June 15, 2011


My children have been poisoned and there is nothing I can do to help them.
—Sun, Henan province, May 2010

Hundreds of thousands of children in China are suffering permanent mental and physical disabilities as a result of lead poisoning. Many of them live in poor, polluted villages next to, and surrounded by, lead smelters and battery factories. Often, their parents work in these factories, bringing more lead into their homes on their clothes, boots, and hands.

China today has the world’s largest population and second largest economy. The country’s gross domestic product has increased ten-fold in the last 15 years. That rise in gross domestic product (GDP) growth has helped lift 200 million people out of absolute poverty since 1978. But this rapid economic development has also exacted a steep environmental price; widespread industrial pollution that has contaminated water, soil, and air and put the health of millions of people—likely even hundreds of millions—at risk. Currently, 20 of the world’s 30 most polluted cities are in China.

Pollution from lead is highly toxic and can interrupt the body’s neurological, biological, and cognitive functions. Children are particularly susceptible, and high levels of lead exposure can cause reduced IQ and attention span, reading and learning disabilities, behavioral problems, hearing loss, and disruption in the development of visual and motor functioning. High levels of lead can cause anemia, brain, liver, kidney, nerve, and stomach damage, as well as comas, convulsions, and even death. Worldwide, lead poisoning kills 230,000 people each year.

Today, lead poisoning is among the most common pediatric health problems in China.While the lack of comprehensive data makes it difficult to determine the extent of the epidemic, a number of sources—including academic and media reports—indicate it is a public health emergency affecting whole communities.

The Chinese government’s ill regard for human rights means it has been able to pursue a model of economic development that is not accountable to its citizens, including poor people who are often particularly susceptible to the most damaging health effects of environmental hazards. But industrial pollution, and the lack of accountability that accompanies it, extends far beyond health issues: it impacts the full realization of human rights in China, including people’s right to life, health, an adequate standard of living, as well as to information, participation, and access to justice.

Underpinning China’s lead poisoning epidemic is a tension between the government’s goals for economic growth and its efforts to curb environmental degradation. The Chinese government has developed numerous laws, regulations, and action plans designed to cut emissions, encourage more environmentally-friendly industries and decrease pollution. Yet these policies are in competition with the Chinese government’s goals for economic development; the first guiding principle of the country’s Twelfth Five-year Plan for Environmental Protection (2011-2015) is “optimizing economic development.”

At the local level, such policy contradictions may encourage factories to cut corners on emissions standards. Corruption and conflict of interest can also undermine environmental protection efforts. Local officials, who often have a legal or financial role in local factories, may be resistant to implementing environmentally friendly technology. Existing environmental laws often lack effective enforcement mechanisms.

This report—based on interviews in Henan, Hunan, Shaanxi, and Yunnan provinces, and research in Beijing and Shanghai between late 2009 and early 2010 — finds that local governments have imposed arbitrary limits on access to blood lead testing; refused appropriate treatment to children and adults with critically high lead levels; withheld and failed to explain test results showing unaccountable improvements in lead levels; and denied the scope and severity of lead poisoning.

Parents said that government officials told them that only children living within one kilometer of a factory smokestack were at risk and that milk was adequate treatment for lead poisoning. Parents reported that local police threatened individuals seeking treatment and information, and those trying to protest against polluting factories have been arrested. Journalists told us they have been intimidated and threatened when trying to report on lead poisoning.

Meanwhile local Environmental Protection Bureaus (EPBs), staffed and supervised by local government officials, have done little to fulfill their obligation to monitor emissions, disseminate information to the public about polluting factories, and enforce environmental regulations that stipulate a factory or polluting entity must be improved or removed when it endangers public health.

Among the many government abuses that Human Rights Watch documented that directly compromised the health of children and adults at risk for lead poisoning are:

Testing Practices

Although local governments have provided some free testing for children under the age of 14, in the areas we visited with acute lead poisoning, seemingly arbitrary restrictions on testing restricted the ability of individuals to access free testing. In some cases, children were denied testing, even when parents were willing to pay for it.

Many parents in Henan and Shaanxi, suspicious about false results showing normal blood lead levels (BLLs), brought their children to towns outside the contaminated area for testing. In every case, these results were much higher than those provided by the local hospital or the Chinese Center for Disease Control and Prevention (CCDC). In Yunnan, many parents said they were denied access to their children’s results and simply told the results were normal.

Access to Information

In Hunan, Henan, Shaanxi, and Yunnan provinces, parents said they only learned that local factories were polluting at toxic levels when their children fell ill. In each province, they said they received no information about the health risks associated with the pollution, including any risk or medical consequences of lead poisoning.

Journalists who reported on lead poisoning told Human Rights Watch that police had followed them or forced them to leave the area when they tried to interview people. A foreign journalist who had been to a polluted site in Hunan said police had questioned his driver, as well as people he had interviewed. A journalist reporting on lead poisoning in Shaanxi was also forced to leave.

Access to Medical Treatment

Parents of children with dangerously high blood lead levels in all four provinces were unable to access effective treatment. They reported that health workers and government officials told them to feed their children specific foods, including apples, garlic, milk, and eggs. In rare cases children were given medicine but inconsistently and without medical supervision. In nearly every case, children were returned to their homes to face ongoing exposure to lead with dangerous and potentially deadly consequences.

Intimidation by Police and Government Officials

In all four provinces, villagers told Human Rights Watch they were scared to ask government officials for more help or information. In Shaanxi province, villagers said police had detained people protesting outside a lead-processing factory. In Hunan, seven people were arrested while trying to seek help for their children.

Remediation and Long-Term Solutions

Most families said they were not financially able to move to an unpolluted area. Villagers in Shaanxi said the government had announced plans to move residents from several villages to other areas but did not know when or if this will happen, where they are supposed to go, and/or how they would earn a living in a new area.

In villages where lead exposure is highest, a generation of cognitively and physically disabled children will need significant and ongoing support. Most parents Human Rights Watch spoke with were generally unaware of these long-term consequences of lead exposure. However, some said their children were already struggling: failing physically or underperforming in school. Yet neither the schools nor the local government had offered special services or opportunities for children with lead poisoning. These needs will become even more acute as the years pass and lead poisoning continues to be neglected.

Occupational Health

In addition to researching the effects of lead on the communities surrounding polluting factories, Human Rights Watch interviewed family members of a female worker in a lead processing plant in Yunnan who died of acute lead poisoning.  Human Rights Watch also interviewed individuals concerned about the absence of adequate worker protections. According to workers in Yunnan, Henan, and Shaanxi, blood lead tests and safety measures are not routine practice.


The Chinese people have already suffered grave consequences as a result of inappropriate and inadequate responses to public health crises. During the 1990s and early 2000s, local officials in Henan and other provinces ran programs for impoverished farmers to sell their blood plasma and platelets. The program was unsanitary and unsafe, but selling blood plasma was profitable for officials, and they continued to deny evidence of an emerging HIV epidemic. Tens of thousands were infected, nearly a majority of adults in some villages, and the public health consequences continue. Similarly, in 2003, SARS was first denied and then downplayed by government health officials who censored media and lied to international health agencies, resulting in ongoing transmission and unnecessary suffering and deaths.

The Chinese government’s response to AIDS and SARS was characterized by corruption, cover-up, and harassment of media and health activists, resulting in a delayed and ineffective public health response. The response to lead poisoning has so far followed this same road, but it is not too late for the Chinese government to take a different approach.

The Chinese government has repeatedly and voluntarily pledged in public statements, in domestic law, and in international treaties to protect the fundamental human rights of its citizens, including their right to the highest attainable standard of health. It must ensure that laws that safeguard human health against environmental hazards are implemented locally and followed consistently. When health is compromised, the government needs to act swiftly to provide health information and evidence-based medical treatment. Further, the government must hold accountable those responsible for protecting the community’s health and wellbeing when they choose actions that instead endanger or neglect health.