Conclusions and way forward

As lead-acid batteries are the fastest growing segment of lead usage, there will be a continuing demand for lead. Economics dictate that lead batteries will be recycled to augment supplies that come from mining sources (UNEP, 2013). Lead can be recycled indefinitely, although there are some losses at each stage, the amount depending on the efficiency of the recycling process. Informal recycling is particularly inefficient in terms of lead losses; moreover the purity of the final product is poor. Lead mining uses large amounts of energy and environmental resources, particularly water. It causes significant environmental degradation and loss of habitat as well as generating large amounts of contaminated waste tailings.


The environmental impact of recycling is potentially much less, for example, recycling lead saves approximately 55–65% of the energy used in mining and processing (UNEP, 2013). Provided it is carried out using appropriate technologies and to an adequate environmental standard, recycling can have less impact on the environment and on human health than mining. As this document indicates, recycling lead-acid batteries must be carried out with care to minimize environmental contamination and protect the health of workers and communities. While much of the responsibility for ensuring the sound management of used lead-acid batteries lies with the environment sector, the health sector must also play its part. This includes ensuring that health-care practitioners have training on, and resources for, the diagnosis and management of lead poisoning, educating local communities on the health hazards of lead, and taking action to inform the responsible authorities when lead poisoning associated with recycling is discovered. Furthermore, health ministries should aim to ensure the availability of laboratory capacity for blood lead testing and should work with industry to reduce employee exposures.


AGENDA (2016) Used lead acid battery (ULAB) recycling in Tanzania: survey report. Dar es Salaam: AGENDA for Environment and Responsible Development; 2016 (, accessed 3 January 2017). 

Al Khayat A, Menon NS, Alidina MR (1997) Acute lead encephalopathy in early infancy – clinical presentation and outcome. Annals Tropical Paediatrics. 1997; 17(1):39-44. ATSDR (2007) Toxicological profile for lead. Atlanta (GA): Agency for Toxic Substances and Disease Registry; 2007 ( tp13.pdf, accessed 3 January 2017). 

ATSDR (2015) Case studies in environmental medicine: Taking an exposure history. Atlanta (GA): Agency for Toxic Substances and Disease Registry; 2015 (, accessed 3 January 2017).

 Attina TM, Trasande L (2013). Economic costs of childhood lead exposure in low- and middle-income countries. Environmental Health Perspectives. 2013; 121:1097–1102 (, accessed 3 January 2017).

 Baker EL, Folland DS, Taylor TA, Frank M, Peterson W, Lovejoy G, Cox D, Housworth J, Landrigan PJ (1977). Lead poisoning in children of lead workers: home contamination with industrial dust. New England Journal of Medicine. 1997; 296(5):260–261 ( NEJM197702032960507, accessed 3 January 2017).

Barbosa F, Tanus-Santos JE, Gerlach RF, Parsons PJ (2005). A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environmental Health Perspectives. 2005; 113(12):1669–1674 (, accessed 3 January 2017).

 Barry PSI (1975). Comparison of concentrations of lead in human tissues. British Journal of Industrial Medicine. 1975; 32:119–139 (https://www.ncbi.nlm., accessed 3 January 2017).

Bartlett ES, Trasande L (2014). Economic impacts of environmentally attributable childhood health outcomes in the European Union. European Journal of Public Health. 2014; 24(1):21-26 ( long, accessed 3 January 2017).

 Bastrup-Madsen P (1950). Dimercaprol in acute lead poisoning. Lancet. 1950; 2(5):171-172 ( S0140673650911494, accessed 3 January 2017). 

Belay M, Belay A, Genet Z (2015). Safety practices and awareness of lead acid battery recyclers in Addis Ababa, Ethiopia. Addis Ababa: Pesticide Action Nexus Association; 2015 (, accessed 3 January 2017). 

Bellinger DC (2004a). Lead. Pediatrics. 2004; 113(4, Supplement 3):1016- 1022 (, accessed 3 January 2017).

 Bellinger DC (2004b). What is an adverse effect? A possible resolution of clinical and epidemiological perspectives on neurobehavioral toxicity. Environmental Research. 2004; 95:394-405. Bhattacharya A, Shukla R, Bornschein RL, Dietrich KN & Keith R (1990). Lead effects on postural balance of children. Environmental Health Perspectives. 1990; 89:35-42 ( envhper00422-0036.pdf, accessed 3 January 2017). 

Blacksmith Institute (2009). The problem. In: Pollutant: Lead [website]. New York: Blacksmith Institute; 2009 ( html, accessed 3 January 2017). 

Bleecker ML, Ford DP, Lindgren KN, Hoese VM, Walsh KS, Vaughan CG (2005). Differential effects of lead exposure on components of verbal memory. Occupational & Environmental Medicine. 2005; 62(3):181-187 (http://oem., accessed 3 January 2017).

 California Environmental Protection Agency (2015). DTSC announces order to close Exide facility and steps to protect community with enhanced cleanup. Department of Toxic Substances Control News Release, March 12 2015. Available at (, accessed 3 January 2017). 

Cavalleri A, Trimarchi F, Gelmi C, Baruffini A, Minoia C, Biscaldi G, Gallo G (1982). Effects of lead on the visual system of occupationally exposed subjects. Scandinavian Journal of Work Environment & Health. 1982; 8(Suppl 1):148-151. CDC (2010). Guidelines for the identification and management of lead exposure in pregnant and lactating women. Atlanta (GA): US Centers for Disease Control and Prevention; 2010 ( leadandpregnancy2010.pdf, accessed 3 January 2017). 

CDC (2012). Low level lead exposure harms children: A renewed call for primary prevention. Atlanta (GA): US Centers for Disease Control and Prevention; 2012 (, accessed 3 January 2017). 

CDC (2013). Guidelines for measuring lead in blood using point of care instruments. Atlanta (GA): US Centers for Disease Control and Prevention; 2013 ( pdf, accessed 3 January 2017). 

CEC (2016). Environmentally sound management of spent lead-acid batteries in North America: Technical guidelines. Montreal: Commission for Environmental Cooperation; 2016 (in English, French & Spanish) ( en/item/11665-environmentally-sound-management-spent-lead-acid-batteriesin-north-america, accessed 25 January 2017)

 Chen SS, Chen TJ, Lin CH, Tseng YT, Lai SL (2005). Neurobehavioral changes in Taiwanese lead-exposed workers. Journal of Occupational & Environmental Medicine. 2005; 47:902-908. Cheng Y, Schwartz J, Sparrow D, Aro A, Weiss ST, Hu H (2001). Bone lead and blood lead levels in relation to baseline blood pressure and the prospective development of hypertension: the Normative Aging Study. American Journal of Epidemiology. 2001; 153(2):164-171 ( content/153/2/164.full.pdf+html, accessed 3 January 2017). 

Chia SE, Chia HP, Ong CN, Jeyaratnam J (1996). Cumulative concentrations of blood lead and postural stability. Occupational & Environmental Medicine. 1996; 53:264-268 (, accessed 3 January 2017).

 Chia SE, Chia HP, Ong CN, Jeyaratnam J (1997). Cumulative blood lead levels and neurobehavioral test performance. Neurotoxicology. 1997; 18(3):793-803. Chisolm JJ Jr, Barltrop D (1979). Recognition and management of children with increased lead absorption. Archives of Diseases of Childhood. 1979; 54(4):249-262 ( archdisch00794-0005.pdf, accessed 3 January 2017). 

Chisolm JJ Jr (1978). Fouling one’s own nest. Pediatrics. 1978; 62:614–617. CLSI (2013). Measurement procedures for the determination of lead concentrations in blood and urine; approved guidelines - 2nd edition. CLSI document C40-A2. Wayne (PA): Clinical and Laboratory Standards Institute; 2013. CREPD (2015). Baseline study about facts in waste lead-acid battery recycling in Cameroon. Yaoundé: Centre de Recherche et d’Education pour le Développement; 2015 (, accessed 3 January 2017). 

Cullen MR, Robins JM, Eskenazi B (1983). Adult inorganic lead intoxication: Presentation of 31 new cases and a review of recent advances in the literature. Medicine. 1983; 62:221-247. Daniell WE, Tung LV, Wallace RM, Havens DJ, Karr CJ, Diep NB, Croteau GA, Beaudet NJ, Bao ND (2015). Childhood lead exposure from battery recycling in Vietnam. BioMed Research International. 2015; Article ID 193715 (http://, accessed 3 January 2017). 

Demetriades A, Birke M (2015). Urban geochemical mapping manual: Sampling, Sample preparation, Laboratory analysis, Quality control check, Statistical processing and map plotting. Brussels: EuroGeoSurveys; 2015 (http:// Mapping_Manual.pdf, accessed 3 January 2017).

 Dietrich KN, Ris MD, Succop PA, Berger OG, Bornschein RL (2001). Early exposure to lead and juvenile delinquency. Neurotoxicology & Teratology. 2001; 23(6):511-518 ( S0892036201001842, accessed 3 January 2017).

 EC (1998). Council Directive 98/24/EC of 7 April 1998 on the protection of the health and safety of workers from the risks related to chemical agents at work (fourteenth individual Directive within the meaning of Article 16(1) of Directive 89/391/EEC). Official Journal 5 May 1998; L 131, 41:11-23 (http://eur-lex., accessed 3 January 2017). 

EC (2008). Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe. Official Journal 11 June 2008, L 152, 51:1-44 ( do?uri=OJ:L:2008:152:0001:0044:en:PDF, accessed 3 January 2017).

 Ettinger AS, Roy A, Amarasiriwardena CJ, Smith D, Lupoli N, Mercado-García A, Lamadrid-Figueroa H, Tellez-Rojo MM, Hu H, Hernández-Avila M (2014). Maternal blood, plasma, and breast milk lead: lactational transfer and contribution to infant exposure. Environmental Health Perspectives. 2014; 122:87–92 (https://, accessed 3 January 2017).

 Ettinger AS, Tellez-Rojo MM, Amarasiriwardena C, Gonzalez-Cossio T, Peterson KE, Aro A, Hu H & Hernandez-Avila M (2004). Levels of lead in breast milk and their relation to maternal blood and bone lead levels at one month postpartum. Environmental Health Perspectives. 2004; 112:926-931 (https://www.ncbi.nlm., accessed 3 January 2017). 

EURO (1999). Monitoring ambient air quality for health impact assessment. Copenhagen: WHO Regional Office for Europe; 1999 (http://www.euro.who. int/data/assets/pdf_file/0010/119674/E67902.pdf, accessed 3 January 2017). 

EUROBAT (2013). Battery Associations from North America and Europe, the Middle East and Africa join forces to strengthen workers’ protection. Press release 19 June 2013 (, accessed 26 January 2017). 

FAO (2016). General standard for contaminants and toxins in food and feed (Codex Stan 193-1995). Rome: Food and Agriculture Organization; 2016 ( en/?lnk=1&  ntaminants and toxins in food and feed (Codex Stan 193-1995). Rome: Food and Agriculture Organization; 2016 ( en/?lnk=1& RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS / 37 odex%252FStandards%252FCODEX%2BSTAN%2B193-1995%252FCXS_193e. pdf, accessed 3 January 2017). Fergusson DM, Horwood LJ (1993). The effects of lead levels on the growth of word recognition in middle childhood. International Journal of Epidemiology. 1993; 22:891-897. Fergusson DM, Horwood LJ, Lynskey MT (1997). Early dentine lead levels and educational outcomes at 18 years. Journal of Child Psychology & Psychiatry. 1997; 38:471-478. Fewtrell L, Kaufmann R, Prüss-Ustün A (2003). Lead – Assessing the environmental burden of disease at national and local levels. Environmental Burden of Disease Series, No.2. Geneva: World Health Organization; 2003 ( quantifying_ehimpacts/publications/en/, accessed 3 January 2017).

 Frith D, Yeung K, Thrush S, Hunt BJ, Hubbard JG (2005). Lead poisoning – a differential diagnosis for abdominal pain. Lancet. 2005; 366:2146 (http://www., accessed 3 January 2017). 

Future Market Insights (2014). Lead Acid Battery Market: Global Industry Analysis and Opportunity Assessment 2014 – 2020 [website] ( http://www., accessed 3 January 2017). 

Garza A, Vega R, Soto E (2006). Cellular mechanisms of lead neurotoxicity. Medical Science Monitor. 2006; 12:RA57-65 ( download/index/idArt/447121, accessed 3 January 2017). Gerr F, Letz R, Stokes L, Chettle D, McNeill F, Kaye W (2002). Association between bone lead concentration and blood pressure among young adults. American Journal of Industrial Medicine. 2002; 42(2):98-106. Gottesfeld P & Pokhrel, AK (2011). Review: lead exposure in battery manufacturing and recycling in developing countries and among children in nearby communities. Journal of Occupational & Environmental Hygiene. 2011; 8(9):520-532. Graziano JH, Popovac D, Factor-Litvak P, Shrout P, Kline J, Murphy MJ, Zhao YH, Mehmeti A, Ahmedi X, Rajovic B, Zvicer A, Nenezic DU, Lolacono NJ, Stein Z (1990). Determinants of elevated blood lead during pregnancy in a population surrounding a lead smelter in Kosovo, Yugoslavia. Environmental Health Perspectives. 1990; 89:95-100 ( articles/PMC1567790/pdf/envhper00422-0095.pdf, accessed 3 January 2017). Green VA, Wise GW, Callenbach J (1976). Lead poisoning. Clinical Toxicology. 1976; 9:33-51. Greig J, Thurtle N, Cooney L et al. (2014). Association of blood lead level with neurological features in 972 children affected by an acute severe lead poisoning outbreak in Zamfara State, Northern Nigeria. PLoS ONE 9(4): e93716. (http://, accessed 3 January 2017).

 38 / RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS Gulson BL, Mizon KJ, Korsch MJ, Palmer JM, Donnelly JB (2003). Mobilization of lead from human bone tissue during pregnancy and lactation — a summary of long-term research. Science of the Total Environment. 2003; 303:79-104. Haefliger P, Mathieu-Nolf M, Lociciro S, Ndiaye C, Coly M, Diouf A, Faye AL, Sow A, Tempowski J, Pronczuk J, Filipe Junior AP, Bertollini R, Neira M (2009). Mass lead intoxication from informal used lead-acid battery recycling in Dakar, Senegal. Environmental Health Perspectives. 2009; 117(10):1535-1540 (https://, accessed 3 January 2017).

 Haut Conseil de la santé publique (2014). Détermination de nouveaux objectifs de gestion des expositions au plomb. Synthèse et recommandations. Paris: Haut Conseil de la santé publique; 2014 ( avisrapportsdomaine?clefr=444, accessed 3 January 2017). Healey N, Jones-Otazo H, Walker M, Knafla A (2010). Toxicological review and recommended toxicological reference values for environmental lead exposure in Canada. Report prepared for Health Canada ( php?option=com_docman&task=doc_details&gid=21069&Itemid=270&lang=en, accessed 3 January 2017)

 Health Canada (2013). Final human health state of the science report on lead. Ottawa: Health Canada; 2013 ( contaminants/dhhssrl-rpecscepsh/index-eng.php, accessed 3 January 2017). 

Hodge J, Nielsen J, Dignam T, Brown MJ (2015). Small area surveillance to estimate prevalence of childhood blood and environmental lead levels. Atlanta (GA): US Centers for Disease Control and Prevention; 2015 (http://www.cdc. gov/nceh/lead/BLL_PrevalenceStudy_TrainingManual_Final_508.pdf, accessed 3 January 2017).

 IHME (2016). Global lead exposure. In: GBD Compare [website]. Seattle (WA): Institute for Health Metrics and Evaluation, University of Washington; 2016 (, accessed 3 January 2017).

 ILA (2015). Lead recycling fact sheet. London: International Lead Association; 2015 ( pdf, accessed 3 January 2017).

 ILA (2017) Lead use statistics. In: Lead facts [website] (http://www.ila-lead. org/lead-facts/lead-uses--statistics, accessed 8 June 2017). 

Metals Study Groups (2016). Metals Despatch. 2016; Issue No 21 ( type=N&from=1, accessed 3 January 2017). 

Iwata T, Yano E, Karita K, Dakeishi M, Murata K (2005). Critical dose of lead affecting postural balance in workers. American Journal of Industrial Medicine. 2005; 48(5):319-325. Janin Y, Couinaud C, Stone A, Wise L (1985). The “lead-induced colic” syndrome in lead intoxication. Surgery Annual. 1985; 17:287-307. RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS / 39 JECFA (2011). Safety evaluation of certain food additives and contaminants. WHO Food Additive Series: 64. 73rd Report of the Joint FAO/WHO Expert Committee on Food Additives, pages 381-497. Geneva: World Health Organization; 2011 ( pdf, accessed 3 January 2017).

 Jennings AA (2013). Analysis of worldwide regulatory guidance values for the most commonly regulated elemental surface soil contamination. Journal of Environmental Management. 2013; 118: 72–95 Kabala C, Singh BR (2001). Fractionation and mobility of copper, lead, and zinc in soil profiles in the vicinity of a copper smelter. Journal of Environmental Quality. 2001; 30(2):485-492 ( pdf, accessed 26 January 2017).

 Kaul B, Mukerjee H (1999). Elevated blood lead and erythrocyte protoporphyrin levels of children near a battery-recycling plant in Haina, Dominican Republic. International Journal of Occupational & Environmental Health. 1999; 5(4):307- 312. Kaul B, Sandhu RS, Depratt C, Reyes F (1999). Follow-up screening of leadpoisoned children near an auto battery recycling plant, Haina, Dominican Republic. Environmental Health Perspectives. 1999; 107(11):917–920 (https://, accessed 3 January 2017).

 Koller K, Brown T, Spurgeon A, Levy L (2004). Recent developments in low-level lead exposure and intellectual impairment in children. Environmental Health Perspectives. 2004; 112(9):987-994 ( articles/PMC1247191/pdf/ehp0112-000987.pdf, accessed 3 January 2017). Kosnett MJ, Wedeen RP, Rothenburg SJ, Hipkins KL, Materna BL, Schwartz BS, Hu H, Woolf A (2007). Recommendations for medical management of adult lead exposure. Environmental Health Perspectives. 2007; 115(3):463- 471 ( 000463.pdf, accessed 26 January 2017). Lanphear BP, Hornung R, Khoury J, Yolton K, Baghurst P, Bellinger DC, Canfield RL, Dietrich KN, Bornschein R, Greene T, Rothenberg SJ, Needleman HL, Schnaas L, Wasserman G, Graziano J, Roberts R. (2005). Low-level environmental lead exposure and children’s intellectual function: an international pooled analysis. Environmental Health Perspectives.2005; 113(7):894–899. (https://www.ncbi., accessed 3 January 2017).

 Levallois P, Lavoie M, Goulet L, Nanel AJ, Gingras S (1991). Blood lead levels in children and pregnant women living near a lead-reclamation plant. Canadian Medical Association Journal. 1991; 144(7): 877-885. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration (2002). Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360(9349):1903-1913 (http://www.; Erratum 40 / RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS in: Lancet. 2003; 361(9362):1060 article/PIIS0140-6736(03)12816-4/fulltext, accessed 3 January 2017). 

Lidsky TI, Schneider JS (2003). Lead neurotoxicity in children: basic mechanisms and clinical correlates. Brain. 2003; 126:5-19 ( content/126/1/5.long, accessed 3 January 2017).

 Loghman-Adham M (1997). Renal effects of environmental and occupational lead exposure. Environmental Health Perspectives. 1997; 105:928-939 (https:// pdf, accessed 3 January 2017).

 Manhart A, Schleicher T (2015). The recycling chain for used lead-acid batteries in Ghana. Freiburg: Oeko-Institut; 2015 ( php?id=3, accessed 3 January 2017).

 Manhart A, Smera T, Kuepouo G, Mathai D, Mng’anya S, Schleicher T (2016). The deadly business – findings from the lead recycling Africa project. Freiburg: Oeko-Institut; 2016 (, accessed 3 January 2017). 

Markowitz ME, Weinberger HL (1990). Immobilization-related lead toxicity in previously lead-poisoned children. Pediatrics 1990; 86:455-457 (http://, accessed 3 January 2017).

 Matte TD, Figueroa JP, Ostrowski S, Burr G, Jackson-Hunt L, Baker EL (1991). Lead exposure from conventional and cottage lead smelting in Jamaica. Archives of Environmental Contamination & Toxicology. 1991; 21:65–71. McNutt TK, Chambers-Emerson J, Dethlefsen M, Shah R (2001). Bite the bullet: lead poisoning after ingestion of 206 lead bullets. Veterinary & Human Toxicology. 2001; 43:288-289. Mendelsohn AL, Dreyer BP, Fierman AH, Rosen CM, Legano LA, Kruger HA, Lim SW, Courtlandt CD (1998). Low-level lead exposure and behavior in early childhood. Pediatrics. 1998; 101:E10 ( content/pediatrics/101/3/e10.full.pdf, accessed 3 January 2017).

 Mielke HW, Reagan PL (1998). Soil is an important pathway of human lead exposure. Environmental Health Perspectives. 1998; 106(Suppl 1):217-229 (https://www., accessed 3 January 2017).

 MoEP (2012). Ambient air quality standards GB 3095-2012. Beijing: Ministry of Environmental Protection; 2012 ( dqhjzlbz/201203/W020120410330232398521.pdf, accessed 3 January 2017). 

Mushak P (1993). New directions in the toxicokinetics of human lead exposure. Neurotoxicology. 1993; 14:29-42. NAS (1972). Lead: airborne lead in perspective. Committee on Biologic Effects of Atmospheric Pollutants, Division of Medical Sciences. Washington (DC): National Academy of Sciences; 1972. RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS / 41 Nawrot TS, Thijs L, Den Hond EM, Roels HA, Staessen JA (2002). An epidemiological re-appraisal of the association between blood pressure and blood lead: a metaanalysis. Journal of Human Hypertension. 2002; 16:123-131 (http://www., accessed 3 January 2017). 

Needleman H (2004). Lead poisoning. Annual Review of Medicine. 2004; 55:209- 222. Needleman HL, Riess JA, Tobin MJ, Biesecker G, Greenhouse JB (1996). Bone lead levels and delinquent behavior. JAMA. 1996; 275:363-369. Needleman HL, Schell A, Bellinger D, Leviton A, Allred EN (1990). The long-term effects of exposure to low doses of lead in childhood. An 11-year follow-up report. New England Journal of Medicine. 1990; 322:83-88 ( full/10.1056/NEJM199001113220203#t=article, accessed 3 January 2017). 

NEPC (2016). National Environment Protection (Ambient Air Quality) Measure. Canberra: National Environment Protection Council; 2016 (https://www.legislation., accessed 3 January 2017).

 NTP (2012). Health effects of low-level lead. National Toxicology Program Monograph. Bethesda (MD): National Institutes of Health; 2012 (http://ntp., accessed 3 January 2017).

 OSHA (1978). Lead Standard 29 CFR 1910.1025. Washington (DC): Occupational Safety and Health Administration, US Department of Labor; 1978. (https://www. id=10030, accessed 3 January 2017). 

OSHA (2002) Lead – secondary lead smelter. In: eTools [website]. Washington (DC): Occupational Safety and Health Administration; 2002 (https://www.osha. gov/SLTC/etools/leadsmelter/index.html, accessed 3 January 2017). 

Otto DA, Fox DA (1993). Auditory and visual dysfunction following lead exposure. Neurotoxicology. 1993; 14(2-3):191-207. Paddock RC (2016). The toxic toll of Indonesia’s battery recyclers. National Geographic. 31 May 2016 ( indonesia-s-toxic-toll/, accessed 3 January 2017). 

Perlstein MA, Attala R (1966). Neurologic sequelae of plumbism in children. Clinical Pediatrics. 1966; 5:292-298. Pichery C, Bellanger M, Zmirou-Navier D, Glorennec P, Hartemann P, Grandjean P (2011). Childhood lead exposure in France: benefit estimation and partial cost-benefit analysis of lead hazard control. Environmental Health. 2011; 10:44 (, accessed 3 January 2017).

 Rabinowitz MB (1991). Toxicokinetics of bone lead. Environmental Health Perspectives. 1992; 91:33-37 ( PMC1519353/pdf/envhper00387-0038.pdf, accessed 3 January 2017). 42 / RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS Ratzon N, Froom P, Leikin E, Kristal-Boneh E, Ribak J (2000). Effect of exposure to lead on postural control in workers. Occupational & Environmental Medicine. 2000; 57:201-203 (, accessed 3 January 2017). 

Rothenberg SJ, Schnaas L, Salgado-Valladares M, Casanueva E, Geller AM, Hudnell HK, Fox DA (2002). Increased ERG a- and b-wave amplitudes in 7- to 10-year-old children resulting from prenatal lead exposure. Investigative Ophthalmology & Visual Science. 2002; 43:2036-2044 (http://iovs.arvojournals. org/article.aspx?articleid=2123755, accessed 3 January 2017).

 Rubens O, Logina I, Kravale I, Eglite M, Donaghy M (2001). Peripheral neuropathy in chronic occupational inorganic lead exposure: a clinical and electrophysiological study. Journal of Neurology,Neurosurgery & Psychiatry. 2001; 71:200-204 (, accessed 3 January 2017). 

Safe Work Australia (2013). Workplace exposure standards for airborne contaminants. Canberra: Safe Work Australia; 2013 (http://www.safeworkaustralia., accessed 3 January 2017). 

Schwartz BS, Lee BK, Bandeen-Roche K, Stewart W, Bolla K, Links J, Weaver V, Todd A (2005). Occupational lead exposure and longitudinal decline in neurobehavioral test scores. Epidemiology. 2005; 16:106-113. Schwartz J, Landrigan PJ, Baker Jnr EL, Orenstein WA, von Lindern IH (1990). Lead-induced anemia: dose-response relationships and evidence for a threshold. American Journal of Public Health. 1990; 80:165-168 (http://www.ncbi.nlm., accessed 3 January 2017). 

Selevan SG, Rice DC, Hogan KA, Euling SY, Pfahles-Hutchens A, Bethel J (2003). Blood lead concentration and delayed puberty in girls. New England Journal of Medicine. 2003; 348:1527-3156. ( NEJMoa020880#t=article, accessed 3 January 2017).

 Silbergeld EK, Schwartz J, Mahaffey K (1988). Lead and osteoporosis: mobilization of lead from bone in postmenopausal women. Environmental Research. 1988; 47:79–94. Stokes L, Letz R, Gerr F, Kolczak M, McNeill FE, Chettle DR, Kaye WE (1998). Neurotoxicity in young adults 20 years after childhood exposure to lead: the Bunker Hill experience. Occupational & Environmental Medicine. 1998; 55:507-516 (, accessed 3 January 2017).

 Stollery BT, Broadbent DE, Banks HA, Lee WR (1991). Short term prospective study of cognitive functioning in lead workers. British Journal of Industrial Medicine. 1991; 48:739-749 ( PMC1035449/pdf/brjindmed00035-0019.pdf, accessed 3 January 2017). 

RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS / 43 Suplido ML, Ong CN (2000). Lead exposure among small-scale battery recyclers, automobile radiator mechanics, and their children in Manila, the Philippines. Environmental Research Section A. 2000; 82:231-238. ten Bruggenkate CM, Lopes Cardozo E, Maaskant P, van der Waal I (1975). Lead poisoning with pigmentation of the oral mucosa. Review of the literature and report of a case. Oral Surgery, Oral Medicine & Oral Pathology. 1975; 39(5):747- 753. Thurtle N, Grieg J, Cooney L, Amitai Y, Ariti C, Brown MJ, Kosnett MJ, Moussally K, Sani-Gwarzo N, Akpan H, Shanks L, Dargan PI (2014). Description of 3180 courses of chelation with dimercaptosuccinic acid in children ≤5 years with severe lead poisoning in Zamfara, northern Nigeria: a retrospective analysis of programme data. PLOS Medicine. 2014; 11(10):1-18 (http://www.plosmedicine. org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001739, accessed 3 January 2017).

 Tong S (1998). Lead exposure and cognitive development: persistence and a dynamic pattern. Journal of Paediatrics & Child Health. 1998; 34:114-118. Tong S, Baghurst P, McMichael A, Sawyer M, Mudge J (1996). Lifetime exposure to environmental lead and children’s intelligence at 11-13 years: the Port Pirie cohort study. British Medical Journal. 1996; 312:1569-1575 (http://www.bmj. com/content/312/7046/1569; accessed 3 January 2017). 

Tong S, Baghurst PA, Sawyer MG, Burns J, McMichael AJ (1998). Declining blood lead levels and changes in cognitive function during childhood: the Port Pirie Cohort Study. JAMA. 1998; 280:1915-1919 ( journals/jama/fullarticle/188249, accessed 3 January 2017).

 Trasande L, Liu Y (2011). Reducing the staggering costs of environmental disease in children, estimated at $76.6 billion in 2008. Health Affairs (Millwood). 2011; 30(5):863–870 (, accessed 3 January 2017). 

Troesken W (2006). Lead exposure and eclampsia in Britain, 1883-1934. Environmental Research. 2006; 101(3):395-400. UNEP (2003). Technical guidelines for the environmentally sound management of waste lead-acid batteries. Secretariat of the Basel Convention. Basel Convention series/SBC No. 2003/9. Geneva: Basel convention Secretariat; 2003 (http://www. pdf, accessed 3 January 2017). 

UNEP (2004). National management plans for used lead acid batteries. Training manual for the preparation of national used lead acid batteries environmentally sound management plans in the context of the implementation of the Basel Convention. Basel Convention Series / SBC No 2004/5. Geneva: Basel convention Secretariat; 2004 (, accessed 3 January 2017). 

UNEP (2010). Final review of scientific information on lead. Nairobi: United Nations Environment Programme; 2010 ( 44 / RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS Portals/9/Lead_Cadmium/docs/Interim_reviews/UNEP_GC26_INF_11_ Add_1_Final_UNEP_Lead_review_and_apppendix_Dec_2010.pdf, accessed 3 January 2017).

 UNEP (2013). Environmental risks and challenges of anthropogenic metals flows and cycles. Paris: United Nations Environment Programme; 2013 (http:// tabid/106142/default.aspx, accessed 3 January 2017).

 US EPA (1993). Personal Air Sampling and Air Monitoring Requirements under 29 CFR 1910.120. Publication 9360.B-17FS. Washington (DC): United States Environmental Protection Agency; 1993. US EPA (2001). Lead; identification of dangerous levels of lead; Final Rule. Federal Register. 2001; 66(4):1205-1240 (, accessed 3 January 2017). US EPA (2016).

 Fact sheet: Decision - National Ambient Air Quality Standards for lead. Washington (DC): United States Environmental Protection Agency; 2016 ( naaqs_nfr_fact_sheet.pdf, accessed 3 January 2017). 

Valciukas JA, Lilis R, Eisinger J, Blumberg WE, Fischbein A, Selikoff IJ (1978). Behavioral indicators of lead neurotoxicity: results of a clinical field survey. International Archives of Occupational & Environmental Health. 1978; 41(4):217- 236. van der Kuijp TJ, Huang L, Cherry CR (2013). Health hazards of China’s lead-acid battery industry: a review of its market drivers, production processes, and health impacts. Environmental Health. 2013; 12:61 (http://ehjournal.biomedcentral. com/articles/10.1186/1476-069X-12-61, accessed 3 January 2017). 

Wang J-D, Jang C-S, Hwang Y-H, Chen Z-S (1992). Lead contamination around a kindergarten near a battery recycling plant. Bulletin of Environmental Contamination & Toxicology. 1992; 49:23-30 ( publication/21764004_Lead_contamination_around_a_kindergarten_near_a_ battery_recycling_plant, accessed 25 January 2017). 

Wedeen RP (1988). Bone lead, hypertension, and lead nephropathy. Environmental Health Perspectives. 1988; 78:57-60 ( PMC1474623/pdf/envhper00429-0059.pdf, accessed 3 January 2017). 

Weidenhamer JD, Kobunski PA, Kuepouo G, Corbin RW, Gottesfeld P (2014). Lead exposure from aluminum cookware in Cameroon. Science of the Total Environment. 2014; 496:339-47. Weidenhamer JD, Fitzpatrick MP, Biro AM, Kobunski PA, Hudson MR, Corbin RW, Gottesfeld P (2017).

 Metal exposures from aluminum cookware: an unrecognized public health risk in developing countries. Science of the Total Environment. 2017; 579: 805-813.). Were FH, Kamau GN, Shiundu PM, Wafula GA, Moturi CM (2012). Air and blood lead levels in lead acid battery recycling and manufacturing plants in Kenya. Journal of Occupational & Environmental Hygiene. 2012; 9(5):340-344. RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS / 45 White RF, Diamond R, Proctor S, Morey C, Hu H (1993). Residual cognitive deficits 50 years after lead poisoning during childhood. British Journal of Industrial Medicine. 1993; 50(7):613-622 ( PMC1035497/pdf/brjindmed00007-0037.pdf, accessed 3 January 2017). 

WHO (1995). Lead. Environmental Health Criteria 165. Geneva: World Health Organization; 1995 (, accessed 3 January 2017). 

WHO (2000). Air quality guidelines for Europe, 2nd edition. Copenhagen: WHO Regional Office for Europe; 2000 ( pdf_file/0005/74732/E71922.pdf?ua=1, accessed 3 January 2017). WHO (2010a) Childhood lead poisoning. Geneva: World Health Organization; 2010 (, accessed 3 January 2017). 

WHO (2010b). WHO Human health risk assessment toolkit. Geneva: World Health Organization; 2010 ( areas/ra_toolkit/en/, accessed 3 January 2017).

 WHO (2010c). WHO Guidelines on drawing blood: best practices in phlebotomy. Geneva: World Health Organization; 2010 ( sign/drawing_blood_best/en/, accessed 3 January 2017). 

WHO (2011a). Brief guide to analytical methods for measuring lead in blood. Geneva: World Health Organization; 2011 ( public_health/lead_blood.pdf, accessed 3 January 2017). 

WHO (2011b). Guidelines for Drinking-water Quality, 4th edition. Geneva: World Health Organization; 2011 ( publications/dwq-guidelines-4/en/, accessed 3 January 2017). 

Wilhelm M, Beinzow B, Angerer J, Schulz C (2010). Reassessment of critical lead effects by the German Human Biomonitoring Commission results in suspension of the human biomonitoring values (HBM I and HBM II) for lead in blood of children and adults. International Journal of Hygiene and Environmental Health. 2010; 213:265-269 ( S143846391000043X, accessed 3 January 2017). 

Williamson AM, Teo RKC (1986). Neurobehavioural effects of occupational exposure to lead. British Journal of Industrial Medicine. 1986; 43(6):374-380 (https:// pdf, accessed 3 January 2017). 

Winship KA (1989). Toxicity of lead: a review. Adverse Drug Reactions & Acute Poisoning Reviews. 1989; 8(3): 117-152. Wright JP, Dietrich KN, Ris MD, Hornung RW, Wessel SD, Lanphear BP, Ho M, Rae MN (2008). Association of prenatal and childhood blood lead concentrations with criminal arrests in early adulthood. PLoS Medicine. 2008;5(5):e101 ( journal.pmed.0050101&type=printable, accessed 3 January 2017). 

46 / RECYCLING USED LEAD-ACID BATTERIES: HEALTH CONSIDERATIONS Wu T, Buck GM, Mendola P (2003). Blood lead levels and sexual maturation in U.S. girls: the Third National Health and Nutrition Examination Survey, 1988- 1994. Environmental Health Perspectives. 2003; 111(5):737-741 (https://, accessed 3 January 2017). 

Zhang F, Liu Y, Zhang H, Ban Y, Wang J, Liu J, Zhong L, Chen X, Zhu B (2016). Investigation and evaluation of children’s blood lead levels around a lead battery factory and influencing factors. International Journal of Environmental Research and Public Health. 2016; 13:541. ( PMC4923998/pdf/ijerph-13-00541.pdf, accessed 3 January 2017).

Culled from:

Department of Public Health, Environmental and Social Determinants of Health (PHE) World Health Organization (WHO) Avenue Appia 20 – CH-1211 Geneva 27 – Switzerland Email:


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