Lead exposure remains one of the most neglected public health threats of our time. There is no known safe level of lead in the human body. Even low exposure can irreversibly damage children's brain development, impair learning, and increase lifelong risks of cardiovascular disease. Despite the phase-out of leaded petrol and some regulatory progress, exposure continues through contaminated water, food, soil, household dust, informal recycling, and poorly managed waste. India bears a disproportionate share of this burden. UNICEF and Pure Earth estimates suggest that about half of Indian children have blood lead levels above recommended thresholds, with the highest risks concentrated among poorer households and informal workers. The impacts extend beyond health, undermining education outcomes and long-term economic productivity.
At the same time, climate change has emerged as one of the defining public health challenges of the 21st century. India is already experiencing more frequent and intense heatwaves, prolonged droughts, severe floods, cyclones, and coastal inundation. These hazards damage infrastructure, disrupt water and food systems, and strain health services. What is less recognised is that climate change does not act alone. It amplifies existing environmental risks, including exposure to toxic metals such as lead. Climate extremes increasingly disturb long-standing environmental reservoirs of lead. Heatwaves accelerate the deterioration of ageing urban infrastructure, including old water pipes and lead-based paints, especially in informal settlements and older housing. This increases contamination of household dust and drinking water. Heat stress and dehydration can also enhance the body's absorption of lead, raising risks for children and pregnant women.
Droughts and desertification resuspend contaminated soils as fine dust, increasing inhalation exposure from legacy lead originating in industrial activity, mining, smelting, waste dumping, and historical traffic emissions. Reduced water availability can concentrate lead in soils and crops, heightening dietary exposure in food-insecure regions.
Floods and extreme rainfall present a different but equally serious pathway. Floodwaters mobilise lead stored in soils, sediments, landfills, e-waste sites, and industrial zones, spreading contamination across residential areas and agricultural land. Drinking water sources can be compromised, and post-flood clean-up often exposes families to toxic debris. Along India's long coastline, cyclones damage housing, power systems, and waste infrastructure, dispersing lead-containing materials. Sea-level rise and saltwater intrusion further increase the risk of lead leaching into groundwater in vulnerable coastal districts.
Even the energy transition, if poorly governed, can aggravate the problem. Renewable energy expansion is essential for climate mitigation, yet lead-acid batteries remain widely used in solar backup systems, vehicles, and emergency power supplies due to their low cost and availability. Informal battery recycling and unsafe dismantling release lead into air, soil, and water, exposing workers and nearby communities. Without strong regulation and safe recycling systems, climate solutions risk shifting pollution rather than eliminating it.
These intersecting risks demand integrated policy responses, and India already has much of the necessary policy architecture. The National Programme for Climate Change and Human Health (NPCCHH) already recognises health as a cross-cutting concern and is now in the process of integrating toxic exposures such as lead. Similarly, flagship health initiatives -- including the National Health Mission and Ayushman Bharat -- focus on service delivery but are now working towards integrating environmental risk reduction into routine care, surveillance, and disaster preparedness.
Urban policy offers a critical entry point. Housing schemes and urban renewal missions provide opportunities to remove lead-based paints, replace ageing water pipes, and enforce safer construction standards -- especially in low-income settlements where exposure risks are highest. Climate-resilient housing must also be toxin-safe housing. Disaster management plans, increasingly invoked during heatwaves, floods, and cyclones, should explicitly include protection against toxic exposures, prioritising children, pregnant women, and informal workers during emergencies and recovery. Addressing lead exposure alongside the response to the climate-change challenge is not merely a technical fix; it is a matter of equity. Climate hazards and toxic pollution disproportionately affect the same populations -- those with the least resources to protect themselves and the least access to health care. Public awareness is therefore essential. Communities need clear information on how climate extremes can increase toxic exposure and how risks can be reduced before, during, and after climate-related events.
The link between climate change and lead pollution reflects a broader planetary health crisis, where climate instability, chemical pollution, and social vulnerability intersect. Treating these challenges in silos will blunt the effectiveness of India's climate and health investments. Integrating lead elimination into climate action, health missions, and urban development is both feasible and necessary. Protecting children from lead exposure while responding to climate change is not an added burden -- it is an investment in India's resilience, human capital, and future.