Towards the prevention of lead exposure in South Africa: contemporary and emerging challenges.

The prevention of lead exposure continues to constitute a major public health challenge in developed countries. In well-resourced countries major lead exposure reduction interventions have resulted in significant improvements in childhood blood lead distributions. In developing countries on the other hand, while lead exposure and poisoning remain serious public health concerns, a range of prevailing factors and circumstances, such as poverty, a large informal sector, competing public health challenges, low levels of awareness of lead hazards and weak capacity to enforce legislation, contribute to an increase in the scale and intensity of the challenge, and limit the prospects of comparable success in the foreseeable future. This paper collates available information to illustrate that despite some progress, a wide range of sources of lead exist in South Africa, and that certain settings and groups continue to be at high risk of lead exposure. Lead exposure in relation to paint, mining, lead melting in subsistence fishing communities, the consumption of Ayurvedic medicines and food production is described, and discussed with regard to the key factors hindering efforts to prevent lead poisoning and exposure in South Africa and many other developing countries.