The burden of disease from pediatric lead exposure at hazardous waste sites in 7 Asian countries.

Identification and systematic assessment of hazardous wastes sites in low and middle-income countries has lagged. Hazardous waste problems are especially severe in lower income Asian countries where environmental regulations are non-existent, nonspecific or poorly enforced. In these countries extensive unregulated industrial development has created waste sites in densely populated urban areas. These sites appear to pose significant risks to public health, and especially to the health of children. To assess potential health risks from chemical contamination at hazardous waste sites in Asia, we assessed 679 sites. A total of 169 sites in 7 countries were classified as contaminated by lead. Eighty-two of these sites contained lead at levels high enough to produce elevated blood lead levels in surrounding populations. To estimate the burden of pediatric lead poisoning associated with exposure to lead in soil and water at these 82 lead-contaminated sites, we used standard toxicokinetic models that relate levels of lead in soil and water to blood lead levels in children. We calculated blood lead levels, and we quantified losses of intelligence (reductions in IQ scores) that were attributable to lead exposure at these sites. We found that 189,725 children in the 7 countries are at risk of diminished intelligence as a consequence of exposure to elevated levels of lead in water and soil at hazardous waste sites. Depending on choice of model, these decrements ranged from 4.94 to 14.96 IQ points. Given the restricted scope of this survey and the conservative estimation procedures employed, this number is almost certainly an underestimate of the full burden of disease. Exposure to toxic chemicals from hazardous waste sites is an important and heretofore insufficiently examined contributor to the Global Burden of Disease.