Mitigating Lead Exposure in the Philippines: Health Surveillance

The Mitigating Lead Exposure in Low- and Middle-Income Countries (LMICs) project seeks to reduce lead exposure in Asia, Africa, and Latin America from exposure sources such as metal and ceramic cookware, adulterated spices, environmentally unsound used lead-acid battery (ULAB) recycling, and cosmetics. The overarching objective is to assist governments and stakeholders in strengthening institutional capacities, programs, and policies to effectively assess, prioritize, and mitigate lead exposure. Project countries include Colombia, Egypt, Ghana, India, Indonesia, Peru, and the Philippines.

In the Philippines, the Mitigating Lead Exposure in Low- and Middle-Income Countries (LMICs) project is focused on reducing lead exposure through institutionalizing lead detection, referral and management into the national and/or local health system.

Pure Earth Philippines has been working alongside the government to implement blood lead level surveys in the country since 2021, when Pure Earth worked with the government to include testing for lead in their National Nutrition Survey, which takes place every three years. Based on the results of the 2021 lead poisoning survey, which tested 3000 children and pregnant women across 25 areas of the Philippines, it is estimated that around one million children ages 6-9 years have elevated blood lead levels. In September 2024, in partnership with Pure Earth Philippines, Valenzuela City launched its first Blood Lead Level (BLL) screening program, focusing on children with disabilities. This was the first city-led BLL screening and first screening for a particular sector, children with disabilities, in the Philippines. Policies developed, training conducted, protocols established and implemented, data gathered and lessons learned from pilots like Valenzuela City are hoped to strengthen Pure Earth Philippines’ continuing efforts in institutionalizing lead monitoring and surveillance in the country.

Project Objective: Jumpstart lead monitoring and management institutionalization in the national and/or local health system.

Expected Outcomes:

1. Institutionalized blood lead level (BLL) testing in national food and nutrition surveys.
2. Institutionalized case detection and screening of lead poisoning in high-risk areas and for vulnerable populations (e.g. among children with disabilities) at primary health level.
3. Institutionalize referral pathways (i.e. a protocol establishing referral criteria depending on different BLL levels) and case management in “poisoning management centers.”
4. National database or platform for exposure source information is established.

Project Activities:

1. Contribute to the development of protocol for detection and treatment of lead poisoning integration into Universal Health Care package.
2. Contribute to the development and adoption of national clinical case management clinical guidelines.
3. Facilitate training of healthcare providers on updated protocols / guidelines.
4. Expansion of BLL monitoring system in the Philippines.