Lead poisoning in South African children: the hazard is at home.

Lead is a toxic heavy metal that has been used extensively in modern society, causing widespread environmental contamination even in isolated parts of the world. Irrefutable evidence associates lead at different exposure levels with a wide spectrum of health and social effects, including mild intellectual impairment, hyperactivity, shortened concentration span, poor school performance, violent/aggressive behavior, and hearing loss. Lead has an impact on virtually all organ systems, including the heart, brain, liver, kidneys, and circulatory system, resulting in coma and death in severe cases. In recent years, a consensus was reached regarding the absence of a threshold for the key health effects associated with lead exposure and the permanent and irreversible nature of many health and social consequences of lead exposure. The public health problem of environmental lead exposure has been widely investigated in developed countries like the United States of America, where actions taken have led to significant reductions in children's blood lead concentrations. In contrast, there is a relative dearth of information and action regarding lead poisoning in developing countries, particularly in African countries, despite evidence of widespread and excessive childhood lead exposure. In this paper, we will review the information from available published papers, the 'grey literature', and unpublished reports to give an overview of lead exposure in South African children over the past two decades, with particular emphasis on sources of exposure in the home environment.