Toward eliminating children’s lead exposure: a comparison of policies and their outcomes in three lead producing and using countries

Abstract

Though the problem of childhood lead poisoning has been recognized for more than a century, it remains an important threat to children’s health and development. This comparative policy assessment examines and compares environmental and public health policies to prevent children’s exposure of three major lead producing countries. Germany, the USA and Australia were used to explore a range of approaches primarily at the national level to identify best practice, how the lack of finding any ‘safe exposure’ level has been incorporated into policy, and to consider if any international harmonization has occurred. We searched the peer-reviewed literature, government websites, policy documents and grey literature to identify how and when policies were developed, implemented and revised. From this analysis, we present a chronology and discussion of national policy approaches for the main sources of lead exposure for children in each country. We found significant differences in timing and comprehensiveness of environmental policies related to lead. There are significant differences among the countries in biomonitoring and identifying pathways of exposure, with limited information available in Germany and Australia. Though there are significant gaps, the US has the most comprehensive regulations relating to old lead paint in housing, while in Australia, a regulatory framework is lacking. Though all three countries regulate lead in air, the US has the most health protective standard, while Australia lacks the ability to ensure that states meet the national standard. Though each country has developed regulatory frameworks for lead that have reduced children’s exposure, none of the three countries have a comprehensive set of policies that respond to the scientific evidence that there is no identified threshold for lead exposure. While there are differences in the relative importance of lead exposure pathways among the three countries, suggesting the need for different prevention emphases, there is also a strong argument for more international harmonization of exposure standards at the most protective levels. Some environmental policies incorporate current scientific understanding of lead toxicity, however, we identified gaps in standards and enforcement, and as a result, exposure continues to affect the health of children in all three countries.

Keywords

• childhood lead exposure
• BLL
• comparative policy
• lead
• Australia
• Germany