Environmental Lead Exposure and Adult Literacy in Myanmar: An Exploratory Study of Potential Associations at the Township Level.

Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels among townships with both low access ( = 0.05; OR = 2.701 (1.136⁻6.421)) as well with high access to safe sanitation ( = 0.01; OR = 18.40 (1.794⁻188.745)). Local Indicators of Spatial Association (LISA) cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.