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Jack Caravanos

Caravanos, Jack

Jack Caravanos

Clinical Professor of Environmental Public Health Sciences

Professional overview

For Dr. Jack Caravanos, life in the field ranges from jumping onto a motorcycle and navigating the jungles of Madre de Dios in the Peruvian Amazon studying toxic substances to traveling to remotes areas in Zambia, Indonesia, and Bolivia studying lead and other toxic wastes. By cooperating with local governments, his work provides safe, healthy, and evidence-based solutions for pollution problems in low- and middle-income countries.

In partnership with Pure Earth, an international non-profit organization, Dr. Caravanos is studying the impact of gold extraction with mercury in Peru and Indonesia. Since miners are in danger of mercury poisoning, his research team is planning interventions that teach safer techniques for gold extraction. In Kabwe, Zambia - a mining town with exposure to lead - his research will provide methods to institute safer mining practices and policy recommendations to improve environmental remediation laws.

Dr. Caravanos teaches Environmental Health for graduate students and Environmental Health in a Global World for undergraduate students. He also provides opportunities for student researchers in his ongoing projects, including in Indonesia (mercury) and Ghana (e-waste).

To learn more about Dr. Caravanos and his work, visit his website.

Education
BS, Health Science, Hunter College, New York, NY
MS, Environmental Health Engineering, New York University, New York, NY
DrPH, Environmental Health, Columbia University, New York, NY
Honors and awards
Presidential Award for Excellence in Community Service, Hunter College (2013)
Presidential Award for Excellence in Teaching, Hunter College (2006)
Areas of research and study
Artisanal Gold Mining
Dissemination and Implementation of Evidence-based Programs
Environmental Public Health Services
Global Health
Lead poisoning
Publications

Characterization and risk of exposure to elements from artisanal gold mining operations in the Bolivian Andes

Pavilonis, B., Grassman, J., Johnson, G., Diaz, Y., & Caravanos, J.

Publication year

2017

Journal title

Environmental Research

Volume

154

Page(s)

1-9
10.1016/j.envres.2016.12.010
Abstract

Artisanal and small-scale gold mining (ASGM) offers low-skilled workers an opportunity to elevate themselves out of poverty. However, this industry operates with little to no pollution controls and the cost to the environment and human health can be large. The objectives of this study were to measure levels of arsenic (As), manganese (Mn), cobalt (Co), lead (Pb), and mercury (Hg) in the environment and characterize health risks to miners and residents in an area with active ASGM operations. An exposure assessment was conducted at two different mining sites and a nearby village in the Bolivian Anders. The resulting measurements were then used to quantify cancerous and noncancerous health risks to children and adults working at and living near ASGM areas. Soil concentrations of As were well above background levels and showed great variations between the village and mining area. Mercury vapor levels at the two mining sites were approximately 30 times larger than the EPA reference concentration. The risk of developing non-cancerous health effects were primarily due to exposure to As and Hg. The probability of individuals developing cancer was considerably increased with adult miners having a probability of 1.3 out of 100. Cancer potential was driven by exposure to As, with de minimus cancer risk from all other elements. Based on the environmental characterization of elements in soils and Hg vapors, the risk of developing cancerous and non-cancerous health outcomes were above a level of concern based on EPA risk assessment guidance. Personal protective equipment was not worn by workers and Hg amalgam is commonly heated in workers’ homes. Better education of the risks of ASGM is needed as well as simple controls to reduce exposure.

Environmental contamination in Nigeria

Caravanos, J.

Publication year

2017

Journal title

Journal of Health and Pollution

Volume

7
10.5696/2156-9614-7-13.1

Geo-Spatial Characterization of Soil Mercury and Arsenic at a High-Altitude Bolivian Gold Mine

Johnson, G.D., Pavilonis, B., Caravanos, J., & Grassman, J.

Publication year

2017

Journal title

Bulletin of Environmental Contamination and Toxicology

Page(s)

1-6
10.1007/s00128-017-2213-4
Abstract

Soil mercury concentrations at a typical small-scale mine site in the Bolivian Andes were elevated (28–737 mg/kg or ppm) in localized areas where mercury amalgams were either formed or vaporized to release gold, but was not detectable beyond approximately 10 m from its sources. Arsenic was measurable, exceeding known background levels throughout the mine site (77–137,022 ppm), and was also measurable through the local village of Ingenio (36–1803 ppm). Although arsenic levels were high at all surveyed locations, its spatial pattern followed mercury, being highest where mercury was high.

Lead intoxicated children in Kabwe, Zambia

Bose-O'Reilly, S., Yabe, J., Makumba, J., Schutzmeier, P., Ericson, B., & Caravanos, J.

Publication year

2017

Journal title

Environmental Research
10.1016/j.envres.2017.10.024
Abstract

Kabwe is a lead contaminated mining town in Zambia. Kabwe has extensive lead contaminated soil and children in Kabwe ingest and inhale high quantities of this toxic dust. The aim of this paper is to analyze the health impact of this exposure for children. Health data from three existing studies were re-analyzed. Over 95% of children living in the most affected townships had high blood lead levels (BLLs) > 10. μg/dL. Approximately 50% of those children had BLLs ≥ 45. μg/dL. The existing data clearly establishes the presence of a severe environmental health crisis in Kabwe which warrants immediate attention.

Airborne mercury levels at gold processing shops associated with artisanal and small scale gold mining at Madre de Dios, Peru

Caravanos, J.

Publication year

2016

Burden of disease resulting from lead exposure at toxic waste sites in Argentina, Mexico and Uruguay

Caravanos, J., Carrelli, J., Dowling, R., Pavilonis, B., Ericson, B., & Fuller, R.

Publication year

2016

Journal title

Environmental Health: A Global Access Science Source

Volume

15
10.1186/s12940-016-0151-y
Abstract

Background: Though lead contaminated waste sites have been widely researched in many high-income countries, their prevalence and associated health outcomes have not been well documented in low- and middle-income countries. Methods: Using the well-established health metric disability-adjusted life year (DALY) and an exposure assessment method developed by Chatham-Stephens et al., we estimated the burden of disease resulting from exposure to lead at toxic waste sites in three Latin American countries in 2012: Argentina, Mexico and Uruguay. Toxic waste sites identified through Pure Earth's Toxic Sites Identification Program (TSIP) were screened for lead in both biological and environmental sample media. Estimates of cardiovascular disease incidence and other outcomes resulting from exposure to lead were utilized to estimate DALYs for each population at risk. Results: Approximately 316,703 persons in three countries were at risk of exposure to pollutants at 129 unique sites identified through the TSIP database. Exposure to lead was estimated to result in between 51,432 and 115,042 DALYs, depending on the weighting factor used. The estimated burden of disease caused by exposure to lead in this analysis is comparable to that estimated for Parkinson's disease and bladder cancer in these countries. Conclusions: Lead continues to pose a significant public health risk in Argentina, Mexico, and Uruguay. The burden of disease in these three countries is comparable with other widely recognized public health challenges. Knowledge of the relatively high number of DALYs associated with lead exposure may be used to generate support and funding for the remediation of toxic waste sites in these countries and others.

Estimating the Prevalence of Toxic Waste Sites in Low- and Middle-Income Countries

Dowling, R., Caravanos, J., Grigsby, P., Rivera, A., Ericson, B., Amoyaw-Osei, Y., … Fuller, R.

Publication year

2016

Journal title

Annals of Global Health

Volume

82

Page(s)

700-710
10.1016/j.aogh.2016.07.008
Abstract

Background Exposure to heavy metals at contaminated industrial and mining sites, known also as hot spots, is a significant source of toxic exposure and adverse health outcomes in countries around the world. The Toxic Sites Identification Program (TSIP) developed by Pure Earth, a New York–based nongovernmental organization, is the only systematic effort to catalogue contaminated sites globally. To date, TSIP has identified and catalogued 3282 sites in low- and middle-income countries. The TSIP methodology is not designed to survey all contaminated sites in a country. Rather sites are prioritized based on their perceived impact on human health, and only a limited number of the most highly hazardous sites are surveyed. The total number of contaminated sites globally and the fraction of contaminated sites captured by TSIP is not known. Objective To determine the TSIP site capture rate, the fraction of contaminated sites in a country catalogued by TSIP. Methods Ghana was selected for this analysis because it is a rapidly industrializing lower middle income country with a heterogeneous industrial base, a highly urban population (51%), and good public records systems. To develop an estimate of the fraction of sites in Ghana captured by TSIP, assessors targeted randomly selected geographic quadrats for comprehensive assessment using area and population statistics from the Ghana Statistical Service. Investigators physically walked all accessible streets in each quadrat to visually identify all sites. Visual identification was supplemented by field-based confirmation with portable x-ray fluorescence instruments to test soils for metals. To extrapolate from survey findings to develop a range of estimates for the entire country, the investigators used 2 methodologies: a “bottom-up” approach that first estimated the number of waste sites in each region and then summed these regional subtotals to develop a total national estimate; and a “top-down” method that estimated the total number of sites in Ghana and then allocated these sites to each region. Both methods used cluster random sampling principles. Findings The investigators identified 72 sites in the sampled quadrats. Extrapolating from these findings to the entire country, the first methodology estimated that there are 1561 sites contaminated by heavy metals in Ghana (confidence interval [CI]: 1134-1987), whereas the second estimated 1944 sites (CI: 812-3075). The estimated total number of contaminated sites in Ghana is thus 7-9 times the number of sites captured through TSIP. On a population basis, it was estimated that there are between 31 and 115 contaminated sites per million inhabitants in Ghana. Conclusions The findings of this study indicate that the TSIP methodology provides a sound statistical basis for policy formulation. The statistical approaches used in this study can be replicated in other countries to improve estimates of the prevalence of contaminated sites. This information provides important input to calculations of the global burden of disease attributable to hazardous exposures at contaminated sites.

Estimating the prevalence of toxic waste sites in low- and middle-income countries: a Ghanaian case study

Dowling, R., Caravanos, J., & Ericson, B.

Publication year

2016

Journal title

Environmental Monitoring and Assessment

Reducing blood lead levels in children exposed to electronic waste recylcing in Montevideo, Uruguay

Caravanos, J., Feola, G., Laborde, A., Dowling, R., & Hernandez, L.

Publication year

2016

The Global Burden of Lead Toxicity Attributable to Informal Used Lead-Acid Battery Sites

Ericson, B., Landrigan, P., Taylor, M.P., Frostad, J., Caravanos, J., Keith, J., & Fuller, R.

Publication year

2016

Journal title

Annals of Global Health
10.1016/j.aogh.2016.10.015
Abstract

Background: Prior calculations of the burden of disease from environmental lead exposure in low- and middle-income countries (LMICs) have not included estimates of the burden from lead-contaminated sites because of a lack of exposure data, resulting in an underestimation of a serious public health problem. Objective: We used publicly available statistics and detailed site assessment data to model the number of informal used lead-acid battery (ULAB) recyclers and the resulting exposures in 90 LMICs. We estimated blood lead levels (BLLs) using the US Environment Protection Agency's Integrated Exposure Uptake Biokinetic Model for Lead in Children and Adult Lead Model. Finally, we used data and algorithms generated by the World Health Organization to calculate the number of attributable disability adjusted life years (DALYs). Results: We estimated that there are 10,599 to 29,241 informal ULAB processing sites where human health is at risk in the 90 countries we reviewed. We further estimated that 6 to 16.8 million people are exposed at these sites and calculate a geometric mean BLL for exposed children (0-4 years of age) of 31.15 μg/dL and a geometric mean BLL for adults of 21.2 μg/dL. We calculated that these exposures resulted in 127,248 to 1,612,476 DALYs in 2013. Conclusions: Informal ULAB processing is currently causing widespread lead poisoning in LMICs. There is an urgent need to identify and mitigate exposures at existing sites and to develop appropriate policy responses to minimize the creation of new sites.

The prevalence of toxic hotspots in former Soviet countries

Sharov, P., Dowling, R., Gogishvili, M., Jones, B., Caravanos, J., McCartor, A., … Fuller, R.

Publication year

2016

Journal title

Environmental Pollution

Volume

211

Page(s)

346-353
10.1016/j.envpol.2016.01.019
Abstract

Using a global database of contaminated sites, toxic hotspots in eight former Soviet countries were analyzed to identify the prevalence, types and sources of toxic pollution, as well as their associated potential public health impacts. For this analysis, polluted sites in Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Ukraine, and Uzbekistan were compiled and analyzed. The levels of contamination of seven key pollutants were assessed in each country. 424 contaminated sites were identified using data from Blacksmith Institute. Pesticides, lead (Pb), radioactive metals, arsenic (As), mercury (Hg), chromium (Cr), and cadmium (Cd) were the most commonly identified key pollutants. Collectively, these sites pose health risks to an estimated 6.2 million residents. The existing data on toxic hotspots in former Soviet countries likely captures only a small percentage of actual contaminated sites, but suggests potentially severe public health consequences. Additional assessments are needed to understand the risks posed by toxic pollution in the region.

Exposición a plomo: Una tarea pendiente en México

Téllez-Rojo, M.M., & Caravanos, J.

Publication year

2015

Journal title

Salud Publica de Mexico

Volume

57

Page(s)

115-116

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Forouzanfar, M.H., Alexander, L., Anderson, H.R., Bachman, V.F., Biryukov, S., Brauer, M., …

Publication year

2015

Journal title

The Lancet

Volume

386

Page(s)

2287-2323
10.1016/S0140-6736(15)00128-2
Abstract

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

Protecting communities by remediating polluted sites worldwide

Hanrahan, D., Ericson, B., & Caravanos, J.

Publication year

2015

Journal title

Proceedings of the Institution of Civil Engineers: Civil Engineering

Volume

169

Page(s)

33-40
10.1680/jcien.15.00034
Abstract

Millions of people worldwide are suffering health risks as a result of living near highly contaminated sites including abandoned industrial and mining sites, and polluting artisanal areas. More than 3000 sites across 50 developing countries have been identified. Nearly 100 million people are at risk at just these sites. The main impact falls on people in low- and middle-income countries, with children being particularly vulnerable. Interventions have been implemented at about 100 of these sites, with significant success in reducing impacts. This paper aims to draw the attention of practising engineers to the scale and impacts of the problem and to encourage expanded efforts to implement cost-effective solutions. Tackling contaminated sites is part of broader efforts under the umbrella of the Global Alliance on Health and Pollution to reduce environmental pollution, which is one of the largest contributors to the burden of disease worldwide. Clean-up is required but prevention of pollution must also be a high priority.

Spatial associations between contaminated land and socio demographics in Ghana

Dowling, R., Ericson, B., Caravanos, J., Grigsby, P., & Amoyaw-Osei, Y.

Publication year

2015

Journal title

International Journal of Environmental Research and Public Health

Volume

12

Page(s)

13587-13601
10.3390/ijerph121013587
Abstract

Associations between contaminated land and socio demographics are well documented in high-income countries. In low- and middle-income countries, however, little is known about the extent of contaminated land and possible demographic correlations. This is an important yet sparsely researched topic with potentially significant public health implications as exposure to pollution remains a leading source of morbidity and mortality in low-income countries. In this study, we review the associations between several socio demographic factors (population, population density, unemployment, education, and literacy) and contaminated sites in Ghana. Within this context, both correlation and association intend to show the relationship between two variables, namely contaminated sites and socio demographics. Aggregated district level 2010 census data from Ghana Statistical Service and contaminated site location data from Pure Earth’s Toxic Sites Identification Program (TSIP) were spatially evaluated using the number of sites per kilometer squared within districts as the unit of measurement. We found a low to medium positive correlation (ρ range: 0.285 to 0.478) between contaminated sites and the following socio demographics: higher population density, higher unemployment, greater education, and higher literacy rate. These results support previous studies and suggest that several socio demographic factors may be reasonably accurate predictors of contaminated site locations. More research and targeted data collection is needed to better understand these associations with the ultimate goal of developing a predictive model.

A simplified risk-ranking system for prioritizing toxic pollution sites in low- and middle-income countries

Caravanos, J., Gualtero, S., Dowling, R., Ericson, B., Keith, J., Hanrahan, D., & Fuller, R.

Publication year

2014

Journal title

Annals of Global Health

Volume

80

Page(s)

278-285
10.1016/j.aogh.2014.09.001
Abstract

Background In low- and middle-income countries (LMICs), chemical exposures in the environment due to hazardous waste sites and toxic pollutants are typically poorly documented and their health impacts insufficiently quantified. Furthermore, there often is only limited understanding of the health and environmental consequences of point source pollution problems, and little consensus on how to assess and rank them. The contributions of toxic environmental exposures to the global burden of disease are not well characterized. Objectives The aim of this study was to describe the simple but effective approach taken by Blacksmith Institute's Toxic Sites Identification Program to quantify and rank toxic exposures in LMICs. This system is already in use at more than 3000 sites in 48 countries such as India, Indonesia, China, Ghana, Kenya, Tanzania, Peru, Bolivia, Argentina, Uruguay, Armenia, Azerbaijan, and Ukraine. Methods A hazard ranking system formula, the Blacksmith Index (BI), takes into account important factors such as the scale of the pollution source, the size of the population possibly affected, and the exposure pathways, and is designed for use reliably in low-resource settings by local personnel provided with limited training. Findings Four representative case studies are presented, with varying locations, populations, pollutants, and exposure pathways. The BI was successfully applied to assess the extent and severity of environmental pollution problems at these sites. Conclusions The BI is a risk-ranking tool that provides direct and straightforward characterization, quantification, and prioritization of toxic pollution sites in settings where time, money, or resources are limited. It will be an important and useful tool for addressing toxic pollution problems in LMICs. Although the BI does not have the sophistication of the US Environmental Protection Agency's Hazard Ranking System, the case studies presented here document the effectiveness of the BI in the field, especially in low-resource settings. Understanding of the risks posed by toxic pollution sites helps assure better use of resources to manage sites and mitigate risks to public health. Quantification of these hazards is an important input to assessments of the global burden of disease.

Blood lead levels in mexico and pediatric burden of disease implications

Caravanos, J., Dowling, R., Téllez-Rojo, M.M., Cantoral, A., Kobrosly, R., Estrada, D., … Fuller, R.

Publication year

2014

Journal title

Annals of Global Health

Volume

80

Page(s)

269-277
10.1016/j.aogh.2014.08.002
Abstract

Background Although there has been success in reducing lead exposure with the phase-out of leaded gasoline, exposure to lead in Mexico continues to threaten the health of millions, much of which is from lead-based glazes used in pottery that leaches into food. Objectives An extensive historical review and analysis of available data on blood lead levels in Mexican populations was conducted. We used a calculated geometric mean to evaluate the effect of lead on the pediatric burden of disease. Methods An extensive bibliographic search identified 83 published articles from 1978 to 2010 with blood lead level (BLL) data in Mexican populations representing 150 data points from more than 50,000 study participants. Values from these publications were categorized into various groupings. We then calculated the incidence of disease and disability-adjusted life-years resulting from these BLLs using the World Health Organization's burden of disease spreadsheets for mild mental retardation. Results Reviewing all relevant studies, the geometric means of Mexican BLLs in urban and rural areas were found to be 8.85 and 22.24 ug/dL, respectively. Since the phase-out of leaded gasoline, the mean in urban areas was found to be 5.36 ug/dL and the average in rural areas is expected to be much higher. The U.S. Centers for Disease Control and Prevention's (CDC) upper limit of blood lead in children under the age of 6 years is 5 ug/dL and the current U.S. average is 1.2 ug/dL. Our results indicate that more than 15% of the population will experience a decrement of more than 5 IQ points from lead exposure. The analysis also leads us to believe that lead is responsible for 820,000 disability-adjusted life-years for lead-induced mild mental retardation for children aged 0 to 4 years. Conclusion Lead continues to threaten the health of millions and remains a significant cause of disability in Mexico. Additional interventions in reducing or managing lead-based ceramic glazes are necessary to protect the public health.

Case 2: Hurricane Sandy: training to improve response and recovery

Gotch, Rosen, & Caravanos, J.

Publication year

2014

Comparison of burden of disease from toxic waste sites with other recognized public health threats in India, Indonesia and the Philippines

Caravanos, J., Gutierrez-Hernandez, L., Ericson, B., & Fuller, R.

Publication year

2014

Journal title

Journal of Health and Pollution

Niveles de plomo en sangre en méxico y su implicación para la carga pediátrica de la enfermedad

Caravanos, J., Dowling, R., Téllez-Rojo, M.M., Cantoral, A., Kobrosly, R., Estrada, D., … Fuller, R.

Publication year

2014

Journal title

Annals of Global Health

Volume

80

Page(s)

e1-e11

Severe environmental contamination and elevated blood lead levels among children — Zambia, 2014

Caravanos, J., Fuller, R., & Robinson, S.

Publication year

2014

Journal title

Morbidity and Mortality Weekly Report

Volume

63

Page(s)

1013

The pediatric burden of disease from lead exposure at toxic waste sites in low and middle income countries

Chatham-Stephens, K., Caravanos, J., Ericson, B., Landrigan, P., & Fuller, R.

Publication year

2014

Journal title

Environmental Research

Volume

132

Page(s)

379-383
10.1016/j.envres.2014.04.018
Abstract

Background: The impact of lead from toxic waste sites on children in low and middle income countries has not been calculated due to a lack of exposure data. We sought to calculate this impact in Disability Adjusted Life Years (DALYs). Materials and methods: Using an Integrated Exposure Uptake Biokinetic (IEUBK) model, we converted soil and drinking water lead levels from sites in the Blacksmith Institute[U+05F3]s Toxic Sites Identification Program (TSIP) into mean blood lead levels (BLLs). We then calculated the incidence of mild mental retardation (MMR) and DALYs resulting from these BLLs. Results: The TSIP included 200 sites in 31 countries with soil (n=132) or drinking water (n=68) lead levels, representing 779,989 children younger than 4 years of age potentially exposed to lead. Environmental lead levels produced a range of BLLs from 1.56 to 104.71. μg/dL. These BLLs equated to an estimated loss of 5.41-8.23 IQ points, resulting in an incidence of MMR of 6.03 per 1000 population and 76.1 DALYs per 1000 population. Discussion: Soil and water lead levels at toxic waste sites predict BLLs that lower the intelligence quotient (IQ), with the resulting MMR potentially limiting individual- and country-level development. The preventable burden of disease produced by these sites highlights the need for toxic waste sites to be systematically identified, evaluated, and remediated.

Approaches to systematic assessment of environmental exposures posed at hazardous waste sites in the developing world: The Toxic Sites Identification Program

Ericson, B., Caravanos, J., Chatham-Stephens, K., Landrigan, P., & Fuller, R.

Publication year

2013

Journal title

Environmental Monitoring and Assessment

Volume

185

Page(s)

1755-1766
10.1007/s10661-012-2665-2
Abstract

In the developing world, environmental chemical exposures due to hazardous waste sites are poorly documented. We describe the approach taken by the Blacksmith Institute's Toxic Sites Identification Program in documenting environmental chemical exposures due to hazardous waste sites globally, identifying sites of concern and quantifying pathways, populations, and severity of exposure. A network of local environmental investigators was identified and trained to conduct hazardous waste site investigations and assessments. To date, 2,095 contaminated sites have been identified within 47 countries having an estimated population at risk of 71,500,000. Trained researchers and investigators have visited 1,400 of those sites. Heavy metals are the leading primary exposures, with water supply and ambient air being the primary routes of exposure. Even though chemical production has occurred largely in the developed world to date, many hazardous waste sites in the developing world pose significant hazards to the health of large portions of the population. Further research is needed to quantify potential health and economic consequences and identify cost-effective approaches to remediation.

Assessing levels of lead contamination in soil and predicating pediatric blood lead levels in Tema, Ghana

Kwame-Aboh, I., Sampson, M., Atiemo, M., Nyaab, M., Abra-Kom, L., Caravanos, J., & Kuranchie-Mensah, H.

Publication year

2013

Journal title

Journal of Health and Pollution

Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010

Chatham-Stephens, K., Caravanos, J., Ericson, B., Sunga-Amparo, J., Susilorini, B., Sharma, P., … Fuller, R.

Publication year

2013

Journal title

Environmental Health Perspectives

Volume

121

Page(s)

791-796
10.1289/ehp.1206127
Abstract

Background: Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. Objective: We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. Methods: Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. Results: We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. Conclusions: Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.

Contact

jack@nyu.edu +1 (212) 992-5624 715/719 Broadway New York, NY 10003