Industry and consumer products as lead exposure sources among children across 3 regions in Ghana.

The prevalence of childhood lead exposure in low- and middle-income countries is garnering growing international attention. However, there is limited national and subnational data on blood lead levels and contributing sources of exposure. Between November 2022 and January 2023, lead exposure sources were assessed for 288 children from across 9 communities in 3 regions of Ghana: Greater Accra (4 communities), Ashanti (3 communities), and the Northern Region (2 communities). Study areas were selected to capture populations living near formal and informal lead-related industry, as well as control areas without known industrial activities. Study participants were selected as a subset from a blood lead sampling effort conducted by the Ghana Health Service, in partnership with Pure Earth and UNICEF, which included 3,227 children aged 12-59 months. Of all households included in the blood lead survey, 288 (9%) were randomly selected for detailed assessments to identify potential sources of lead exposure. These home-based assessments included data collection on soil, dust, drinking water, paint, metal and ceramic cookware, cooking spices, cosmetics, jewelry, and toys. With the exception of drinking water, all elements of the assessments were carried out with a portable X-Ray Fluorescence analyzer. Concentrations of lead above 100 ppm in soil surrounding households were found to raise the risk of a child's blood lead levels exceeding 10 μg/dL by 20 times. The use of traditional eyeliner (chilo) increased this risk by more than 40 times. The disparate sources identified highlight the need for representative sampling and home-based investigations to prioritize interventions to reduce blood lead levels. In Ghana, it is evident that interventions are required on multiple fronts with the involvement of diverse stakeholders to address the high prevalence of elevated blood lead levels, including mitigating industrial pollution as well as tightening controls on consumer products.