This year, we report on six soil pollutants that pose an outsized threat to human health. The top six threats — lead, radionuclides, mercury, hexavalent chromium, pesticides and cadmium — collectively affect the health of 95 million people and account for 14.7 million Disability Adjusted Life Years (DALYs) lost in low- and middle-income countries. Exposure to these pollutants result in debilitating and life-threatening diseases, especially in children. “These top six toxic threats clearly stand out among the others around the world”, says Richard Fuller, President of Pure Earth. “They affect more people, at more sites, and at a more concentrated dose than other pollutants.”
For the first time, it is possible to provide both population at risk figures and estimated Disability Adjusted Life Years (DALYs) for the Top Six Toxins.
*Estimate includes 800k to 1 million at risk based on point source exposure to radionuclides derived from 91 identified sites in the Toxic Sites Identification Program.
“The toxicological profiles of the top six are well-defined and severe,” says Dr. Jack Caravanos, Pure Earth Research Director. “In almost all cases, affordable interventions exist to mitigate the worst exposures from sites exhibiting these contaminants.”
There is one change in this year’s top six list: cadmium replaces arsenic. Both are very serious toxic pollutants, but the story of arsenic is much complicated by the enormous extent of the problems caused by use of groundwater from aquifers contaminated by naturally released arsenic.
The impact numbers presented are based primarily on accumulated experience in assessing sites. “Over the past seven years, our teams have visited some 2,300 sites in 49 countries,” explains Caravanos. “This experience has given us a unique insight into the pollution profiles of certain industries and areas.”
Transition from Communicable to Chronic
This year’s analysis, building on a decade of effort, also reveals an important shift in the burden of disease around the world. As progress is made combating communicable diseases such as HIV and tuberculosis, the relative importance of chronic, non-communicable disease is emerging. Pollution is now widely accepted as one of the key risk factors for non-communicable disease (NCD).
The World Health Organization has estimated that by 2020, NCDs will be responsible for 80 percent of the global burden of disease. “Exposure to toxic pollution largely contributes to the prevalence of chronic diseases in affected populations”, explains Fuller. “Deadly toxins that are continually discharged into the environment via poorly managed industrial processes, saturate soil, water, air and crops—and make their way into the bodies of workers while thoroughly contaminating nearby communities.”
DALYs Increase our Understanding of the Impact of Toxins on Human Health
The 2012 Worst Polluted report established the first set of figures for the health burden of toxic pollution at contaminated sites, by estimating for this pollution — the basic parameter developed by the World Health Organization for assessing the Global Burden of Disease — the Disability Adjusted Life Year or DALY. In the years since then, these DALY estimates have been expanded and refined, resulting in broad acceptance by the international health community of this evidence of the impacts of toxic pollutants. Seeing the aggregate of years of life lost due to exposure to these toxicants, presents a more complete understanding of their impact.
Rapid Globalization Threatens Health, Developing Economies Need Environmental Assistance
“Low- and middle-income countries continue to grapple with the health consequences of exposure to these pollutants, often driven by rapid globalization and the export of polluting industries,” says Stephan Robinson, Executive Director, Green Cross Switzerland. “Pure Earth and Green Cross Switzerland continue to raise awareness of these pollution issues, conduct intervention and outreach programs, and find low cost solutions to perform site remediation.” Each of the pollutants described affect the health and lives of millions globally, often an end product of the livelihoods that sustain them. “Efforts also include assisting governments to shift industrial processes to safer, more sustainable methods that can ensure the livelihoods of millions, while reducing the health impacts and suffering of both workers and families,” says David Hanrahan, Pure Earth Senior Economic and Engineering Advisor.
Minimal Progress, Cause for Hope
Although little progress has been made in remediating sites with the worst toxins since publishing the Top Six in 2010, recent developments point to a shift beginning to take place.
SDG’s: After much effort and debate, the UN General Assembly approved the Sustainable Development Goals (SDGs), including a goal to reduce the health consequences of all forms of pollution – soil, water and air – broadened from the initial goal addressing only air pollution.
PMEH: The World Bank recently announced the formation of the Pollution Management and Environmental Health (PMEH) program to assist countries with pollution management planning and infrastructure.
Global Commission on Pollution, Health and Development:This new commission is a partnership of the medical journalThe Lancet, the Global Alliance on Health and Pollution and the Icahn School of Medicine at Mount Sinai, and comprises the world’s most influential leaders, researchers and practitioners in the fields of pollution management, environmental health and sustainable development. “The Commission aims not just to inform the public dialogue, and increase awareness,” explains Fuller, “but to lay the foundation for solving the global pollution problem by defining pollution’s many effects on health, economics, and development, and then presenting these data to world leaders to raise the priority of pollution control in the international development agenda and thus increase the resources allocated to this pressing global health problem.”
These global steps forward demonstrate a very welcome movement by the international community to prioritize and take action on toxic pollution. International organizations can support local and national actions with technical and financial resources but in the end, it is national and local governments that must take the substantive actions on the ground.