Lead is a dangerous neurotoxin that was commonly used in water pipes, paint, gasoline, and household products until the late 20th century.
Even several decades after regulations limited and phased out lead in these products, childhood lead poisoning remains a major public health crisis in the United States and globally.
Thousands of children each year suffer irreversible health consequences from exposure to this preventable environmental hazard. While lead poisoning cases have fallen dramatically since the mid-20th century, much work remains to fully eradicate this toxic legacy.
The Ongoing Flint Water Crisis
The Flint water crisis is an ongoing public health disaster that started in 2014 when the city of Flint, Michigan switched its water supply to the Flint River but failed to apply corrosion inhibitors to the water. This caused lead to leach from aging pipes into the drinking water, exposing around 100,000 residents to dangerously high lead levels.
Flint is a predominantly Black city where over 40% of residents live below the poverty line. Activists and scientific studies have pointed to systemic racism as a factor in the inadequate response to this crisis by government officials .
Thousands of children were poisoned by the lead contamination and the long-term health impacts continue to emerge. The Flint crisis underscored that lead pipes and paint still pose major risks in communities nationwide.
It became a symbol of environmental injustice and sparked efforts to finally remove lead plumbing across the U.S. However, Flint still does not have clean water, showing the challenge of remediating an expansive aging infrastructure system reliant on lead.
Polluted water flows from the Flint River through Flint, Michigan during their water crisis.
The Hazards and Health Effects of Lead
Lead is well known to be highly toxic, especially to children. According to the World Health Organization (WHO), there is no safe level of exposure to lead, which poses risks to multiple body systems . Even blood lead levels as low as 5 μg/dL can impair intellectual development and cause behavioral difficulties in children.
The Centers for Disease Control and Prevention (CDC) states that lead exposure can damage the central nervous system and brain, leading to reduced IQ, learning disabilities, impaired growth, and behavioral disorders. It can also harm the cardiovascular, renal, reproductive, immune, and hematologic systems . The neurological and behavioral effects may be irreversible.
WHO estimates that 30% of idiopathic intellectual disability, 4.6% of cardiovascular disease, and 3% of chronic kidney disease worldwide can be attributed to lead poisoning . Studies have linked childhood lead exposure to a 70% increase in cardiovascular mortality later in life .
Ongoing Lead Poisoning Cases
Despite major reductions over past decades, lead poisoning remains a very real threat, especially for children living in poorer communities.
In the United States, over half a million children aged 1-5 have blood lead levels above the current CDC reference value of 3.5 μg/dL . In certain cities and regions, the rates are even higher. Recent NBC News investigations found that childhood blood lead testing has plummeted during the COVID-19 pandemic . This means many cases are being missed.
Globally, UNICEF estimates 800 million children have concerning blood lead levels. On October 23, 2022, WHO observed the 10th International Lead Poisoning Prevention Week to highlight that lead claims almost 1 million lives per year, with even more suffering lifelong disabilities .
Insidious and Hard to Detect
Unlike acute poisoning cases seen in the past, today's lead exposure is usually chronic and low-level. This makes it very hard to recognize, as there are often no blatant symptoms initially.
According to the CDC, common symptoms like abdominal pain, fatigue, infertility, and learning disabilities emerge only after dangerous amounts have accumulated in the body over time . Behavioral and neurological effects emerge subtly.
By the time a child shows clear symptoms or is identified through blood lead testing, significant exposure has already occurred. A child's future abilities may be irreversibly impaired.
Major Sources of Lead Exposure
Some of the major sources of lead exposure include:
- Lead paint and dust - Especially in older homes built before 1978 when lead paint was banned for residential use. As paint flakes and deteriorates over time, it creates lead dust that children ingest or inhale .
- Lead pipes - Lead may leach from old water pipes and plumbing into drinking water. Partial lead service lines can also contaminate water .
- Soil contamination - From deteriorated exterior paint, industrial pollution, or residues from leaded gasoline .
- Lead-glazed pottery - Lead can leach from ceramicware glazes into food and liquids .
- Cosmetics - Certain traditional cosmetics may contain dangerous lead levels .
- Contaminated spices, candy, toys - Lead has been found in these and other consumer products, particularly when imported .
- Take-home exposures - Workers in lead-related industries may bring lead dust home on clothes, leading to exposure of children in their household .
- Folk remedies - Some traditional remedies use lead and can cause poisoning when ingested .
Lead-Acid Batteries - Improper disposal of lead-acid batteries or exposure to the components of these batteries can lead to lead exposure.
Lead bullets - Time spent at firing ranges can lead to exposure.
Disproportionate Impact on Minority and Low-Income Communities
The burdens of lead poisoning fall disproportionately on marginalized communities.
According to the CDC, non-Hispanic Black children in the U.S. have higher average blood lead levels than other groups . Rates of elevated lead levels are also higher among families living below the poverty line.
Several factors contribute to this health inequity:
- Older, poorly maintained housing - Heavily concentrated in low-income urban neighborhoods. More likely to have lead paint hazards .
- Proximity to industrial pollution - Low-income areas often border factories, smelters, rail yards, and other sources of lead emissions .
- Limited resources for remediation - Low-income families often lack options to move out of contaminated homes or funds to repair hazards .
- Reluctance of landlords - May evict families rather than eliminate lead hazards, though illegal .
- Linguistic/cultural barriers - Impede awareness and access to testing/intervention in immigrant communities .
Environmental racism and injustice are major factors perpetuating lead poisoning .
The Lasting Impacts of Historical Exposure
Today's public health crisis is rooted in heavy lead use throughout much of the 20th century. During this period, the majority of children suffered dangerous lead exposure:
- Researchers estimate over half of Americans alive today were exposed to concerning lead levels in childhood .
- Blood lead levels considered safe decades ago would be deemed dangerous by today's standards - Causing lifelong health consequences for adults exposed as children .
- Studies link childhood lead exposure to increased cardiovascular mortality and other chronic diseases later in life - Due to lead's lasting impacts on the body .
- On average, early lead exposure resulted in a 2.6-point reduction in IQ among children from the 1950s to 1980s as they grew up, with implications for intellectual disability and learning problems .
The toxic legacy of historical lead use continues to haunt older generations today.
Ongoing exposure of our children compounds the problem.
Progress Made, But the Lead Fight Continues
Thanks to public health efforts, regulations, and changing materials use, lead poisoning rates have fallen dramatically since the 1970s. But the work is far from finished.
Key milestones in reducing lead exposure include:
- 1970s - Lead phased out of residential paint and gasoline. Lead pipes banned .
- 1991 - Lead solder banned in food cans .
- 2000s - Many countries restricted lead in paints, gasoline, and food cans .
- 2010s - 84 countries enacted legal limits on lead paint .
- 2020s - Lead pipe removal gaining momentum after the Flint water crisis .
However, lead is still ubiquitous in older homes, infrastructure, and soils. Complete eradication is a daunting challenge requiring political will and massive resources over generations. But it is a necessary task to protect children's health and ability to thrive.
The Need for Primary Prevention
Expert consensus holds that we must shift focus to primary prevention of lead poisoning from waiting until children are harmed to act. Key prevention priorities include:
- Expanding lead screening of children and pregnant women .
- Eliminating lead paint hazards through abatement and strict housing standards .
- Replacing all lead service lines for drinking water .
- Developing lead-safe standards for consumer products .
- Educating all families on lead risks and prevention .
- Addressing legacy contamination of soil through cleanup requirements and barriers .
- Regulating emissions from lead industries and avoiding siting homes nearby .
- Training pediatricians and public health providers on environmental exposures .
Primary prevention is essential to eliminate lead poisoning, rather than just managing its effects.
The Time is Now to End the Lead Scourge
Over many decades, lead has quietly claimed millions of victims while profit-driven interests delayed action or downplayed risks. The science confirming lead's irreversible health hazards - even at trace levels - has long been clear.
What has been missing is the public outrage and political priority to fully eradicate lead from our environment.
Recent failures like the Flint water crisis have shattered public trust. They revealed that many government agencies still do not take lead risks seriously enough.
This painful crisis also created momentum to finally remedy the lead scourge plaguing our children.
There should be no higher health priority than ensuring the safety of children's developing minds and bodies. The only acceptable lead exposure level for kids is zero.
The time is now for bold policies, funding, and immediate action to eliminate this fully preventable threat once and for all. Our children's futures hang in the balance.
 World Health Organization. (2022, October 23). Almost 1 million people die every year due to lead poisoning, with more children suffering long-term health effects.
 Centers for Disease Control and Prevention. (2022, January 7). Lead. https://www.cdc.gov/nceh/lead/default.htm
 Lanphear, Bruce P et al. “Low-level lead exposure and mortality in US adults: a population-based cohort study.” The Lancet. Public health vol. 3,4 (2018): e177-e184. doi:10.1016/S2468-2667(18)30025-2
 Savage, N. & Kite A. (2022, May 2). Known to be toxic for a century, lead still poisons thousands of Midwestern kids. NPR.
 World Health Organization. (2022, August 11). Lead poisoning.
 Centers for Disease Control and Prevention. Preventing Lead Exposure in Young Children: A Housing-Based Approach to Primary Prevention of Lead Poisoning. October 2004, https://www.cdc.gov/nceh/lead/publications/primarypreventiondocument.pdf.
 Cleaning up America's lead water pipes." The Boston Globe, 24 Dec. 2021, https://www.bostonglobe.com/2021/12/24/opinion/cleaning-up-americas-lead-water-pipes/
 "Flint water crisis: Report says 'systemic racism' played role." CNN Politics, 18 Feb. 2017, https://edition.cnn.com/2017/02/18/politics/flint-water-report-systemic-racism/index.html.