Lead contamination has been estimated to account for around 900,000 deaths per year worldwide (IHME, 2019). Typically developing countries suffer the most, where the use of lead in paint and other household products is often not fully regulated or controlled. Thus, in this article, we aim to observe the scale of the problem in Georgia and discuss potential interrelated policy options.

Lead is a heavy metal found within the Earth’s crust. Given its properties – high malleability and resistance to corrosion – it has long been used for a wide range of industrial applications. Some of its common uses include commercial fuel, paints, and food containers (Agency for Toxic Substances and Disease Registry, 2020). Lead is also a toxic chemical to humans, and children are particularly vulnerable to its negative effects for two reasons – they digest more lead particles because of natural hand-to-mouth activities, and due to physiological differences, they absorb more lead via digestion compared to adults. Lead poisoning may cause cognitive and physical deficits in children, including altering their neuromotor and neurosensory functions and affecting learning. In severe cases of poisoning, coma, convulsions, and even death have all been documented among young children (Ibid).

Alarming results from Georgia’s 2018 Multiple Indicator Cluster Survey (MICS) pointed to a largely ignored public health issue in the country – where 41% of children aged 2-7 were reported to have a concentration of lead equal to or more than 5 micrograms per deciliter of blood (μg/dL) (UNICEF, 2018). There is presently no recognized safe lead concentration level in the human body, and according to the World Health Organization (WHO), even a concentration of 5 μg/dL may lead to irreversible health conditions, to which children are particularly vulnerable. These consequences span from affected brain development to acquired immunotoxicity, and may even negatively affect a child’s social behavior and educational advancement.

The Georgian government has carried out certain investigations into the lead content of various widely used household products. A 2019 study carried out with 17 families residing in Tbilisi revealed that lead levels exceeded the norms outlined by the law in 17.9% of samples, which included those taken from food, toys, clothing, and cosmetics (Parliament of Georgia, 2020).

According to local experts, common sources of lead distribution are dust particles near construction sites, leaded paint, and soil contamination, which is particularly acute in Western Georgia (Parliament of Georgia, 2020). These findings are in line with results reported by MICS and identified that in some regions of Western Georgia, such as Adjara, Guria, Samegrelo-Zemo Svaneti, and Imereti, the percentage of children with blood lead concentrations of 5 μg/dL or above-reached levels as high as 85.4%, 73.2%, 71.2%, and 60.8% respectively (UNICEF, 2018) (Figure 1).

Figure 1.  Percentage of Children with Elevated Blood Lead Levels in Georgia

Source: UNICEF

The Georgian Scientific Research Center of Agriculture suggests that the level of lead in food has decreased significantly over the last decade – an improvement that is linked to the elimination of leaded gasoline. Nevertheless, exposure to lead in food items is still six times higher in Georgia than the European average (SRCA, 2018).

When discussing the various public policy alternatives for tackling lead poisoning, it is important to be able to evaluate the costs of lead contamination. According to the Institute for Health Metrics and Evaluation, lead accounts for 62.5% of the global burden of developmental intellectual disability of uncertain origin; 8.2% of hypertensive heart disease; 7.2% of ischemic heart disease; and 5.65% of the global burden of strokes (Ibid).

While the health effects of lead contamination are irreversible, this does not imply there is no space for improvement. Since there is no effective treatment for excessive levels of lead in blood, the main policy option is prevention. For instance, through a number of successful policies, the United States has managed to reduce the mean concentration of lead in children aged 1-5; from 15 μg/dL in 1978 to 0.7 μg/dL in 2016 (OWID, 2022). Certain methods could certainly still be applicable in Georgia, including:

1. Eliminating existing lead paint hazards in older homes

Leaded paint is one of the most common sources of lead contamination in Georgia. It is noteworthy that older homes built during Soviet times commonly used leaded paint during construction. This creates a problem for all residents in these dwellings, and unfortunately, the families who cannot afford to renovate their homes are usually more vulnerable to such negative effects (Parliament of Georgia, 2020). On the positive side, it appears that there are in fact some simple solutions to the problem. One assessment of the correlation between lead pollution and health outcomes for children was conducted by the Health Impact Project in the USA. This pilot project revealed that repainting older homes across the United States – specifically those with households including young children – would have protected more than 311,000 children born in 2018 from lead poisoning (Health Impact Project, 2017).

2. Ensuring that further renovation, repair, and painting practices are safe

The same project demonstrated that other solutions, such as the enforcement of compliance with nationally defined safety standards for various renovation projects, could potentially have protected around 211,000 children born in 2018 (Health Impact Project, 2017). However, given that there are no specific standards in the country and that informal working arrangements are quite common in the construction sector, the enforcement of such a project in Georgia might prove costly and hardly feasible.

3. Ensuring the safe disposal of lead-acid batteries and electronics

Considering that soil contamination is one of the most widespread sources of lead pollution in Georgia, efforts should be made to ensure the safe disposal of batteries and electronics; instead of the utilization of landfills and other locations that contaminate the environment and in particular the soil.

This move could involve supporting the enforcement of the law, restricting the disposal of hazardous electronic waste, and the construction of special infrastructure and landfills to avoid soil contamination. Concurrently, awareness-raising campaigns should promote the separation of electronic products from other waste. As such, policies benefitting waste segregation could also potentially accelerate this process.

Despite efforts in previous decades to decrease lead contamination – most notably through the elimination of leaded petroleum products – Georgia remains one of the most problematic parts of Europe for the extent of lead in the blood of children, who are the most vulnerable to the adverse effects of both physical and mental development (Ericson et al., 2021; World Bank, 2019).

Despite the severity of this issue and its grave consequences, including impeded intellectual development and educational achievement, the issue has been left without due attention and little is being done to address this silent environmental intoxicator, which is particularly severe in Western Georgia.

As the two main sources of lead contamination in Georgia are leaded paint and polluted soil, public policy should be aimed at tackling these two notable issues. In particular, the government should eliminate the hazard of leaded paints in older buildings, which most often threatens low- and middle-income households. In addition, the proper disposal of lead-acid batteries and electronics should be encouraged by awareness campaigns, accompanied by the construction of special landfills that ensure their proper disposal within a distinctive infrastructure.

REFERENCES

Agency for Toxic Substances and Disease Registry. (2020). Toxicological Profile for Lead. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. Retrieved 20 February 2022, from: https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=96&tid=22.

Ericson, B., Hu, H., Nash, E., Ferraro, G., Sinitsky, J., & Taylor, M. P. (2021). Blood lead levels in low-income and middle-income countries: a systematic review. The Lancet Planetary Health, 5(3), e145-e153.

Institute for Health Metrics and Evaluation. (2019). GBD Compare. IHME, University of Washington.

Parliament of Georgia. (2020). Assessment of Lead Pollution in Georgia. Retrieved 20 February 2022, from https://info.parliament.ge/file/1/BillReviewContent/263763.

Scientific Research Center of Agriculture. (2018). Risk Assessment of Lead Prevalence in Food Report. Retrieved 20 February 2022, from:

https://srca.gov.ge/files/%E1%83%A2%E1%83%A7%E1%83%95%E1%83%98%E1%83%90-%E1%83%90%E1%83%9C%E1%83%92%E1%83%90%E1%83%A0%E1%83%98%E1%83%A8%E1%83%98.pdf. 

UNICEF. (2018). Multiple Indicator Cluster Survey 2018. NBS, UNICEF.

World Bank. (2019). Population ages 0-14, total. Retrieved 20 February 2022, from: https://data.worldbank.org/indicator/SP.POP.0014.TO.