Lead Toxicity as an Intergenerational Public Health Crisis in India: Evidence, Surveillance, and Regulatory Challenges

ABSTRACT Lead contamination remains a persistent and underestimated public health crisis in the Indian subcontinent, driven by both legacy pollution and contemporary consumer-product exposure. This review synthesizes evidence from 2000–2025 on toxicological mechanisms, epidemiological patterns, exposure pathways, analytical detection methods, and regulatory frameworks. Despite global progress in reducing lead exposure, India continues to report disproportionately high blood lead levels (BLLs), particularly among children and pregnant women. Major exposure routes include industrial emissions, improper recycling of lead-acid batteries, contaminated cookware (Aluminum), intentional adulteration of spices such as turmeric, and traditional cosmetics and medicines. Analytical evaluation demonstrates that while ICP-MS and GF-AAS provide accurate clinical detection, XRF and point-of-care analyzers are essential for large-scale field screening. Regulatory analysis reveals significant disparities in FSSAI and BIS limits across food categories, processed foods, paints, and consumer materials, highlighting gaps that enable chronic exposure. This review emphasizes the need for harmonized contaminant standards, enhanced surveillance capacity, targeted abatement of high-risk products, and strengthened public awareness. Addressing India’s lead burden requires integrated scientific, regulatory, and public health interventions to prevent intergenerational toxicity and safeguard national health. Keywords: Lead toxicity, Blood lead levels (BLLs), Exposure pathways, Regulatory standards