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Standards for levels of lead in soil and dust around the world

  • Omosehin D. Moyebi , Tamba Lebbie and David O. Carpenter EMAIL logo
Published/Copyright: June 11, 2024
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Reviews on Environmental Health
From the journal Reviews on Environmental Health Volume 40 Issue 1

Abstract

Lead poisoning is a serious environmental health problem in every country in the world. Exposure to lead results in neurocognitive and behavioral changes, has adverse effects on the immune system, causes anemia, hypertension and perturbs other organ systems. The effects of lead poisoning are most critical for children because their bodies are growing and developing, and particularly because agents that reduce cognitive function and attention span as well as promote disruptive behavior will have life-long consequences. Lead exposure, especially to children, is a major health disparity issue. If the next generation starts with reduced cognitive ability, there will be significant barriers for development of skills and country-wide development. While there are many sources of exposure to lead, the commonest source is lead in soil and dust. Since lead is an element, it does not go away and past releases of lead into the environment remain as soil and dust contamination. This is an especially important route of exposure to children because children regularly play in soil and are exposed via hand-to-mouth activity. In addition to indoor sources of lead, contaminated soil is tracked on shoes or feet and blown by air currents into homes, accumulating in household dust which is a major source of exposure for both children and adults. The purpose of this review is to determine standards presumed to be health protective for lead and dust in different countries. We find that many countries have no standards for lead in soil and dust and rely on standards set by the World Health Organization or the US Environmental Protection Agency, and these standards may or may not be enforced. There is considerable variation in standards set by other countries.

Keywords: lead in soil; dust; blood lead; IQ; violence

Introduction

Lead is an extremely dangerous but useful element. It has positive uses as a shield for ionizing radiation, for storing energy in lead batteries, and weights for lifting and diving. It also has unfortunate uses as an additive to paint and gasoline and as ammunition, as well as use as lead casings to protect electrical and other kinds of cables. Its use as a solder in food containers and water fountains and in pipes for transport of drinking water have also increased human exposure [1]. All of these have significantly increased the levels of lead distributed into the environment in soil and dust. While all countries have ceased use of leaded gasoline for vehicles [2], lead is still added to some aviation fuel [3]. Developed countries have banned lead in paint for many years, but lead is still found in many enamel paints from less developed countries [4]. Many lead pipes and casings remain in use or have been abandoned but not removed. Combustion, especially from coal, releases lead into the air [5]. Lead smelters are also significant sources of local lead contamination of soil. These past uses of lead have led to elevated concentrations of lead in soil and dust. The result is that lead in soil and dust remain a significant route of human exposure and adverse health effects.

Health effects

Neurobehavioral effects of lead exposure

Lead has no beneficial effect in the human body. All actions of lead are negative. Lead has harmful effects on the nervous, endocrine, cardiovascular, renal, reproductive, and immune systems [6], [7], [8], [9], [10], [11]. The effects that occur at the lowest level of exposure are neurobehavioral, including a reduction in cognitive ability as reflected in decreased intelligence quotient (IQ), reduction of attention span and reduced ability to deal with frustration [12].

A classic study by Needleman et al. [13] reported on lead exposure to children through measurement of lead in baby teeth. Because lead is a divalent cation, like calcium it is deposited and persistent in bones and teeth. By comparing neurobehavioral outcomes in children with high vs. low levels of lead in baby teeth, Needleman and colleagues showed that high lead was associated with a 5–7 IQ point decrement relative to children less exposed to lead. The children were more easily distracted, were not persistent, were more dependent, less organized, hyperactive, more impulsive and easily frustrated and had a low overall level of functioning. There was also a dose-dependent reduction in attention span, more disruptive behavior, and poorer performance in school. Children exposed to lead still have a range of IQs, but at every part of the frequency distribution curve children with high lead have a lower IQ than children with low lead exposure. These results have also been replicated widely by other investigators [14], [15], [16]. One result is that childhood lead exposure leads to an increased failure to complete high school and an increase in reading disability.

These actions are most serious during early life, where exposure to lead can lead to permanent neurobehavioral decrements. Young children are highly susceptible to lead exposure due to their hand-to-mouth behavior, as well as the tendency of children to pick and eat things like lead-containing paint chips, commonly referred to as pica. Children have a higher intestinal absorption and retention rate than adults [17], 18]. Childhood lead poisoning can result in hyperactivity, memory disorders, hallucinations, and irritability. Acute poisoning in children can cause paralysis, convulsions, coma, and brain damage in fatal cases [18].

These observations have been confirmed by many studies from different countries [19], [20], [21], [22]. Exposure of children to lead is of the greatest public concern because the decrements in cognitive function and shortened attention span may last for a lifetime. Lead impairment on biochemical processes include lead reaction with proteins, inhibition of actions of calcium in the body, and alteration of gene expression [18]. Studies by Rogan et al. [23] reported that chelation therapy of young children with high levels of lead reduced the serum lead concentration, but did not result in improvement of cognitive, behavioral, or neuropsychological function in the children when tested several years later. This suggests that early life exposure to lead results in irreversible damage.

With a reduced ability to pay attention, it is no wonder that these children have reduced cognitive function and life-long productivity, since if you cannot pay attention how can you learn? Lead exposure leads to all the symptoms of attention deficit hyperactivity disorder [24], learning disability, antisocial behavior and even altered motor control. In a meta-analysis, Marcus et al. [25] concluded that the relationship between conduct problems and lead-exposure in children was of the same order of magnitude as that between lead exposure and IQ.

There have been a number of reports documenting the economic losses that result from childhood exposure to lead. A study from New Zealand concluded that each 5 μg/dL elevation in blood lead was associated with a 1.79-unit lower score in socio-economic status [26]. Grosse et al. [27], estimated that for each IQ point gained in 3.8 million 2-year-old children, their work productivity as adults was increased by 1.76–2.38 %, leading to a lifetime economic benefit of $119–249 billion. A study from France did a cost-benefit analysis of the cost of removal of lead in soil and dust in relation to the economic cost of childhood lead levels of 15 and 24 μg/L (European standards) and concluded that removal of lead resulted in a benefit of €3.78 billion and €1.88 billion, respectively [28].

While there has been a major focus on lead in children, there is clear evidence that lead exposure in adulthood also results in reduced IQ and cognitive performance [29], [30], [31], [32], [33], [34].

The USEPA has long held that for non-cancer health effects there is a concentration below which there is no hazard. This has been definitively shown not to be true for the reduction in IQ from lead exposure upon consideration of many different studies [21], as shown in the Figure 1 below. The evidence shows that there is a steeper decline in IQ with increments of increased lead exposure at concentration below 10 μg/dL above that level. There is no indication of any threshold concentration of lead that does not cause a reduction in IQ, and the reduction in IQ does not increase linearly with dose. Non-linear dose response curves are now being found for many endocrine and neurologic effects of xenobiotics [35].

Figure 1: Log-linear model for concurrent blood lead concentration along with linear models for concurrent blood lead levels among children with peak blood lead levels above and below 10 μg/dL [21].
Figure 1:

Log-linear model for concurrent blood lead concentration along with linear models for concurrent blood lead levels among children with peak blood lead levels above and below 10 μg/dL [21].

The behavioral effects of lead exposure, including shortened attention span and reduced ability to deal with frustration leads to an increase in juvenile delinquency [36], antisocial behavior and crime [37]. This is especially important during adolescence [38]. Nkomo et al. [39] reported that elevated lead levels in adolescent boys were associated with anti-social and destructive behavior, including attacking people. Lead exposure during childhood is associated with greater risk of substance abuse [40] and impaired lifelong mental health [41]. There is clear evidence that elevated lead levels in childhood leads to increased rates of criminal behavior and incarceration in adults, especially among males Wright et al. [42]; Carpenter and Nevin [43]; Boutwell et al. [44]; Beckley et al. [45].

Cancer

Lead is categorized by the IARC as Group 2A, a probable human carcinogen IARC [46]. This reflects clear evidence that lead exposure can cause cancer in laboratory animals, but equivocal evidence that lead causes cancer in humans. There is limited evidence for elevations in occupational lead exposure and some cancers [46].

Other non-cancer effects of lead exposure

While the neurobehavioral effects of lead are the most important from a societal point of view, there are many other diseases caused by lead exposure. Among the most important are the effects on the immune system. Lead exposure results in elevations in allergy and asthma, and this is due to an elevation in levels of immunoglobin IgE [10], 47]. Other diseases include anemia [7], 48], delayed sexual maturation of girls [49], earlier age of menopause in women [50], delayed time to pregnancy [51], altered onset of puberty in boys [52], increased male infertility [53], elevated risk of atherosclerosis [54] and hypertension [6], increased risk of dental caries [55] and even increased risk of neurodegenerative diseases such as amyotrophic lateral sclerosis [11]. There is some evidence that childhood lead exposure leads to reduced brain gray matter volume in adults, especially in males [56]. The most dramatic report is “In a nationally representative sample of the US population, blood lead levels as low as 5–9 μg/dL were associated with an increased risk of death from all causes, cardiovascular disease and cancer” [57].

While these are serious diseases, the concentration of lead that is associated with elevated rates for most of them is much higher than that associated with the neurobehavioral effects.

Lead exposure in developed and developing countries

As is the case for many environmental contaminants, it is evidently clear that lead levels in blood are almost always higher in developing countries. Ericson et al. [58] reported average blood lead levels in children in Palestine to be 9.30 μg/dL and levels in Pakistani adults to be 11.36 μg/dL, as compared to the US Centers for Disease Control and Prevention standard of 3.5 μg/dL [59], which is already too high to be health protective. There are multiple reasons for these disparities based on economic development and lack of regulation. Developing countries often do not have rigorous standards regulating lead release from industries or in content in products. Many polluting industries, such as lead smelters and e-waste recycling facilities, move from developed to developing countries lacking stringent lead emission standards. However, lead poisoning in children is not limited to developing countries. According to Laidlaw et al. [60] there were 9.6 million children (24.5 %) in the U.S. with blood lead levels between 2 and 10 μg/dL.

Routes of exposure to lead

Like any environmental contaminant, exposure to lead can occur by ingestion, inhalation, or dermal absorption. Ingestion and inhalation are the major routes of exposure to lead.

Lead in drinking water is a serious concern because in the past much of the drinking water was transported in lead pipes. Serious lead contamination of whole communities because of lead pipes has been found recently in the US [61]. Lead can get into drinking water from containers with lead solder, especially if stored for longer periods of time. This can come from tanks storing water in drinking fountains [62], or as in the case of high lead solder in stainless steel rainwater tanks in Tasmania [63]. Some ascribe the decline of the Roman Empire to drinking wine from leaden goblets, where the acidity promotes leaching of the lead [64].

Food is also a major source of lead exposure. Lead content of agricultural soils is a concern because of the possibility that the lead will be absorbed by plants and thus enter the food supply. Certain non-food plants have been demonstrated to be effective for phytoremediation of lead contaminated sites [65]. Uptake of lead is a special concern in paddy rice fields because rice, more than other grains, will concentrate metals. However, this is a greater concern for arsenic than lead [66]. Elevations in lead concentration have been demonstrated in Vietnam in vegetables grown near automobile service stations that have elevated lead levels in local soil and water [67]. Most leafy green vegetables do not accumulate lead from the roots, but if grown on contaminated soil can have significant lead concentrations on the leaves if not adequately washed [68], 69]. Because of the historical uses of lead, there are significant levels of lead in such things as fertilizers, lime and sewage sludge, and these are applied to agricultural fields, where the lead accumulates in soil, leading to dust [70]. Wastewater also often has elevated lead concentrations. Some seafood products contain significant concentrations of lead [71], and meat can be contaminated with lead if killed with lead shot [72]. However, for vegetables, the major concern is soil particles on the surface that are not adequately washed [73].

Another concern is exposure of the fetus to lead during fetal development. It is known that late in pregnancy calcium is mobilized from maternal bones and if the mother has elevated lead exposure the lead will be mobilized as well [74]. Charkiewicz and Backstrand [75] reported that the levels of lead in the umbilical cord can be as high as 85 % of that in the pregnant mother’s body. However, there is no robust evidence that prenatal lead exposure has adverse neurobehavioral effects on child neurodevelopment. In a study of Mexican children, Farias et al. [76] monitored blood lead, mercury and manganese in 253 pregnant women and applied the Bayley Scale of Infant Development at 1, 3, 6 and 12 months of age of the child, and found reduced neurodevelopment only when the interaction with all three metals was considered. Inoue et al. [77] studied neurocognitive effects in 80,759 children in relation to maternal lead concentration between 6 and 36 months of age. They concluded that there was no convincing evidence for an inverse association between prenatal lead exposure and neurodevelopment in early childhood. In a systemic review of 26 publications, Santana et al. [78] concluded that it is not possible to associate gestational lead exposure to neurobehavioral deficits. These observations suggest that there may be a greater sensitivity of the developing brain to lead exposure in the early post-natal years than during fetal development.

Lead is not volatile but is often attached to particulates in air [79], 80] that can be inhaled. Coal miners can be exposed to elevated lead by inhalation of coal dust [81]. Thus, inhalation of particulates containing lead is a major route of exposure. These particulates also ultimately deposit on the ground and become a significant contributor to lead in soil and dust, as described below. Lead particulates can come from natural sources, such as volcanoes and forest fires, but anthropogenic sources dominate causes of airborne lead [70]. The use of lead as an additive to paint in the past and to a lesser degree even today has resulted in some children being exposed to very elevated concentrations of lead by chewing lead-painted surfaces and eating paint chips [82]. Children’s consumption of paint chips containing lead is a major route of exposure in much of the world [83], 84].

Coal contains varying amounts of lead, and while there are efforts to reduce combustion of coal throughout the world, coal is still widely used in power plants and for home heating in most countries including many developed ones. Liang et al. [5] found that children’s blood lead in Shanghai was primarily a result of combustion of coal after phasing out lead in gasoline. High concentrations of airborne lead have been reported in Indonesia [85], Ghana [86], South Africa [87], Mongolia [88], India [89], China [90] and Pakistan [91]. In most of these countries the elevated concentrations of particulates containing lead are the result of industrial combustion, especially of coal. Thus, inhalation of particulates containing lead is a major route of exposure.

Ongoing sources of lead exposure in different countries include electronic waste recycling, lead contaminated utensils and water, traditional medicines, cosmetics, paint, and batteries, [92], 93]. In Mexico, lead glaze on pottery can cause leaching of lead into fluids and foods that are then consumed. In China, electronic waste and many traditional medicines contain lead. Many children’s toys imported from developing countries contain hazardous metals including lead [92]. This is a problem because children often put these toys in their mouths. E-waste recycling poses particular risks of lead exposure to workers and local residents because of releases of lead to air, soil and dust [93], 94].

Dermal absorption is not a significant route of exposure to lead, although there are cosmetics widely used in many countries containing high levels of lead that may lead to some exposure [95], 96]. This is the case for not only cosmetics used in countries in the Middle East, such as Iran [97], but also in eye cosmetics in developed countries such as Spain and Germany [98].

Sources of lead in soil and dust

The sources of lead in soil and dust vary among different countries, but many sources are common. As an element, lead is present in all soils at low concentrations. Lead concentrations in soils without any unusual source of exposure is typically 10–50 mg/kg [99]. However, anthropogenic activities have caused increases in lead concentrations in soils from ancient times [64], from mining and smelting to widespread use for many different purposes such as waste recycling and disposal, fertilizer application, and fossil fuel combustion [9]. Emissions from lead smelters were found to significantly contribute to the concentrations of lead dust and may be the major source of elevated blood lead levels observed among children in the Port Pirie, South Australia [100]. This study also suggested that kindergarten facilities and/or children’s recreational playground in an outdoor environment is an important source of exposure because of lead in soil and dust. Lead is still being used in the production of battery plates, cable covers, atomic reactor shields, in the construction and chemical industries, soldering materials, paint and ceramics [18], all of which increase the risk of local contamination of soil and dust.

Combustion of coal, which contains varying concentration of lead, in addition to being an important route of inhalation exposure, is an important source of widespread lead deposits to soils and dust [101]. The global addition of tetramethyl and tetraethyllead to gasoline to prevent knocking in the past led to emissions of inorganic lead from the tailpipes of cars and trucks around the world. The legacy of leaded petrol contamination on urban soil and dust is still a major contributor to children’s exposure in Taiwan [102] and California [103]. Robbins et al. [104] found that among children in Cleveland, Ohio, two-thirds of the total lead intake during the period between 1936 and 1993 was due to lead from gasoline. Resongles et al. [105] utilized lead isotopic data and showed that lead deposited in the 20th century from gasoline combustion contributed significantly to current lead levels in London. In addition, some but not all countries still engage in the common practice of adding lead to paint, especially white paint. This often results in contamination of the indoor dust as well as outdoor soil as the paint deteriorates. This was assumed to account for most of the remaining one third of the lead exposure in children [104]. Mielke et al. [103] found that in New Orleans, the concentration of lead in dust resulting from lead in gasoline was a more crucial factor contributing to children’s lead levels than lead-dust from paint.

While most of the sources of lead contamination are found outdoors, when soil and dust are contaminated with lead, it can pollute homes in a variety of ways. It is tracked into homes on feet, shoes and clothes both from work and children’s outdoor play on contaminated soil. Outdoor soil and dust blow into the home through open doors and windows. Children, especially young children, have increased hand-to-mouth activity which is an important route of exposure. Therefore, it is important to continue the advocacy for the discontinuation of lead in the production of materials that are in use by humans. Elimination of lead exposure sources and creating awareness on the harmful effects of lead is critical to reduce lead risks.

Methods

We searched national websites for health and environmental agencies for different countries for “national and state lead standards in soil” and “national and state lead standards in dust”, as well as PubMed and ScienceDirect publications using the terms “lead standards in soil”, “lead standards in dust” and “routes of exposure to lead”. While most publications do not list standards, they often lead to national reports that did list standards for lead in soil and dust.

Results

Lead in soil and dust as an important route of exposure

The major route of exposure to lead in almost all the countries is from unintentional consumption of lead-contaminated soil or dust. There are many studies demonstrating that the concentrations of lead in soil predict lead levels in children’s blood (from Denmark, [106]; from the United States [103], 107]) and as does the concentration of lead in dust (from the United States [108], 109], from Australia, [110], 111]; from Pakistan [112]). In a study in a mining area in China, Carpenter and colleagues found that 86.3 % of the total intake of lead by children was due to soil and dust [113]. Lead in soil contamination is a major concern around e-waste sites in developing countries [93], 114].

Furthermore, there is strong evidence that cleaning to remove the lead-contaminated dust results in a reduction in children’s blood lead levels, although often frequent and repeated cleaning is necessary [115], 116]. Exposure is also associated with personal behaviors, as inadequate hand washing can result in ingestion of contaminated soil or dust by hand-to-mouth activity.

These sources of lead use and release have resulted in lead being present, sometime at high concentrations, in soils and dust. Elevations in lead levels in soil and dust near mining sites has been demonstrated in China [117], 118] and Turkey [119]. Lead-contaminated soil and dust can be ingested, and dust can be inhaled. Exactly how much soil and dust are ingested at various ages is somewhat uncertain. Table 1 shows one estimation as a function of age. USEPA [120] indicates that young children ingest a total of about 110 mg/day, with 50 mg due to soil and 60 mg due to dust. The Canadian Council of Ministers of the Environment assumes that toddlers consume 0.08 mg/day of soil, while all other ages from infants to adult consume 0.02 g/day of soil [121]. A study in China based on soil and dust on children’s hands estimated that the total ingestion from this source was 7.73 mg/day for kindergarten and 6.61 mg/day for primary school children [122].

Table 1:

Expected rate of soil and indoor dust ingestion as a function of age [68].

Source Infant (0–6 months) Toddler (7 months–14 years) Child (5–11 years) Teen (12–19 years) Adult (>20 years)
Soil 0.02 g/day 0.035 g/day 0.038 g/day 0.02 g/day 0.02 g/day
Dust 0.024 g/day 0.043 g/day 0.047 g/day 0.024 g/day 0.024 g/day

As discussed by [105], lead in soil and dust, especially in urban areas, leads to lead in air-borne particulates that pose a significant public health hazard that is very difficult, if not impossible, to adequately address. Removal or covering up of all urban soil near roadways is not realistic because of the cost and logistics. This is a clear reason that setting standards for lead concentrations in soil and dust is critical so as to prioritize the most contaminated sites.

Standards for lead in soil and dust

While the World Health Organization has specific standards for lead in drinking water (10 μg/L) and air (0.5 μg/m3), it does not have specific standards for lead in soil or dust. Previously, WHO had a standard for tolerable weekly intake of lead of 25 μg/kg per week, it has discontinued this standard because of the clear evidence that there is no level of intake that is without harm WHO [4]. USEPA [123] set a standard for lead in soil of 400 ppm in play areas and 1,200 ppm in non-play areas. This EPA standard has been further revised OSWER [124], as shown in Table 2.

Table 2:

National standards for lead in soil.

Country Soil Residential Agricultural Industrial Commercial/industrial Recreational
Canada (HH) [125] 40 mg/kg 70 mg/kg 600 mg/kg 260 mg/kg
Canada (EH) [125] 140 mg/kg [126] 300 mg/kg 70 mg/kg 600 mg/kg 600 mg/kg
New Zealand [127] 400 mg/kg 800 mg/kg 1,500 mg/kg 600 mg/kg
Norway [128] 60 ppm
Vietnam [129] 70 mg/kg
United States [130] 400 mg/kg 800 mg/kg 400 ppm
Netherlands [128] 55 mg/kg
Finland [128] 60 mg/kg
Brazil [131] 17 ppm
Poland [126] 100 mg/kg 600 mg/kg 50 mg/kg
India [132] 300 μg/kg
Australia [133] 300 mg/kg
China [134] 25.56 mg/kg
United Kingdom [135] 80 mg/kg
Indonesia [136] 10 ppm
Tanzania [137] 200 mg/kg
South Africa [138] 230 mg/kg
Argentina [139] 500/140 mg/kg 375/70 mg/kg 1,000/600 mg/kg
Mexico [139] 400 ppm
Germany [140] 400 mg/kg 200 mg/kg
Italy [141] 100 mg/kg

Countries with standards for lead in soil are shown in Table 2. Some countries have only a single guideline for lead in soil, while the vast majority set lead guidelines based on land use or activities. For example, Tanzania (200 mg/kg) and South Africa (230 mg/kg) set lead standard in soil regardless of whether the area is for industrial, residential, or agricultural purpose. However, Canada set standards for each category of land use including soil surface (140 mg/kg). Some provinces and states have more restrictive standards than the federal governments, as shown in Table 3.

Table 3:

State and province standards for lead in soil.

Country Soil Residential Agricultural Industrial Commercial/industrial Recreational
Ontario, Canada [142] 120 μg/g 45 μg/g 120 μg/g
Maryland, USA [143] 200 mg/kg 1,050 mg/kg 550 mg/kg

Lead in soil and dust standards are yet to be developed in most countries. These countries depend on the United States Environmental Protection Agency guidelines. Countries that we were unable to find their lead in soil and/or dust standards are listed in Supplementary Table 1.

Discussion

The results in Tables 2–4 shows that standards for lead in soil and dust vary greatly in different countries. It is also clear that many countries do not have specific standards.

Table 4:

National and state standards for lead in dust.

Country Floors Windowsills Window wells
United States [144] 10 μg/ft2 100 μg/ft2
New York [144] >40 µg/sf >250 µg/sf >400 µg/sf
New York City [145] 5 μg/ft2 40 μg/ft2 100 μg/ft2
France [146] 28 μg/ft2

There are many reasons why it is important that there are rigorous standards for lead levels in soil and dust. Lead in soil and dust is a major factor leading to lead exposure in children, as was clearly demonstrated in a pooled analysis of 12 US epidemiological studies by [108]. They concluded that house dust was the primary source of lead exposure to children, being more important than drinking water, lead paint chips, exposure outside the home, age of the children and socio-economic status of the family. While these studies were all from the US, it is likely that the same associations are true for other countries, even though sources of lead exposure do vary among countries. Lead concentrations in people of all ages in the US fell dramatically after the removal of tetraethyllead from gasoline, remediation of lead-based paints and removal of lead from soldered cans [147].

Since lead is an element, the emissions from coal combustion and leaded gasoline do not disappear but remain in surface soil unless remediation activities are undertaken. This becomes a nearly ubiquitous source of lead in dust, especially in more densely populated urban areas and along major highways. Even though these levels are less than those near the smelters or mining facilities, they pose health hazards.

The public health burden of lead in soils and dust is disproportionately greater in developing countries that have limited ability to control emissions and remediate contaminated soils [148]. The economic productivity of any country is greatly influenced by the cognitive ability of its population. As lead exposure results in a reduction of cognitive function, especially the next generation of children, lead significantly impacts the ability of the developing countries to escape a cycle of continued underachievement [149], 150]. Grosse et al. [27] estimated that each IQ point lost because of lead exposure results in a lifetime loss of productivity of between 1.76 and 2.38 %. Fewtrell et al. [151] have estimated that the mild mental retardation resulting from lead exposure may account for up to 1 % of the global burden of disease, with the highest burden in developing countries. Studies in New Zealand followed children exposed to high lead levels into adulthood and found that for each 5 μg/dL increase in lead exposure at 11 years of age there was a significant 1.34-point increase in general psychopathology [41]. There is some evidence that lead exposure increases the risk of developing adult-onset schizophrenia [152].

Summary and conclusions

Lead in soil and dust pose significant public health hazards. This is especially true for children who are at greater risk of exposure due to play and hand-to-mouth behaviors. While there are serious neurobehavioral and other risks of lead exposure at any age, the greatest concern is for children because exposure to lead early in life results in permanent decrements in cognitive function and behavior. There are serious health disparities among countries regarding lead exposure because many developing countries have less ability to control emissions of lead and exposure, especially of children, leading to a never ending cycle of inability to compete equally for economic and political progress among nations.

Corresponding author: David O. Carpenter, MD, Department of Environmental Health Sciences, School of Public Health, University at Albany, Rensselaer, NY 12144, USA; and A World Health Organization Collaborating Center on Environmental Health, Institute for Health and Environment, University at Albany, 5 University Place, Rensselaer, NY 12144, USA, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: All authors searched the literature, contributed to the writting and reviewed the final draft.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: All funding came from internal funds from the Institute for Health and the Environment, University at Albany.

  6. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/reveh-2024-0030).

Received: 2024-03-13
Accepted: 2024-04-15
Published Online: 2024-06-11
Published in Print: 2025-03-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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  1. Frontmatter
  2. Reviews
  3. Mercury and cadmium-induced inflammatory cytokines activation and its effect on the risk of preeclampsia: a review
  4. Prevalence of chronic obstructive pulmonary disease in Indian nonsmokers: a systematic review & meta-analysis
  5. Beyond the outdoors: indoor air quality guidelines and standards – challenges, inequalities, and the path forward
  6. Cadmium exposure and thyroid hormone disruption: a systematic review and meta-analysis
  7. New generation sequencing: molecular approaches for the detection and monitoring of bioaerosols in an indoor environment: a systematic review
  8. Concentration of Tetrabromobisphenol-A in fish: systematic review and meta-analysis and probabilistic health risk assessment
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  10. Phthalates and uterine disorders
  11. Effectiveness of educational interventions for the prevention of lead poisoning in children: a systematic review
  12. Association between exposure to per- and polyfluoroalkyl substances and levels of lipid profile based on human studies
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  14. Expanding the focus of the One Health concept: links between the Earth-system processes of the planetary boundaries framework and antibiotic resistance
  15. Exploring the link between ambient PM2.5 concentrations and respiratory diseases in the elderly: a study in the Muang district of Khon Kaen, Thailand
  16. Standards for levels of lead in soil and dust around the world
  17. Tributyltin induces apoptosis in mammalian cells in vivo: a scoping review
  18. The influence of geology on the quality of groundwater for domestic use: a Kenyan review
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https://doi.org/10.1515/reveh-2024-0030
Keywords for this article
lead in soil; dust; blood lead; IQ; violence

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Mercury and cadmium-induced inflammatory cytokines activation and its effect on the risk of preeclampsia: a review
  4. Prevalence of chronic obstructive pulmonary disease in Indian nonsmokers: a systematic review & meta-analysis
  5. Beyond the outdoors: indoor air quality guidelines and standards – challenges, inequalities, and the path forward
  6. Cadmium exposure and thyroid hormone disruption: a systematic review and meta-analysis
  7. New generation sequencing: molecular approaches for the detection and monitoring of bioaerosols in an indoor environment: a systematic review
  8. Concentration of Tetrabromobisphenol-A in fish: systematic review and meta-analysis and probabilistic health risk assessment
  9. The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis
  10. Phthalates and uterine disorders
  11. Effectiveness of educational interventions for the prevention of lead poisoning in children: a systematic review
  12. Association between exposure to per- and polyfluoroalkyl substances and levels of lipid profile based on human studies
  13. Summary of seven Swedish case reports on the microwave syndrome associated with 5G radiofrequency radiation
  14. Expanding the focus of the One Health concept: links between the Earth-system processes of the planetary boundaries framework and antibiotic resistance
  15. Exploring the link between ambient PM2.5 concentrations and respiratory diseases in the elderly: a study in the Muang district of Khon Kaen, Thailand
  16. Standards for levels of lead in soil and dust around the world
  17. Tributyltin induces apoptosis in mammalian cells in vivo: a scoping review
  18. The influence of geology on the quality of groundwater for domestic use: a Kenyan review
  19. Biological concentrations of DDT metabolites and breast cancer risk: an updated systematic review and meta-analysis
  20. Letter to the Editor
  21. Ancient medicine and famous iranian physicians
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