How much of a problem is lead poisoning?

Lead poisoning is one of the most common pediatric problems and one of the most preventable. One study shows children with lead levels above 20 micrograms per deciliter were seven times more likely than other students to drop out of high school and six times more likely to have a reading disability. Lead levels above 10 ug/dL can affect intelligence and growth and cause behavioral problems. For pregnant women, it can cause abnormal fetal development.

Nationally, three million children under age six have blood lead levels higher than 10 ug/dL. Young children are especially vulnerable, and high blood lead levels in childhood can affect their whole life, mentally, physically, and behaviorally.

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How do children become lead poisoned?

The most common sources of lead exposure in and around the home are lead-based paint and household dust (i.e., lead dust from peeling, chipping and chalking lead paint). Soil and drinking water can also be sources.

Lead-contaminated household dust comes from opening and closing windows and doors that have lead-based paint on them. It can also come from renovation and remodeling homes with lead-based paint. Also, toys and cribs made before 1978 may contain lead-based paint. Some imported toys and serving dishes still contain lead.

Until 1978, house paint could contain lead, and the U.S. Department of Housing and Urban Development (HUD) estimates 75 percent of private housing has lead-based paint. HUD has estimated that 14 percent of all housing units built before 1980 have lead levels inside the house that exceed guidelines.

Other sources of exposure that are sometimes important include:

• Exposure from persons involved in an occupation or hobby that uses
  lead who carry lead dust home on clothing;

• Fumes and dust from lead-related industrial sources;

• Folk remedies and cosmetics that contain lead (for example,
  azarcon, greta, kohl, and surma).

• Although leaded gasoline is no longer used, it has affected the soil in
  urban areas. Emissions from smelters and battery factories, as well
  as burn-off from oil, coal, waste oil, and incinerated municipal wastes
  also add lead to the soil.

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What are the symptoms of lead poisoning?

It's important to note that children may show no obvious symptoms. If a child actually shows symptoms, the level of poisoning is advanced. High blood lead levels are associated with decreased intelligence, mental retardation, and hyperactivity. Symptoms can include hearing problems, behavior problems, and learning problems. Children with high blood lead levels may have poor appetite, stomach aches, vomiting, constipation, crankiness, loss of energy, headaches, and trouble sleeping. Very high levels can cause coma and convulsions.

A person with blood lead levels exceeding 70 ug/dL is considered severely poisoned, and levels between 100 and 150 can cause death. 

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How can I tell if my child has lead poisoning?

The Centers for Disease Control and Prevention recommends that blood lead testing be part of standard pediatric check-ups, with all children tested by 12 months of age and high-risk children tested at six months. If you answer "yes" to one of the following, your child could be at risk and should be tested.

1. Live in or stay at a house built before 1978 with peeling, chipping or chalking paint?

2. Live in or stay at a house built before 1978 that has recently been remodeled?

3. Have a habit of eating dirt, paint chips, or other non-food items?

4. Live with an adult whose job or hobby exposes them to lead? (Furniture refinishing, electronics, soldering, automotive repair, making stained glass, making fishing weights and lures, reloading shotgun shells and bullets, participating in indoor firing ranges, doing home repairs and remodeling and making pottery)

5. Have a brother sister with high blood lead levels?

6. Have iron deficiency, anemia, sickle cell disease, a developmental delay, or behavioral problems?

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How can I reduce lead in the environment?

• Have your child tested for lead with a blood test during a regular pediatric visit. Children should be tested at about 12 months of age and again at 24 months. High risk children should be tested every 6 months until 2 years of age and then each year until age 6. Record results of tests.

• Wash children's hands after play, before eating, and before bed. Wash their toys, pacifiers and other objects they put in their mouths.

• Use only lead-free ceramics for cooking or storing food. Pottery from foreign countries often contains lead.

• Feed your child 3 meals a day with foods high in calcium (milk, cheese, yogurt) and iron (lean meat, beans, eggs) and give them healthy snacks.

• Use only cold water from the cold water tap for cooking or for making baby formula. Run water from the cold water tap until the temperature changes (about 1 minute).

• Once a week, use detergent to wet mop or damp wipe floors, window sills, furniture or other surfaces that may contain lead in dust.

• If your home was built before 1978, test your home for lead before renovating or repairing. Never dry sand, dry scrape or sandblast paint.

• Keep your child away from peeling, chipping paint.

• Plant shrubs, grass, or other ground cover on bare soil you suspect may contain lead.

• Recycle spent rechargeable batteries.

• Cover lead-painted walls and ceilings with plaster, wallboard, wallpaper, paneling, or lead-free paint.

• Install vinyl siding over lead paint outdoors. These keep lead paint from chipping and falling into places where children live and play.

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Miniblinds. The plastic on some miniblinds deteriorates when exposed to sunlight, heat, or low temperatures. This causes lead dust to form on the blinds' surface, which children can touch. People with children are urged to discard vinyl miniblinds purchased before July 31, 1996. After discarding the blinds, wash the window frame with a high-phosphate detergent and dispose of the wash rag or sponge.

Provide toddlers with a sand box that has a bottom and clean sand. Wash children's hands often, particularly before they eat.

Plant bushes around lead-painted buildings to discourage children from playing where paint chips accumulate and to control the spread of lead paint chips and dust.

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Reduce lead in water and food.Lead or lead-soldered pipes can put lead in your water. Water softeners on cold water lines, brass faucets and fixtures, and lead solder on copper plumbing can add lead to the water supply. Storing drinking water in pottery or leaded crystal containers or pewter can also present a lead hazard. Avoid serving food on ceramic ware or pottery made outside the United States.

Parental hobbies and work. If you work with lead, shower and change clothes and shoes before leaving work. Don't involve your children in hobbies that involve a lot of lead such as stained glass and ceramics production and ammunition reloading.

Urban gardens may have lead in the soil, so even attempts at "organic gardening" might result in leaded food. Remove all dirt from produce by washing or peeling. Vegetables that are rich in iron may contain more lead. Don't let your child play in your garden.

Provide pacifiers or other chew toys so children will not eat paint.

Watch your diet. High-fat diets consisting of animal fat, ice cream, butter, and fried foods increase the amount of lead that blood absorbs.

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