Papers by Perry Gottesfeld
All lead exposures matter
The Lancet Planetary Health, 2021
American Journal of Public Health
In recent years, lead poisoning has received increasing attention as lead production continues to... more In recent years, lead poisoning has received increasing attention as lead production continues to grow and the industry shifts the most polluting processes (e.g., smelting ore and recycling batteries) to low- and middle-income countries. The hazards associated with lead exposures have been well known for centuries while the industry actively promoted lead products. Less well known is how the industry continues to promote the “safe and responsible” use of lead and support research to question the underlying science and avoid regulation. Here I explore the historical context for recent actions that the industry has taken to ensure its longevity. Lead industry associations continue to employ some of the same themes that have proven successful in the past. Efforts to forestall regulatory initiatives to reduce emissions and restrict lead applications continue. Large battery manufacturers and recyclers and their associations place blame on informal-sector recycling to draw focus away from...
Preventing Tuberculosis (TB) in health workers and silica-exposed occupations
Safety and Health at Work, 2022
The COVID-19 pandemic has reminded us of the importance of workplace exposures and transmission i... more The COVID-19 pandemic has reminded us of the importance of workplace exposures and transmission in the control of airborne infectious diseases. The importance of workplace transmission of Tuberculosis (TB) has been well documented for decades, yet these past lessons have largely gone unheeded for health workers and silica-exposed occupations which are some of the highest risk subpopulations. It is estimated that health care workers who represent 3% of the global population made up 14% of reported COVID-19 and the same front-line workers are at three times greater risk for active TB compared to the general population. Despite these known risks, multiple studies have demonstrated that few health workers are provided with training or protections. Workplace TB prevention measures overlap with measures known to reduce the spread of COVID-19 and include improved ventilation, UV germicidal irradiation, personal protective equipment and training. These dual pandemics present an opportunity ...
Metal exposures from source materials for artisanal aluminum cookware
International Journal of Environmental Health Research, 2022
Artisanal aluminum cookware releases lead and other metals that pose significant health risk for ... more Artisanal aluminum cookware releases lead and other metals that pose significant health risk for people in low and middle-income countries. Cookware is made from recycled engine and electronic appliance parts, cans, and other materials. We obtained fourteen custom-made pots from Ghana, produced from seven different scrap aluminum sources. We sought to determine whether avoiding certain source materials could reduce leaching of metals. Cooking was simulated using dilute acetic acid and palm oil. Aluminum released from all pots exceeded recommended guidelines. Variable amounts of lead, cadmium, chromium, nickel and other metals were leached, with the most lead coming from auto radiators and mixed metals. Pots made from engine blocks did not yield detectable amounts of lead. All pots released potentially harmful concentrations of two or more metals. Selective scrap aluminum sourcing for recycled cookware does not avoid metal contamination of food, although some sources may release lower concentrations of certain metals.
Journal of Occupational and Environmental Hygiene, 2011
The battery industry is the largest consumer of lead, using an estimated 80% of the global lead p... more The battery industry is the largest consumer of lead, using an estimated 80% of the global lead production. The industry is also rapidly expanding in emerging market countries. A review of published literature on exposures from lead-acid battery manufacturing and recycling plants in developing countries was conducted. The review included studies from 37 countries published from 1993 to 2010 and excluded facilities in developed countries, such as the United States and those in Western Europe, except for providing comparisons to reported findings. The average worker blood lead level (BLL) in developing countries was 47 µg/dL in battery manufacturing plants and 64 µg/dL in recycling facilities. Airborne lead concentrations reported in battery plants in developing countries averaged 367 µg/m 3 , which is 7-fold greater than the U.S. Occupational Safety and Health Administration's 50 µg/m 3 permissible exposure limit. The geometric mean BLL of children residing near battery plants in developing countries was 19 µg/dL, which is about 13-fold greater than the levels observed among children in the United States. The blood lead and airborne lead exposure concentrations for battery workers were substantially higher in developing countries than in the United States. This disparity may worsen due to rapid growth in lead-acid battery manufacturing and recycling operations worldwide. Given the lack of regulatory and enforcement capacity in most developing countries, third-party certification programs may be the only viable option to improve conditions.
Implementing Silica Dust Controls in the Informal Sector to Prevent Tuberculosis (TB)
Safety and Health at Work, 2022
Improving Occupational Health of Artisanal Mining Communities in Northern Nigeria
Safety and Health at Work, 2022
Occupational and Environmental Medicine
ObjectivesOur objective was to monitor blood lead levels (BLLs) of miners and ore processors part... more ObjectivesOur objective was to monitor blood lead levels (BLLs) of miners and ore processors participating in a pilot programme to reduce lead poisoning and take-home exposures from artisanal small-scale gold mining. A medical surveillance programme was established to assess exposures as new methods aimed at reducing lead exposures from ore were introduced in a community in Nigeria where children experienced substantial lead-related morbidity and mortality.MethodsExtensive outreach and education were offered to miners, and investments were made to adopt wet methods to reduce exposures during mining and processing. We conducted medical surveillance, including a physical exam and repeated blood lead testing, for 61 miners selected from among several hundred who participated in the safer mining pilot programme and consented to testing. Venous blood lead concentrations were analysed using the LeadCare II device at approximately 3-month intervals over a period of 19 months.ResultsOverall...
Journal of Occupational and Environmental Hygiene, 2013
In spite of the availability of substitutes for lead compounds used in paints, manufacturers cont... more In spite of the availability of substitutes for lead compounds used in paints, manufacturers continue to produce these paints for decorative and industrial applications. We report here on the concentration of lead in new paint sold in Cameroon and provide a summary of labeling practices on paints available in the country, based on a market survey. Investigators visited 76 retail and wholesale paint suppliers in Cameroon to collect information from paint product labels and to collect samples of paints to analyze for lead content. Only 8.5% of paints had labels identifying any of the ingredients, and none of the lead paints included any warning language. Based on a convenience sample (weighted to include multiple colors from the most common brands), 61 mostly enamel paints were purchased from retail outlets and analyzed for lead content (median: 2150 ppm; range: <21-500,000 ppm). Sixty-six percent of the new paint samples had concentrations exceeding the U.S. standard of 90 ppm total lead. All but one of the samples with lead concentrations greater than 90 ppm were also greater than 600 ppm. The largest manufacturer in the country-Seigneurie, a subsidiary of the U.S.-based company PPG-had significant lead concentrations in 9 out of 22 (41%) paints tested. There is an immediate need to adopt mandatory standards to limit the lead content of paint manufactured, imported, and sold in the country. To promote safer paint products we recommend the development of a thirdparty certification program for paints without added lead. These recommendations are consistent with the objectives of the Global Alliance to Eliminate Lead Paint established under the auspices of the United Nations to address this problem on a global scale.
Finding the Next Flint: The Need to Update the Blood Lead Reference Value
American Journal of Public Health
Urgent Need for a Comprehensive Public Health Response to Artisanal Small-Scale Mining
Annals of Work Exposures and Health
Informal sector mining is a growing enterprise in countries around the world providing livelihood... more Informal sector mining is a growing enterprise in countries around the world providing livelihood to >40 million self-employed miners. The use of mercury in gold processing has been the sole focus of most research and public health interventions in artisanal mining. Few programs work to improve health among communities mining other commodities including sand, aggregates, quartz, lead, gemstones, coal and other materials. Although mercury is a major environmental challenge in countries with extensive gold mining, artisanal miners are also exposed to silica dust, metals and other safety hazards. The available evidence regarding hazardous exposures among self-employed miners suggests that the public health implications are much broader. There is a growing body of evidence linking exposures to silica dust to tuberculosis and other lung diseases among artisanal miners. Studies have also documented exposures to lead and other metals including arsenic, cadmium, cobalt and chromium in in...
A Call for the Global Elimination of Lead Poisoning
ISEE Conference Abstracts
Declining blood lead levels among small-scale miners participating in a safer mining pilot programme in Nigeria
Occupational and Environmental Medicine
ObjectivesOur objective was to monitor blood lead levels (BLLs) of miners and ore processors part... more ObjectivesOur objective was to monitor blood lead levels (BLLs) of miners and ore processors participating in a pilot programme to reduce lead poisoning and take-home exposures from artisanal small-scale gold mining. A medical surveillance programme was established to assess exposures as new methods aimed at reducing lead exposures from ore were introduced in a community in Nigeria where children experienced substantial lead-related morbidity and mortality.MethodsExtensive outreach and education were offered to miners, and investments were made to adopt wet methods to reduce exposures during mining and processing. We conducted medical surveillance, including a physical exam and repeated blood lead testing, for 61 miners selected from among several hundred who participated in the safer mining pilot programme and consented to testing. Venous blood lead concentrations were analysed using the LeadCare II device at approximately 3-month intervals over a period of 19 months.ResultsOverall...
Commentary health risks from climate fix: The downside of energy storage batteries
Environmental Research
Environmental Health
Although we completely agree with Paulson and Brown that primary prevention to eliminate sources ... more Although we completely agree with Paulson and Brown that primary prevention to eliminate sources of exposure is the best long-term approach to childhood lead poisoning, it is not a strategy that can replace the need to prioritize individuals and communities that are over-exposed. They argue that the CDC should reject the advice of two of its' scientific advisory committees that called on the agency to lower the blood lead reference value for children in the U.S. because it would put clinicians in an untenable position as there is no prescribed clinical response [1]. However, by not informing parents that their children are being exposed to lead at levels well in excess of the median, we are preventing parents from recognizing the need to take precautions to reduce environmental lead exposures.
Soil contamination from lead battery manufacturing and recycling in seven African countries
Environmental research, 2018
Lead battery recycling is a growing hazardous industry throughout Africa. We investigated potenti... more Lead battery recycling is a growing hazardous industry throughout Africa. We investigated potential soil contamination inside and outside formal sector recycling plants in seven countries. We collected 118 soil samples at 15 recycling plants and one battery manufacturing site and analyzed them for total lead. Lead levels in soils ranged from < 40-140,000mg/kg. Overall mean lead concentrations were ~23,200mg/kg but, average lead levels were 22-fold greater for soil samples from inside plant sites than from those collected outside these facilities. Arithmetic mean lead concentrations in soil samples from communities surrounding these plants were ~2600mg/kg. As the lead battery industry in Africa continues to expand, it is expected that the number and size of lead battery recycling plants will grow to meet the forecasted demand. There is an immediate need to address ongoing exposures in surrounding communities, emissions from this industry and to regulate site closure financing proc...
Preventing tuberculosis among high-risk workers
The Lancet. Global health, Jan 24, 2018
Frontiers in Public Health
Blood lead levels (BLLs) are a useful indication of a population exposure to lead from environmen... more Blood lead levels (BLLs) are a useful indication of a population exposure to lead from environmental sources. No previous published study had reported BLLs in Cameroon. Our objective is to characterize exposure levels in children to inform policymakers of potential lead exposure sources. We tested the BLLs of 147 children aged 12 months to 6 years residing in Yaoundé, Cameroon, and conducted an extensive questionnaire with their parents or guardians to characterize potential exposure sources. The geometric mean BLL among this population was 8.0 μg/dl and arithmetic mean level was 8.7 μg/ dl. These levels are more than sixfold higher than the geometric mean BLL reported in the U.S. and more than fivefold higher than those reported in France. In addition, 88% of the children tested had lead levels greater than 5 μg/dl. One limitation of the study is that the selection of the children sampled was not a random survey. The analysis of the responses to the questionnaire failed to uncover any specific exposure patterns. A statistically significant association was noted between the age of the child's home and the duration of exclusive breastfeeding with BLLs. The study points to a need for greater efforts to control sources of lead exposure in Cameroon.
The Lead Battery: A Growing Global Public Health Challenge
American Journal of Public Health
Frontiers in public health, 2015
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Papers by Perry Gottesfeld