Fact File

Lead compounds are added to paint as pigments, drying agents, and anti-corrosives. Alternatives of equivalent quality are available and have been used for decades, particularly in countries with lead paint laws (UNEP 2013). There are some investment costs for manufacturers to reformulate their paints; however, LEEP offers assistance to manufacturers to reduce such costs. Ongoing economic costs to reformulation vary, sometimes increasing but sometimes decreasing (UNEP 2022). By removing lead-based ingredients, paint manufacturers can access markets where lead paints are already restricted.

There is strong evidence that regulating the use of lead is effective in reducing lead exposure and blood lead levels at a population level. This has been seen in many countries as a trend of declining mean blood lead levels following regulation of lead sources, including gasoline and paint (Cañas et al., 2014; Health Canada, 2019; US CDC, 2019). 

Legally binding control measures (lead paint laws) are the most effective way for a country to phase out lead paint because they create strong incentives for change (UNEP, 2018). Voluntary control measures have limited effectiveness because they cannot be enforced.

45% of countries have confirmed legally binding controls on the production, import, sale and use of lead paints (WHO, 2022). A map showing which countries have lead paint laws can be found here.

Lead compounds added to paint result in high lead content, sometimes in the order of tens of thousands of parts per million. Among other applications, this paint is used in homes, schools, and on children’s toys. Paint generates dust and flakes, releasing lead into household dust. Young children ingest this lead-contaminated dust through normal hand-to-mouth behaviour. This exposure can result in elevated blood lead levels and lead poisoning (WHO, 2020).

Other sources of lead exposure include the recycling of lead-acid batteries, poorly controlled lead mining and smelting operations, lead-containing foods and spices, lead ceramic glazes on food containers, lead-containing aluminum cookware, lead pipes, lead-containing traditional remedies, lead-containing cosmetics, and lead-containing fishing weights and ammunition (WHO, 2019).

Almost all countries have now banned leaded gasoline, so this is no longer a significant ongoing source of exposure (UNEP, 2019). Lead paint is an important current and future source of lead exposure, as well as a tractable source to address (O’Connor et al., 2018).

Studies so far have not identified any blood lead level that is safe. In fact, the relationship between lead exposure and neurotoxic effects is stronger at lower blood lead levels (Lanphear et al., 2005).

Lead exposure, even at low levels, damages multiple body systems (NTP, 2012; USEPA, 2013). In children, lead exposure adversely affects the developing brain, causing reduced cognitive development, lower educational attainment, reduced attention span, and behavioural disorders (Lanphear et al., 2005; Mazumdar et al., 2011; Reuben et al., 2017). In adults, lead exposure is associated with renal disease and cardiovascular disease, including hypertension and coronary artery disease (Chowdhury et al, 2018; Lanphear et al., 2018). The Institute for Health Metrics and Evaluation estimated that in 2017 lead exposure was responsible for 1.06 million deaths and 21.7 million DALYs per year (IHME, 2020). This accounts for 1% of the global burden of disease.

The impact of lead exposure on cognitive development significantly reduces an individual’s lifetime earnings and economic productivity. In 2011, the annual economic losses from childhood lead exposure in low and middle-income countries were estimated to be $977 billion (Attina & Trasande 2013). In many lower-income countries the economic costs are estimated to be as much as 5-8% of GDP, indicating that lead exposure can be a significant barrier to economic development and poverty reduction.

Additional socioeconomic costs result from the increase in crime and violence associated with lead exposure. Childhood lead exposure appears to be a significant causal factor in violent crime, and lead exposure reduction correlates strongly with national-level crime reduction (Needleman, 1996; Nevin, 2007; Stretesky and Lynch, 2001). Further costs result from the healthcare needs and treatment of lead poisoning and associated cardiovascular and renal disease (Gould, 2009; Pichery et al, 2011). 

Quantifying future impacts is a difficult task, and there is always a significant degree of uncertainty. Moreover, LEEP is in its early stages, so concrete data on outcomes is still forthcoming. 

However, we conducted a preliminary cost-effectiveness analysis on our paint program in Malawi, which suggested that LEEP’s interventions are highly cost effective and impactful, with an estimated cost per DALY-equivalent averted at $14. There are many uncertainties in this estimate that are explained in more detail here. Founders Pledge estimated that via LEEP’s work it costs $1.66 to prevent one child’s exposure to lead.

Our estimates take into account the harms to health and income averted by the introduction of lead paint laws in one country, as well as the likelihood of success, expected level of enforcement, costs of our work, and costs of government regulation. We also take into account counterfactual impact, so only include the impact of averting additional lead paint exposure for the number of years by which we expect to bring forward the introduction of lead paint laws. 

Feel free to contact us. The LEEP team is happy to answer any questions you might have.