goal, especially in countries with limited regulatory enforcement?

Luby: The main hurdles include overcoming pushback from industries that, like tobacco companies, have a financial incentive to continue producing a product that kills millions of people every year. This requires a clear view of the enormous costs to public health and the environment that come with having a leading position in the economy.

Looking at the great success of removing chlorofluorocarbons from the atmosphere, the technological innovations in aerosol propellants and refrigerants took place in high-income countries, within companies that understood that regulation was on the horizon.

By the time the Montreal Protocol came into effect, low-income countries could purchase new generation propellants in refrigerants that were affordable and did not cause such damage to the Earth’s protective ozone layer.

Lead pollution disproportionately affects marginalized communities. What policy interventions or public health measures can ensure that these vulnerable populations are protected?

Luby: Globally, industrial pollution is disproportionately discharged near communities with limited economic and political influence. Efforts to reduce industrial discharges are important, but because lead is so toxic to the environment and human life, the primary public health response should be to remove it from the economy. In this way, the entire web of life, including humans, would benefit.

Forsyth: And since lead does not break down or disappear on its own, remediation of currently contaminated sites is a companion effort to reduce exposure among the most vulnerable.

Lead chromate in turmeric is a form of food fraud that can have devastating long-term consequences. What immediate steps can governments and international organizations take to stop this practice, and how can consumer awareness be raised?

Forsyth: Our experience in Bangladesh suggests that three immediate actions could end the practice. First, awareness of lead toxicity needs to be raised. Second is improving detection. Food safety officials often have too many priorities, too little bandwidth and limited to no testing capacity. Finally, enforcing food safety policies is essential: fining sellers of spoiled turmeric. Even enforcing food safety policies just once can have a long-lasting effect.

In your research on lead-acid batteries, you highlight their significant contribution to global lead use. What alternative technologies offer the most promise for replacing lead-acid batteries, and how can these solutions be made accessible to developing countries?

Luby: Currently, lithium-ion batteries are lighter, last longer and have a lower total cost of ownership than lead-acid batteries. They are well positioned to immediately replace lead-acid batteries in almost all applications. The best step low-income countries can take is to eliminate tariffs on lithium-ion battery imports so they can compete with the highly polluting lead-acid battery industry.

Forsyth: It is likely that better awareness and financing, such as microfinance loans, will be needed to overcome the higher upfront costs of lead-acid battery alternatives. Due to the increasing electrification of the global energy network, huge investments are being made in battery technology. In the coming decades there will be multiple alternatives, including sodium ion, magnesium-iron, and aluminum-iron technologies.