Jack Caravanos

Clinical Professor of Environmental Public Health Sciences in the Department of Global and Environmental Health

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

Publications

Measurement of Soil Lead Levels Adjacent to Lead-Sheathed Communications Cables

Structured expert judgement approach of the health impact of various chemicals and classes of chemicals

Efficacy of Grignard Pure to Inactivate Airborne Phage MS2, a Common SARS-CoV-2 Surrogate

Desai, G., Ramachandran, G., Goldman, E., Esposito, W., Galione, A., Lal, A., Choueiri, T. K., Fay, A., Jordan, W., Schaffner, D. W., Caravanos, J., Grignard, E., & Mainelis, G. (n.d.).

Publication year

2023

Journal title

Environmental Science and Technology

Volume

57

Issue

10

Page(s)

4231-4240

10.1021/acs.est.2c08632

Abstract

Abstract

Grignard Pure (GP) is a unique and proprietary blend of triethylene glycol (TEG) and inert ingredients designed for continuous antimicrobial treatment of air. TEG has been designated as a ″Safer Chemical” by the US EPA. GP has already received approval from the US EPA under its Section 18 Public Health Emergency Exemption program for use in seven states. This study characterizes the efficacy of GP for inactivating MS2 bacteriophage─a nonenveloped virus widely used as a surrogate for SARS-CoV-2. Experiments measured the decrease in airborne viable MS2 concentration in the presence of different concentrations of GP from 60 to 90 min, accounting for both natural die-off and settling of MS2. Experiments were conducted both by introducing GP aerosol into air containing MS2 and by introducing airborne MS2 into air containing GP aerosol. GP is consistently able to rapidly reduce viable MS2 bacteriophage concentration by 2-3 logs at GP concentrations of 0.04-0.5 mg/m3 (corresponding to TEG concentrations of 0.025 to 0.287 mg/m3). Related GP efficacy experiments by the US EPA, as well as GP (TEG) safety and toxicology, are also discussed.

Lead Levels in a Potters Population and Its Association With the Use of Different Glazes: Cross-Sectional Evaluation of the Approved Pottery Program

Peralta, N., Cantoral, A., Téllez-Rojo, M. M., Trejo-Valdivia, B., Estrada-Sánchez, D., Richardson-L, V., Caravanos, J., & Fuller, R. (n.d.).

Publication year

2022

Journal title

Frontiers in Toxicology

Volume

4

10.3389/ftox.2022.799633

Abstract

Abstract

Lead is one of the most harmful toxic metals to humans. In Mexico, though most potters still use a lead-based glazing process, a new lead-free glaze has been introduced to the production of pottery. The Approved Pottery Program (APP) promotes the production of lead-free pottery. As a component of the APP, we aimed to document in this pilot study the blood lead levels (BLLs) of a sample of potters and the association with the type of glaze used. A cross-sectional study was conducted based on information from 46 potters grouped by 26 workshops. We measured general sociodemographic characteristics, capillary BLLs, and the lead levels of the dirt floors of the workshops. The evaluation of associations and comparisons between glaze types was performed based on a regression model clustered by workshop. The median BLL measured was 13.6 μg/dl (IQR: 7.8–20.4 μg/dl), and 70% of the BLLs were greater than 10 μg/dl. Workshop managers presented higher BLLs compared to others working in the same workshop (median of 14.1 μg/dl (IQR: 11.6–25.3 μg/dl) versus 10.1 μg/dl (IQR: 5.2–16.7 μg/dl), respectively). The median BLLs of potters who used lead-free glaze in at least 80% of production were 8.8 μg/dl (95% CI: −17.3 to −0.3 μg/dl) lower than the BLLs of those who used lead-free glaze in less than 30% of production, adjusted by workshop role. Additionally, the lead levels were significantly lower in workshop dirt floors where lead-free glaze was used in at least 80% of the production compared to those that use less than 30% (180 versus 916 mg/kg; p < 0.05). The use of lead-free glaze in the production of pottery was associated with both lower BLLs in potters and lower soil lead levels in the workshop area.

Pollution and health: a progress update

Fuller, R., Landrigan, P. J., Balakrishnan, K., Bathan, G., Bose-O’Reilly, S., Brauer, M., Caravanos, J., Chiles, T., Cohen, A., Corra, L., Cropper, M., Ferraro, G., Hanna, J., Hanrahan, D., Hu, H., Hunter, D., Janata, G., Kupka, R., Lanphear, B., … Yan, C. (n.d.).

Publication year

2022

Journal title

The Lancet Planetary Health

Volume

6

Issue

6

Page(s)

e535-e547

10.1016/S2542-5196(22)00090-0

Abstract

Abstract

The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science–policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.

Probabilistic estimates of prenatal lead exposure at 195 toxic hotspots in low- and middle-income countries

Zajac, L., Kobrosly, R. W., Ericson, B., Caravanos, J., Landrigan, P. J., & Riederer, A. M. (n.d.).

Publication year

2020

Journal title

Environmental Research

Volume

183

10.1016/j.envres.2020.109251

Abstract

Abstract

Background: Prior estimates of pediatric lead-related disease burden in low- and middle-income countries (LMICs) used population estimates of maternal blood lead levels (BLLs). This approach may underestimate fetal BLLs by not considering potentially high prenatal lead exposure from toxic hotspots. Objectives: We developed a probabilistic approach to using the Adult Lead Methodology (ALM) to estimate fetal BLLs from prenatal exposure to lead-contaminated soil at hotspots in the Toxic Site Identification Program (TSIP). Methods: We created distributions for each ALM parameter using published literature and extracted soil lead measurements from the TSIP database. Each iteration of the probabilistic ALM randomly selected values from the input distributions to generate a site-specific fetal BLL estimate. For each site, we ran 5000 model iterations, producing a site-specific fetal BLL distribution. Results: 195 TSIP sites, in 33 LMICs, met our study inclusion criteria; an estimated 820,000 women of childbearing age are at risk for lead exposure at these sites. The predicted geometric means (GM) for site-specific fetal BLLs ranged from 3.3 μg/dL to 534 μg/dL, and 98% of sites had estimated GM fetal BLLs >5 μg/dL, the current reference level of the United States Centers for Disease Control and Prevention (CDC), while 11 sites had estimated GM fetal BLLs above the CDC chelation threshold of 45 μg/dL. Discussion: The TSIP soil lead data and this probabilistic approach to the ALM show that pregnant women living near TSIP sites may have BLLs that put their fetus at risk for neurologic damage and other sequelae, underscoring the need for interventions to reduce lead exposure at toxic hotspots.

Assessment of the prevalence of lead-based paint exposure risk in Jakarta, Indonesia

Ericson, B., Hariojati, N., Susilorini, B., Crampe, L. F., Fuller, R., Taylor, M. P., & Caravanos, J. (n.d.).

Publication year

2019

Journal title

Science of the Total Environment

Volume

657

Page(s)

1382-1388

10.1016/j.scitotenv.2018.12.154

Abstract

Abstract

While lead-based paint has been banned for use in residential settings in most high-income countries, it remains commonly available in many low- and middle-income countries (LMICs). Despite its continued availability, little is known about the specific exposure risk posed by lead-based paint in LMICs. To address this knowledge gap, an assessment of home and preschool dust and paint was carried out in Greater Jakarta, Indonesia. A team of investigators used field portable X-ray Fluorescence (pXRF) to measure 1574 painted surfaces for the presence of lead (mg/cm2) and collected 222 surface dust wipe samples for lead loading (μg/m2) from 103 homes and 19 preschools across 13 different neighborhoods of Jakarta. The assessment found that 2.7% (n = 42) of pXRF measurements and 0.05% (n = 1) of dust wipe samples exceeded the commonly applied USEPA guideline values for paint (1 mg/cm2) and dust (floors: 431 μg/m2; window sills: 2691 μg/m2). Thus, contrary to expectations the locations analyzed in Greater Jakarta showed that exposure risk to lead-based paint appears low. Further study is required in other settings to confirm the findings here. Precautionary measures, such as the proposed ban on lead-based paint, should be taken to prevent the significant social and economic costs associated with lead exposure.

Conflicting conclusions or competing methodologies? Documenting soil lead pollution in Owino Uhuru, Kenya

Caravanos, J. (n.d.).

Publication year

2019

Journal title

Journal of Health and Pollution

Volume

9

Issue

21

10.5696/2156-9614-9.21.190301

A meta-analysis of blood lead levels in India and the attributable burden of disease

Ericson, B., Dowling, R., Dey, S., Caravanos, J., Mishra, N., Fisher, S., Ramirez, M., Sharma, P., McCartor, A., Guin, P., Taylor, M. P., & Fuller, R. (n.d.).

Publication year

2018

Journal title

Environment international

Volume

121

Page(s)

461-470

10.1016/j.envint.2018.08.047

Abstract

Abstract

Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.

Cost Effectiveness of Environmental Lead Risk Mitigation in Low-and Middle-Income Countries

Ericson, B., Caravanos, J., Depratt, C., Santos, C., Cabral, M. G., Fuller, R., & Taylor, M. P. (n.d.).

Publication year

2018

Journal title

GeoHealth

Volume

2

Issue

2

Page(s)

87-101

10.1002/2017GH000109

Abstract

Abstract

Environmental remediation efforts in low-and middle-income countries have yet to be evaluated for their cost effectiveness. To address this gap we calculate a cost per Disability Adjusted Life Year (DALY) averted following the environmental remediation of the former lead smelter and adjoining residential areas in Paraiso de Dios, Haina, the Dominican Republic, executed from 2009 to 2010. The remediation had the effect of lowering surface soil lead concentrations to below 100 mg/kg and measured geometric mean blood lead levels (BLLs) from 20.6 μg/dL to 5.34 ug/dL. Because BLLs for the entire impacted population were not available, we use environmental data to calculate the resulting disease burden. We find that before the intervention 176 people were exposed to elevated environmental lead levels at Paraiso de Dios resulting in mean BLLs of 24.97 (95% CI: 24.45–25.5) in children (0–7 years old) and 13.98 μg/dL (95% CI: 13.03–15) in adults. We calculate that without the intervention these exposures would have resulted in 133 to 1,096 DALYs and that all of these were averted at a cost of USD 392 to 3,238, depending on assumptions made. We use a societal perspective, meaning that we include all costs regardless of by whom they were incurred and estimate costs in 2009 USD. Lead remediation in low-and middle-income countries is cost effective according to World Health Organization thresholds. Further research is required to compare the approach detailed here with other public health interventions.

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

Johnson, G. D., Pavilonis, B., Caravanos, J., & Grassman, J. (n.d.).

Publication year

2018

Journal title

Bulletin of Environmental Contamination and Toxicology

Volume

100

Issue

2

Page(s)

259-264

10.1007/s00128-017-2213-4

Abstract

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. (n.d.).

Publication year

2018

Journal title

Environmental Research

Volume

165

Page(s)

420-424

10.1016/j.envres.2017.10.024

Abstract

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.

Pollution and global health – An agenda for prevention

Landrigan, P. J., Fuller, R., Hu, H., Caravanos, J., Cropper, M. L., Hanrahan, D., Sandilya, K., Chiles, T. C., Kumar, P., & Suk, W. A. (n.d.).

Publication year

2018

Journal title

Environmental health perspectives

Volume

126

Issue

8

10.1289/EHP3141

Abstract

Abstract

SUMMARY: Pollution is a major, overlooked, global health threat that was responsible in 2015 for an estimated 9 million deaths and great economic losses. To end neglect of pollution and advance prevention of pollution-related disease, we formed the Lancet Commission on Pollution and Health. Despite recent gains in understanding of pollution and its health effects, this Commission noted that large gaps in knowledge remain. To close these gaps and guide prevention, the Commission made research recommendations and proposed creation of a Global Observatory on Pollution and Health. We posit that successful pollution research will be translational and based on transdisciplinary collaborations among exposure science, epidemiology, data science, engineering, health policy, and economics. We envision that the Global Observatory on Pollution and Health will be a multinational consortium based at Boston College and the Harvard T.H. Chan School of Public Health that will aggregate, geocode, and archive data on pollution and pollution-related disease; analyze these data to discern trends, geographic patterns, and opportunities for intervention; and make its findings available to policymakers, the media, and the global public to catalyze research, inform policy, and assist cities and countries to target pollution, track progress, and save lives.

Prevention-intervention strategies to reduce exposure to e-waste

Heacock, M., Trottier, B., Adhikary, S., Asante, K. A., Basu, N., Brune, M. N., Caravanos, J., Carpenter, D., Cazabon, D., Chakraborty, P., Chen, A., Barriga, F. D., Ericson, B., Fobil, J., Haryanto, B., Huo, X., Joshi, T. K., Landrigan, P., Lopez, A., … Suk, W. (n.d.).

Publication year

2018

Journal title

Reviews on Environmental Health

Volume

33

Issue

2

Page(s)

219-228

10.1515/reveh-2018-0014

Abstract

Abstract

As one of the largest waste streams, electronic waste (e-waste) production continues to grow in response to global demand for consumer electronics. This waste is often shipped to developing countries where it is disassembled and recycled. In many cases, e-waste recycling activities are conducted in informal settings with very few controls or protections in place for workers. These activities involve exposure to hazardous substances such as cadmium, lead, and brominated flame retardants and are frequently performed by women and children. Although recycling practices and exposures vary by scale and geographic region, we present case studies of e-waste recycling scenarios and intervention approaches to reduce or prevent exposures to the hazardous substances in e-waste that may be broadly applicable to diverse situations. Drawing on parallels identified in these cases, we discuss the future prevention and intervention strategies that recognize the difficult economic realities of informal e-waste recycling.

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. (n.d.).

Publication year

2017

Journal title

Environmental Research

Volume

154

Page(s)

1-9

10.1016/j.envres.2016.12.010

Abstract

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. (n.d.).

Publication year

2017

Journal title

Journal of Health and Pollution

Volume

7

Issue

13

Page(s)

1

10.5696/2156-9614-7-13.1

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. (n.d.).

Publication year

2016

Journal title

Environmental Health: A Global Access Science Source

Volume

15

Issue

1

10.1186/s12940-016-0151-y

Abstract

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., Akuffo, B., & Fuller, R. (n.d.).

Publication year

2016

Journal title

Annals of Global Health

Volume

82

Issue

5

Page(s)

700-710

10.1016/j.aogh.2016.07.008

Abstract

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. (n.d.).

Publication year

2016

Journal title

Environmental Monitoring and Assessment

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. (n.d.).

Publication year

2016

Journal title

Annals of Global Health

Volume

82

Issue

5

Page(s)

686-699

10.1016/j.aogh.2016.10.015

Abstract

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., Kashdan, Z., & Fuller, R. (n.d.).

Publication year

2016

Journal title

Environmental Pollution

Volume

211

Page(s)

346-353

10.1016/j.envpol.2016.01.019

Abstract

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.

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

Lead exposure: A pending task in Mexico

Téllez-Rojo, M. M., & Caravanos, J. (n.d.).

Publication year

2015

Journal title

Salud Publica de Mexico

Volume

57

Issue

2

Page(s)

115-116

Protecting communities by remediating polluted sites worldwide

Hanrahan, D., Ericson, B., & Caravanos, J. (n.d.).

Publication year

2015

Journal title

Proceedings of the Institution of Civil Engineers: Civil Engineering

Volume

169

Issue

5

Page(s)

33-40

10.1680/jcien.15.00034

Abstract

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. (n.d.).

Publication year

2015

Journal title

International journal of environmental research and public health

Volume

12

Issue

10

Page(s)

13587-13601

10.3390/ijerph121013587

Abstract

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.