Lead Exposure Sources, Health Effects, and Disease Burden Worldwide: A Review

Lead exposure remains a significant global public health challenge despite reductions in environmental lead pollution following the worldwide elimination of leaded gasoline use by motor vehicles. Lead contamination arises from multiple sources, including mining and industrial processes, lead-acid battery production and recycling, lead-based paints, aviation fuels, plumbing materials, spices, and other contaminated consumer products. Lead accumulates in the body and can cause neurodevelopmental impairments in children and cardiovascular disease, kidney damage, and other health effects in adults. Hundreds of millions of children and adults have blood lead levels above concentrations associated with adverse health outcomes. Low- and middle-income countries have higher average blood lead levels and higher rates of lead-associated morbidity and mortality than high-income countries. This comprehensive review integrates information on the sources of lead exposure, the health impacts of lead toxicity, and the epidemiology of lead-related diseases by age, sex, and country income level. The persistence of lead in the environment and its substantial public health impacts underscore the need for scaled-up efforts to reduce lead exposure through regulatory measures, safer industrial practices, and public health interventions, such as enforcing bans on lead paint and improving e-waste recycling practices.