While the global use of lead has decreased, paint sold across Asia still contains excessive levels of the toxic substance. Meanwhile, awareness of the risks and health consequences from lead exposure remains inadequate.
With the almost complete phase-out of leaded petrol worldwide, attention has turned to other sources of lead exposure and its deadly effect on humans. Statistics from a 2013 New York University report on the cost of lead exposure to the economies of developing countries reveal that consumption of the damaging element has increased since 1970, despite the fact that lead petrol has been almost entirely phased out.
One way that people who, despite having no connection to industries where they might be directly exposed to lead are still consuming huge amounts of it, is through paint.
Lead is used in paint because it makes it less susceptible to cracking and increases its opacity. It is also used to intensify colors, meaning the brighter the color of the paint the higher concentrations of lead it is likely to have. Lead is also used to speed up drying times and to stop rust.
But the danger doesn't start until years after the paint has dried and begins to wear. Dust from paint flakes or the sanding of painted surfaces creates lead-filled particles that can be inhaled, and collect in people's systems.
Dr Sara Brosché from IPEN, a global organization working to eliminate toxic substances around the world, says the reasons why lead is still being used in Asia are a lack of knowledge of the dangers and a reluctance to change, "because that is how they have always done it."
While globally the paint industry has contracted, the opposite has occurred in Asia which is now the biggest paint market in the world. Brosché says that while low income earners typically do not live in painted homes, "with rising incomes and an emerging middle class, the number of people who can afford painted interiors and exteriors in their homes and schools has been increasing dramatically."
According to the World Health Organization (WHO), just 30 countries have completely phased out the use of lead in paints, and most other places have some sort of guidelines around the substance. The "Global Alliance to Eliminate Lead Paint" run by the WHO and the UN Environment Program (UNEP) aims to raise that figure to 70 by next year.
Meanwhile figures from the European Union and IPEN's 2014 Asia Regional Paint Report show that while countries such as the Philippines have introduced regulations, overwhelmingly paints sold in Asia still contain excessive lead levels.
Worse still, Brosché says none of the paints found to contain lead in the research had any warnings on their labels.
Despite industry making up the majority of users of high lead products in Asia, the problem is exacerbated by the fact that industrial and residential living areas are growing geographically closer together. This has been highlighted in China, with a series of cases in recent years of mass lead poisonings, with the victims living nearby to factories.
Even cookware has been shown to contain lead. Published in August of this year a study by Ashland University in the United States revealed the excessive amounts of lead that can leach out of metal used for cooking when it is heated up. Across Africa and Asia cookware and utensils made of scrap metal are commonplace, and can include parts from cars and materials used in construction.
The report's authors refer to the high numbers of people exposed to lead as a "global lead poisoning epidemic," and stress that cookware is just one of a number of factors contributing to lead exposure.
Even limited contact with lead, at levels earlier regarded safe by the WHO and without any external symptoms, can cause irreversible health consequences. These can include kidney damage, high blood pressure, and an increased risk of cardiovascular diseases. Pregnant women with a build up of lead in their systems can pass on toxic side effects to their unborn children.
However, it is young children who are most at risk. A report from the New York-based environmental research organization the Blacksmith Institute showed that many children who were exposed to lead during their childhoods grew up to have lower IQs, and that this and other damage to the brain "is permanent and irreversible and that there is no current form of medical treatment that can reverse the brain injury caused by lead once this injury has occurred."
High levels of lead exposure can cause comas, convulsions and even death, with children who survive these conditions likely left with permanent physical and mental injury.
The WHO attributes around 600,000 new cases of intellectual disabilities in children to lead exposure every year.
In a study published in 2013 by New York University, the total cost to Asia's economy was calculated at around 700 billion USD, compared to 134.7 billion USD in Africa and 142.3 billion USD in Latin America and the Caribbean. The report's authors say East and Southeast Asia make up the bulk of this shortfall, and the "burden of lead-associated disability and economic cost is now borne by developing countries."
The cheapest public health intervention
While regulations around lead were introduced in most parts of the world in the 1970s and 80s, a 2012 UNEP and IPEN survey showed large parts of Asia continued to ignore or under-regulate the issue.
The 2014 report on the Asia lead paint elimination project states that "a few countries in Asia do regulate the allowed lead content in decorative paints," including Singapore and Sri Lanka. Other places have voluntary standards, such as Thailand whose regulation calls for paints to include less than 100 parts per million (ppm) of lead. But tests conducted by the Ecology Alert and Recovery Thailand Foundation showed that despite the alleged checks, most paints still contained levels higher than this.
Other experts say the problem is the developing world is always playing catch-up, and the infrastructure needed to test and properly regulate the use of lead across the country just doesn't exist.
Low public awareness is another factor stopping manufacturers from switching from lead to less dangerous additives. Johnson Ongking, vice-president of one of Indonesia's largest paint companies, Boysen Paints, agrees with this, admitting they simply didn't realize the danger. "Honestly, we just weren't that aware of the hazards of lead in paint." Since 2007 the company has phased out lead completely from its range.
Jack Weinberg, Senior Policy Advisor with IPEN is more blunt. He says there is one reason the issue hasn't yet been solved: laziness.
He dismisses the argument that using lead saves money on production costs for manufacturers, saying the savings are marginal at best.
Research from IPEN's Regional Paint Report supports this view, calling the costs involved in reformulating paints to avoid adding lead "minimal." Their research showed the majority of suppliers that had eliminated the deadly element hadn't raised the price of their paints.
Weinberg says intervention now will save costs in the long run. "Eliminating lead paint is about the cheapest public health intervention with the greatest public health benefit imaginable."
Dr Leonardo Trasande has a similiar view. The expert says that in order to avoid future complications arising from childhood lead exposure - such as continuing medical care - action must be taken now. "The only way to avoid the large economic costs related to lead exposure is primary prevention," he says.
According to IPEN the best way to get rid of lead in paint once and for all is through binding legal requirements, company-mandated action and national certification schemes in each country. Brosché is also confident. "It is absolutely possible to eliminate dangerous levels of lead in paint," she says.