Howard Hu, MD, MPH, ScD, presents on lead exposure at the 77th World Health Assembly and lends expertise to Indian Health Officials

Until five years ago, lead exposure had been declining worldwide. This in part, was due to the removal of lead from gasoline, paint, and plumbing systems. “However, in recent years, there has been an increased infusion of lead back into the economy,” reveals Howard Hu, MD, MPH, ScD, professor of population and public health sciences. “Blood levels which serve as a good indicator of lead exposure, have been rising again among children and adults particularly in low- and middle-income countries where our team estimated that a third of all children have elevated blood lead levels,” he shares.

In May, during the 77th Session of the World Health Assembly (WHA), Hu was invited to present at a ministerial dialogue on preventing maternal and child exposure to toxic lead. The event, which brought together health ministers from around the world, highlighted its effects on learning, economic loss, and life-long health. “New population studies continue to reveal how toxic lead is. When we examined the dose-response relationship, we found that IQ is dropping even at the lowest lead levels of one microgram per deciliter,” explains Hu. His research has also found abnormalities of behavior such as attention deficit disorders, depression and anxiety being associated with lead.

Hu has been conducting research on lead exposure and toxicity for decades uncovering insights on its damage to the body either through the acceleration of the aging process in the brain, or its association with hypertension, heart attacks and stroke. His new study has also shown the implications of lead during pregnancy which mobilizes lead stored in the mother’s bones and crosses the placenta attacking the fetal nervous system. Recently, he worked as a consultant with UNICEF to publish a report and video highlighting the implications of lead exposure on children especially pertaining to decreasing IQ points and brain function. “The ticket to a better future for so many of our economies is the knowledge economy which relies on the intelligence of our younger generations,” he shares. The video was seen by executives at USAID who then organized the session at the WHA to further raise awareness of the global lead epidemic across generations.

The uptick of lead exposure has likely been the result of increasing lead in industry as well as the processing of lead in informal industries such as the dumping of electronic waste and the unsafe recycling of car batteries in small town industries through incineration. This has led to contamination of surrounding communities either through inhalation of fumes or leached water systems. “Lead is also increasingly found in household products such as cookware and has been found in spices in Southeast Asia in a bid to improve appearance and increase weight,” he divulges.

“The reality is that all of us have more lead in our bodies than our ancestors did, yet lead has no useful purpose in the body. Even in the US, where the blood levels we see in the general population are low, this is still ten to 50 times higher than they were before we started mining lead out of the ground. Even at very low levels, we can show that lead interferes with various molecular mechanisms that are important for neural transmission or starving off oxidative damage to our heart and blood vessels. We have not been able to see a threshold below which lead does not have an effect— leading to the prescription to avoid it as much as possible,” he advises.

Indian health officials have recognized Hu’s expertise in this area, inviting him to serve as a public health environmental medicine expert in an intergovernmental working group. They are kick-starting a national campaign to identify and address lead exposure in the country. Hu, who currently co-chairs the Research Council for the Public Health Foundation of India, presented on the harms and implications of lead exposure. “Hopefully, we’ll see investments not only from governments, but also from foundations to fund major campaigns to advance these efforts,” he says.

Hu maintains that tackling this epidemic will involve stakeholders beyond the health sector to address the wide-ranging scope of lead exposure. “The countries have to wake up! Lead exposure is an invisible problem that requires screening to identify the extent of this problem. If we can get the right enforcement, education, monitoring and surveillance in place, lead exposure is an imminently addressable problem,” he concludes.