Table 1_Lead exposure across early life in Latin America and the Caribbean: prevention strategies and reproductive health considerations.docx

Lead exposure remains a persistent public health problem, with direct implications for reproductive and child health. Toxic and bioaccumulative, the metal persists in the environment due to historical use in fuels, paints, and ceramics, as well as industrial and mining activities. The aim of this study was to synthesize recent evidence on lead exposure in children from Latin America and the Caribbean (LAC), assessing outcomes related to human reproduction. A literature review was conducted according to PRISMA guidelines on the PubMed, Web of Science, and LILACS databases, covering the period from January 1, 2022, to January 30, 2026. The search was carried out on January 30, 2026, and only original articles in English, Portuguese, and Spanish were included. 165 studies were identified, of which 22 met the inclusion criteria. Four studies evaluated maternal exposure during pregnancy, while the remaining publications addressed exposures during childhood or in the general population. Some children participating in the included studies had blood lead levels exceeding the international reference value of 3.5 μg·dL−1. Glazed ceramics, mining activities, improper e-waste management, and water and soil contamination emerged as the main exposure sources. Negative effects included cognitive deficits, learning difficulties, behavioral changes, and, in some contexts, juvenile delinquency. Despite regulatory advances and updated reference values, shortcomings remain, such as a lack of systematic biomonitoring and longitudinal studies. Reproductive effects beyond childhood remain, such as premature births and low birth weight. With no safe level, defining priorities for reproductive, child, and intergenerational health in LAC is paramount.