Why Afghans are being slowly poisoned by their evening meal

Afghanistan has one of world’s highest rates of lead exposure and a mounting body of evidence suggests cookware could be to blame

The process starts with lumps of scrap metal – mostly car parts like gearbox casings, radiators, wheels and body panels – stacked high in the yard outside the workshop.
Piece by piece they are melted down into ingots in a ramshackle furnace that spews thick, black smoke into the air over the factory in the province of Ghor in central Afghanistan.
The workers here have little more than scarves to protect themselves against the pollutants – many do not even have gloves to wear as they carry crucibles of molten metal across the to the waiting moulds.
Firooz Ahmad has worked at the factory for eight years and spends 10 hours a day at his workstation turning the cast aluminium hulls into the pressure cookers that almost every Afghan family uses to prepare their daily meals.
The 39-year-old has no idea that he is being slowly poisoned by the metal cooking pots, called kazans, that he makes every day.
“Is it dangerous?” he says when asked if he is worried about lead poisoning.
“I have headaches and persistent pains in my joints and sometimes it’s difficult to breathe – maybe I am poisoned!” he says, laughing.
He is not alone. Afghanistan has one of the world’s highest rates of lead exposure, with an average blood lead level nearly three times that of nearby India and almost five times that of China, according to the best available data.
A mounting body of evidence suggests that kazans and other cooking pots made of low-quality recycled aluminium could be to blame. The ubiquitous pots are often given as wedding gifts and can be found in every corner of the country.
In recent years, researchers have been trying to find out why they were seeing dramatically elevated blood lead levels among Afghan refugee children who had arrived in the United States.
In 2022, researchers in Washington state screened dozens of imported aluminium and stainless steel cooking pots and “simulated [the] cooking and storage” of food.
They found that every single piece of aluminium cookware donated by Afghan refugee families exceeded the US Food and Drug Administration’s limit for the maximum lead intake from food.
The worst offenders were the kazans – one of which “leached sufficient lead to exceed the childhood limit by 650-fold”.
By contrast, none of the pressure cookers made from stainless steel were found to exceed the safety levels.
Soon after the report was published, several US states put out health advisories warning of the dangers of the Afghan pressure cookers. And earlier this year Washington became the first US state to ban the manufacturing, sale or distribution of cooking pots contaminated with lead.
But news of the danger posed by the kazans does not appear to have reached Afghanistan.
The Telegraph understands that there was a furtive attempt to focus on cooking equipment contaminated with lead under the US-backed government of Hamid Karzai, but it petered out when he lost power in 2014.
Ten years on, none of the Taliban health ministry officials The Telegraph spoke to were familiar with the problem or of any plans to deal with it.
If it is not dealt with, however, the consequences for Afghanistan could be severe and long-lasting.
Lead poisoning contributes to some five-and-a-half million premature deaths around the world every year and accounts for a significant global disease burden due to the long-term damage it causes, including an increased risk of high blood pressure and kidney damage later in life.
There is no safe level of exposure, according to the World Health Organisation, and some 800 million children are believed to be affected globally, including almost every child in Afghanistan.
The pernicious effects the heavy metal can have on health are particularly acute for young children and mothers.
Lead builds up in the body over time and is stored in the teeth and in the bones.
High levels of exposure can severely damage the brain and central nervous system, causing convulsions, comas, and even death.
Even in smaller doses, lead can cause severe learning disabilities. It has also been linked to a greater incidence of violence and criminality in adulthood.
“The evidence is that lead poisoning just hurts kids’ cognitive development,” said Dr Alice Evans, a Senior Lecturer in the Social Science of Development at King’s College London.
“It’s not like you’ll have a sick day, so to speak, but rather it affects how the brain is developing, and the way that economists have been able to show this is that kids who are affected have worse progression in school,” she told The Telegraph. “They’re more likely to be suspended, and it seems they’re more likely to be associated with violent crime.”
The sudden decline of crime rates across the industrialised world, but particularly in America in the 1990s, has been attributed to the removal of lead from paint and petrol.
While some scientists are still sceptical of a causal link between lead and crime rates – the lead-crime hypothesis – the correlation between falling levels of lead in the blood of young children and violent crime is startling, as this graph shows:
There have been several other apparent success stories.
Most recently, researchers in Bangladesh managed to identify turmeric enhanced with vibrant yellow lead chromate as a major cause of the sky-high blood lead levels they were seeing.
The discovery prompted the country’s Food Safety Authority to start a highly successful two-pronged campaign, warning the public of the dangers of contaminated spices and patrolling the markets with X-ray fluorescence analysers to detect lead.
It may be harder to pin Afghanistan’s problem on a single culprit like the kazans, said Rachel Bonnifield, a Senior Fellow at the Centre for Global Development.
Countries that have suffered decades of conflict like Afghanistan also tend to have much higher levels of lead in the environment, she said, adding that Kohl, or surma – the traditional eyeliner worn by many Afghans from extremely young ages – has also been identified as a potential source.
The antimony it is usually made from is often mistaken for, and found alongside, galena, or lead sulfide.
More broadly, understanding the true extent of Afghanistan’s lead poisoning problem is complicated by the lack of data, she said. But what is clear is the severity of the impact it can have.
“The consequences of lead poisoning for global health, for children’s education and for overall development and economic growth are, frankly, staggering,” she told a recent conference.
The Telegraph confronted the owner of a kazan factory about the potential danger of his products.
Enayat, who owns a factory producing cooking pots in the western province of Herat, said he had heard of “rumours” about lead poisoning.
“These are just rumours,” he told The Telegraph. “We now have European customers, and our competitors are spreading these false rumours about poisoning.”
“I’ve been in this business for 20 years and have never encountered a case,” he said, adding that in his factory they only use “pure aluminium” to make their pots.
Convincing Afghans of the dangers of lead poisoning may too be an uphill battle.
Mr Ahmad, the craftsman from Ghor who gets paid about £4 a day, said he and his co-workers had only one priority.
“We only care about bread and how to fill our stomachs here, that’s the challenge and nothing else,” he said.
Protect yourself and your family by learning more about Global Health Security