The Toxic Site Identification Program (TSIP) endeavours to identify and screen contaminated sites in low- and middle-income countries where public health is at risk. The TSIP is not intended to be a comprehensive inventory of such sites, but rather is an effort to begin to understand the scope of the problem. More than 3,100 sites have been identified so far, and more than 1,800 screened on site. These sites alone represent a potential health risk to more than 80 million poor people. However, these 3,000 sites likely represent a small fraction of the overall total. By way of example, over the past twenty years, the United States Environmental Protection Agency (U.S. EPA) has identified tens of thousands of sites in the US alone that require remediation, and its National Priorities List for urgent remediation currently contains more than 1,300 sites. [1] Analysis of the data and trends in the TSIP database indicates that as many as 200 million people may be affected. In order to carry out site assessments, Pure Earth utilizes a network of national experts in each country to visit and document hazardous waste sites. These national investigators, often from the environment or health departments at a national university, are trained to identify and assess contaminated sites using a rapid assessment tool called the Initial Site Screening (ISS) protocol. Government representatives also attend the training. The ISS identifies major elements of a contaminated site, including estimated population at risk, key pollutant information, human exposure pathway data and sampling data. As part of the training, a field visit is made by the group to demonstrate the methodology for assessing the human health impact of toxic sites. Since 2012, GAHP has held training workshops in fourteen countries, and trained nearly 150 investigators and 90 government representatives how to identify and assess toxic sites.

Today, public exposures to lead come primarily from the informal production and recycling of used lead-aid batteries (including motorbike, car and truck batteries); lead in paint, dyes, cookware and other household products; and lead contamination in food. Pure Earth has conducted more than 1,000 field assessments of sites contaminated with lead. Our strategies have proven effective in addressing lead contamination. Our approach includes: Rapid Environmental And Health Risk Assessments Site Prioritization And Project Selection Detailed Environmental And Health Risk Assessments Conceptual Site Modeling Alternative Remediation Analysis Remediation

Much of the mercury released into the environment is the result of small-scale and artisanal gold mining (ASGM). Mercury used in the gold separation process (known as “amalgamation”) results in the discharge of an estimated 1,000 tons of mercury annually, representing about 30% of the world’s anthropogenic mercury releases according to United Nations Industrial Development Organization (UNIDO). Once mercury pollution reaches waterways, it is transform into methylmercury—one of the most toxic organic compounds and a powerful neurotoxin. According to UNIDO, as much as 95 percent of all mercury used in ASGM mining is released into the environment. Pure Earth has conducted more than 500 field assessments of sites contaminated with mercury. Our strategies have proven effective in addressing mercury contamination. Our approach includes: Rapid Environmental And Health Risk Assessments Site Prioritization And Project Selection Detailed Environmental And Health Risk Assessments Conceptual Site Modeling Alternative Remediation Analysis Remediation and Risk Reduction Strategies

The Commission on Pollution and Health is an initiative of The Lancet, the Global Alliance on Health and Pollution (GAHP), and the Icahn School of Medicine at Mount Sinai. The Commission comprises many of the world’s most influential leaders, researchers and practitioners in the fields of pollution management, environmental health and sustainable development. The Report by the Commission on Pollution and Health will be published in The Lancet in the fall of 2017. The Report will analyze and communicate the massive scope of the health and economic costs of air, water and soil pollution. Through analyses of existing and emerging data, the Report will reveal pollution’s severe and underreported contribution to the Global Burden of Disease. It will uncover the economic costs of pollution to low- and middle-income countries, and compare the costs of inaction to the costs of available solutions. It will inform key decision makers around the world about the burden that pollution places on health and economic development, and about cost-effective pollution control solutions and strategies. The Commission will bring pollution squarely into the international development agenda. Commission Partners The Lancet is one of the world’s oldest and best known medical journals, publishing a weekly journal and nine monthly specialty journals in the fields of global health, diabetes and endocrinology, oncology, haematology, neurology, psychiatry, respiratory medicine, infectious diseases and HIV. The Global Alliance on Health and Pollution (GAHP) is a collaborative body that facilitates the provision of technical and financial resources to governments and communities to reduce the impacts of pollution on health in low- and middle-income countries. GAHP members include World Bank, European Commission, UNEP, UNDP, UNIDO, Asian Development Bank, ministries of environment and health from around the world, and a host of civil society organizations. The non-profit organization Pure Earth (formerly Blacksmith Institute) is the Secretariat of GAHP and coordinates the work of the Commission. The Icahn School of Medicine at Mount Sinai is an international leader in medical and scientific training, biomedical research, and patient care. It is the medical school for the Mount Sinai Health System, which includes seven hospital campuses, and has more than 5,000 faculty and nearly 2,000 students, residents and fellows.