Scientific studies provide solid evidence of risks from several occupational and environmental toxicants, which in some cases have resulted in the establishment of causal associations with negative health outcomes including neurological disorders, respiratory diseases, and cancer. In response, several countries, especially high-income countries, have introduced occupational and environmental regulations that ban or restrict these toxicants. However, many toxicants with well-established health risks are still used, especially in low- and middle-income countries. For example, lead is still found in several consumer products, including products intended for children. The asbestos industry has continued their business as usual in Asian, Eastern European, and Latin American countries. The expansion of gold mining activities in low- and middle-income countries has resulted in the introduction of large amounts of mercury into the environment. Many countries where these toxicants are used lack the institutional capacity to address these problems, lacking research institutions and scientists to monitor effects. Important ethical questions include: What should be the role of the international scientific community towards the continued use of toxicants with proven health risks? Do we need to build infrastructure to understand exposure pathways to both workers and the public in these countries, and how can we fund these initiatives? What actions could be taken to develop rapid global responses to protect those exposed? Could we improve global surveillance initiatives to detect the distribution and use of toxic substances and identify the corporations and individuals that currently use them with impunity?