This research brief was produced as part of the China Environment Forum's partnership with Western Kentucky University on the U.S. AID-supported China Environmental Health Project
In 2007, it seemed that practically every few weeks, there was a report of a Chinese import being recalled because it contained a dangerous ingredient or was tainted with lead. There was lead in the paint of children's toys and in play jewelry. In early 2008, lead was found in children's sunglasses imported from China. Understandably, American consumers were worried about the effect lead in products could have on their children, but little discussion was raised on the impact lead could be having on children in China. If lead was in the final product in America, then it was most definitely in the production process in the country of origin. Besides emissions from toy and other industries, China is facing considerable lead pollution from smelters and potentially lingering health impacts from lead in auto exhaust.
Lead Causes Harm
There is no specific contamination route for lead. Humans can intake lead by breathing it in or consuming it in liquids or food. The current World Health Organization's (WHO) "safe" limit for lead in blood, originally set in 1995, is 10 micrograms per deciliter (µg/dL). Yet there is no detectable safe blood lead level—at every measurable level of lead, there is associated harm. Lead has been linked to drops in IQ points, behavioral problems, and Attention Deficit Hyperactivity Disorder (ADHD). Lead exposure can also cause anemia, damage to the gastrointestinal tract, and kidneys. Chronic exposure can even lead to DNA damage.  While also dangerous to adults, it is especially harmful in young children because it negatively affects their cognitive and nervous system development. High levels of lead exposure can cause stunted growth in children, severe brain damage, mental retardation, and even death. Children also absorb more lead from the environment because they eat, drink, and breathe more per pound than adults. Lead poisoning is a prevalent problem around the world, especially in developing countries such as China. Studies have consistently shown that Chinese children have much higher blood lead levels (BLL) than even the WHO's "safe" limit.
Sources of Lead in China
Over the past decade China has been tightening regulations controlling the use of lead. Just in the past few years, the government passed lead standards for fertilizers in 2002 and for food in 2004. According to the New York Times, Chinese lead standards are more stringent than U.S. ones in the case of household and consumer paint, although lead continues to be detected in exported toys. In September 2007, in response to the many recalls of Chinese products, China signed an agreement with the United States to ban lead paint in the manufacture of toys and to address other product safety issues. Despite the tightened regulations, implementation and enforcement are lagging.  Even though China banned the production of leaded gasoline in 1999, phasing it out in major cities through the early 2000s, it is still available, especially in the western provinces.  Fully eliminating leaded gasoline will reduce BLLs, but an October 1999 report in China Medical Journal showed that the BLL of Shanghai children did not drop as much as expected after the leaded gasoline phase out, suggesting that additional lead emissions from industrial sources also need to be addressed.  Besides residual use of leaded gasoline, coal-burning, smelting factories, and lead paint also contribute to lead in China's environment. Lead is also naturally occurring, and China is the global leader in mining and producing it. 
Another source of lead is the e-waste recycling industry. Despite the Basel Convention of 1989, in which countries agreed to restrict the transboundary movement of hazardous waste, e-waste from developed countries still finds it way into China and other Asian countries for dismantling. The United States is the only developed country that has not ratified the Basel Convention, and developed countries that have ratified the Basel Convention continue to export their computer and electronic waste to China. On China's end, enforcement on e-waste imports is incomplete at best. There are towns in Southern China, such as Guiyu in Guangdong Province, whose main source of economic income is processing e-waste. In Guiyu, 60 to 80 percent of families carry out e-waste recycling in small-scale workshops. A study published in July 2007 found that over 80 percent of Guiyu children tested had BLL greater than 10 µg/dL, more than double the percentage for children tested in a neighboring non-e-waste recycling town.  (For more information see "High Tech's Toxic Legacy in China" in China Environment Series 9 and "China as E-Waste Dumping Ground: A Growing Challenge to Ecological and Human Health.")
High Blood Lead Levels in Chinese Children
In August 2006, long unchecked emissions from a smelting plant in Huixian County of Gansu Province in northwest China sickened thousands, of which 334 children were found to have excessive lead in their bloods and among them 62 were confirmed to suffer from lead poisoning.  An unpublished study by researchers with the Chinese Medical Association noted that of the 11,348 schoolchildren tested in Shenzhen, 65 percent had an "unsafe" BLL above 10 µg/dL. 
The majority of studies in China have focused on the BLL of children in individual provinces and cities. A literature review carried out by researchers in Beijing of 1994-2004 studies attempted to achieve a greater understanding of trends throughout the country. One of the review's findings was that children living in urban or industrial areas had significantly higher BLL than those living in rural areas.  (See Table 1).
Lead notably persists in the environment and can bioaccumulate in bodies, with effects long after the initial source of lead is gone. Thus, even if China were to completely stop using lead tomorrow, lead has long-term implications beyond a drop in IQ points. Recent studies indicate that increased mental deterioration may be linked to lead exposure decades prior.  Lead exposure today or in the past can also cause the loss of potential economic gain because of cognitive impairment for individuals who have been exposed. This in turn has a trickle-up effect on the nation's educational and economic capital as a whole.
But the situation may be getting better. Experts believe that children's BLL will begin to decrease over time as China continues to clean up its environment, invest in and develop cleaner technologies, and improve enforcement of its regulations.  A study presented by Zhang Yanfeng of the Capital Institute of Pediatrics in Beijing at the International Conference on Children, Health, and the Environment in 2007 provides some evidence of that. The researchers sampled blood of children ages 0-6 in 14 Chinese cities over the span of three years, beginning in 2004. While there was no statistically significant difference between the average BLL from year to year (with a geometric mean of 46.89µg/L), there was a significant drop in the prevalence of elevated BLL (>100µg/L).  (See Tables 2 and 3)
There is a great need for a national study to understand how widespread and serious lead contamination is in China's environment and to what degree it is affecting human health (particularly children). The 2006 Beijing literature review attempted to do so, but it relied solely on individual studies carried out in very limited geographic areas. In the 1990s, the U.S. Environmental Protection Agency worked with its Chinese counterparts to gather health data and successfully phase out leaded gasoline by the year 2000; however, there is still great opportunity for U.S. data collection organizations to work with Chinese groups build the quality and quantity of data on lead and children's health in China. Having a the national picture of lead exposure would provide the basis for a national strategy to attempt to mitigate the problem.
Debbie Yan Lee received her Master of Public Policy from the School of Public Policy at the University of Maryland, specializing in environmental policy. She is currently a program associate at the Washington, D.C.-based nonprofit facilitator RESOLVE, Inc. She can be reached at firstname.lastname@example.org.
Jing Chen—a summer 2008 research intern with the China Environment Forum—is a Ph.D. student in the Department of Government and Politics at the University of Maryland, College Park. She can be reached at email@example.com.
 Thuppil Venkatesh, "Effect of Environmental Lead on the Health Status of Women and Children in Developing Countries," presented at the International Conference on Children, Health and Environment, June 2007, Vienna. http://inchesnetwork.net/Lead_Venkatesh.pdf
 David Barbosa, "Why all the lead in Chinese-made goods?" Taipei Times 13 September 2007. http://www.taipeitimes.com/News/editorials/archives/2007/09/13/2003378572
 Cynthia Washam, 2002, "Lead Challenges China's Children," Environmental Health Perspectives 110(10): A 567. http://www.ehponline.org/docs/2002/110-10/forum.html
 Xiz Huo, Lin Peng, Xijin Xu, Liangkai Zheng, Bo Qiu, Zongli Qi, Bao Zhang, Dai Han, and Zhonxian Piao, 2007, "Elevated Blood Lead Levels of Children in Guiyu, and Electronic Waste Recycling Town in China," Environmental Health Perspectives 115(7): 1113-1117. http://www.ehponline.org/docs/2007/9697/abstract.html".
 "62 Children Confirmed to Have Lead Poisoning," China Daily October 10, 2006. Online http://www.china.org.cn/english/government/183353.htm
 Cynthia Washam, "Lead Challenges China's Children," Environmental Health Perspectives, Vol. 110, 2002, Online http://www.questia.com/googleScholar.qst?docId=5000676662.
 "Lead pollution by gasoline – a persisting problem," EVISA, 18 July 2006, Online http://www.speciation.net/Public/News/2006/07/18/2228.html.
Shunqin Wang and Jinliang Zhang, 2006, "Review: Blood lead levels in children, China," Environmental Research 101: 412.
 Malcolm Ritter, "Lead Linked to Aging in Older Brains," Associated Press, 27 January 2007, Online http://ap.google.com/article/ALeqM5i2HzspLEIip5vX5M5okbrd3arPKQD8UEBSGG0.
 Zhang Yanfeng, "Blood Lead Level of Chinese Children (0-6 years old)," presented at International Conference on Children, Health, and Environment, June 2007, Vienna.