The pediatric burden of disease from lead exposure at toxic waste sites in low and middle income countries.
BACKGROUND
The impact of lead from toxic waste sites on children in low and middle income countries has not been calculated due to a lack of exposure data. We sought to calculate this impact in Disability Adjusted Life Years (DALYs).


METHODS
Using an Integrated Exposure Uptake Biokinetic (IEUBK) model, we converted soil and drinking water lead levels from sites in the Blacksmith Institute's Toxic Sites Identification Program (TSIP) into mean blood lead levels (BLLs). We then calculated the incidence of mild mental retardation (MMR) and DALYs resulting from these BLLs.


RESULTS
The TSIP included 200 sites in 31 countries with soil (n=132) or drinking water (n=68) lead levels, representing 779,989 children younger than 4 years of age potentially exposed to lead. Environmental lead levels produced a range of BLLs from 1.56 to 104.71 µg/dL. These BLLs equated to an estimated loss of 5.41-8.23 IQ points, resulting in an incidence of MMR of 6.03 per 1000 population and 76.1 DALYs per 1000 population.


CONCLUSIONS
Soil and water lead levels at toxic waste sites predict BLLs that lower the intelligence quotient (IQ), with the resulting MMR potentially limiting individual- and country-level development. The preventable burden of disease produced by these sites highlights the need for toxic waste sites to be systematically identified, evaluated, and remediated.
Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA. Electronic address: kevin.chatham.stephens@gmail.com.
Kevin
K
Chatham-Stephens
School of Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA.
Jack
J
Caravanos
Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA.
Bret
B
Ericson
Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
Philip
P
Landrigan
Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA.
Richard
R
Fuller
D002675:Child, Preschool; D017281:Cost of Illness; D003906:Developing Countries / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000032:analysis*; D064371:Hazardous Waste Sites; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*
D007854:Lead
Blood lead level; Children; Disability adjusted life year; Low and middle income country; Toxic waste site