June 05, 2014 Medical Conditions

Preventing Childhood Lead Poisoning

Exposure to lead in the home represents a significant public health threat to children. At least four million households have children living in them that are being exposed to high levels of lead. Half a million U.S. children from one to five years old have tested positive for lead levels above five micrograms per deciliter, which is the amount at which the CDC recommends public health actions such as home assessments and further monitoring. The good news is that lead poisoning is entirely preventable.

Lead is a toxic metal that has the potential to affect multiple body systems, including the brain, blood cells, heart, and kidneys. While the government has taken a proactive approach to preventing lead poisoning by banning lead paint in housing since 1978, the reality is that many homes were built before that time. It is safe to assume that a house built before 1987 has at least some lead-based paint.

Early exposure to lead may not cause symptoms, so monitoring with appropriate testing before problems occur is essential to children to prevent effects of lead toxicity. All children under age two should have a lead level checked routinely. This can be ordered through your pediatrician’s office.

How to Prevent Lead Poisoning

Children under six years old are at the highest risk for lead poisoning because they grow so fast and they are likely to put their hands or other items, which may be contaminated with lead dust, into their mouths. The greatest risk is for children living at or below the poverty line in older housing. It’s not just the child’s house that can be a source of exposure. If a child spends a lot of time at grandparents’ homes or in a daycare facility, those could be possible sources of lead exposure, too. Your state and local health departments can help you get information about testing your home for lead, and in some cases provide free home test kits to help determine your risk. If your home test is positive, there are steps you can take in your home to reduce your child’s risk of exposure. Your local health department is a great source of information on this.

If you’re not sure whether your home has lead-based paint, take these precautions:

  • Be sure that your child does not come into contact with peeling paint or surfaces with old paint where a child might chew (like window sills, door jambs, etc.).
  • If you’re having renovation done that is likely to disturb old paint or create debris, children and pregnant women should not be present until the area has been thoroughly cleaned.
  • If there is chipping paint on walls or doors, create a physical barrier to prevent small chips or dust; use duct tape or contact paper to cover the surface until it can be appropriately sanded, repainted, and thoroughly cleaned.
  • Lead contamination can be in household dust and outside soil, so wash children’s hands and toys frequently. Remove shoes before entering the home in order to prevent lead-contaminated soil from being tracked in from outside.
  • Floors, surfaces, and window sills and wells should be wet-mopped/wet-wiped every few weeks so that they remain free of leaded dust.
  • If possible, have children play outdoors in grass, mulch, or wood chips instead of bare soil.
  • Avoid eating candy from Mexico, as it has been found to contain lead.
  • Watch for recalls on toys and children’s products and remove from the home any that have been recalled.
  • When using tap water for drinking, cooking, or preparing baby formula, use only cold water, as hot water is more likely to contain higher lead levels. Any lead in your household water is likely from your plumbing, not from the water supply itself.

Blood Tests to Determine Lead Levels

Because a child with lead exposure often does not appear or feel sick, New York State requires that all children are tested twice for lead poisoning before age two. The goal of testing is to prevent problems before they occur, and is particularly important for developing children of this age. Lead is found in dust, air, water, soil and in some household products, which is why it’s important to have your child tested regardless of whether you live in an older house. Your child’s health care provider is required to ask questions about the possibility of lead exposure up to when the child turns six years old; if there is a possibility of exposure, the provider should have the child get a repeat test just to be sure. Blood tests are preventative tests and are covered by your insurance, there is no fee for this test. Often testing is done with a simple finger stick.

Understanding Lead Test Results

The average lead test result for children is around 2 micrograms per deciliter. If the result is 0 to 4, it is considered “undetectable,” and should not be a concern.

A blood lead level above 5 micrograms per deciliter represents a potential concern for your child, and will be addressed by your healthcare provider and potentially by public health officials to determine further monitoring and investigating possible sources of exposure.

For any blood level between 5 and 45 micrograms per deciliter, it will be important to follow up with your child’s healthcare provider and public health authorities to continue to monitor the level and to avoid further exposure.

Blood levels over 45 micrograms per deciliter usually require treatment with medical therapy to prevent permanent effects of lead poisoning.

Symptoms of Lead Poisoning

Although a single high dose of lead could cause emergent symptoms, it’s more likely that lead poisoning will build in the body over a period of time. You might not see any obvious signs of poisoning, but even very low exposure can affect a child’s mental development in the long term. The younger the child, the more vulnerable she or he is – unborn babies are most vulnerable of all.

Signs of lead poisoning can include:

  • Behavior and attention problems
  • Problems in school
  • Hearing problems
  • Kidney damage
  • Reduced IQ
  • Slow body growth

Symptoms include:

  • Abdominal pain, cramps
  • Aggression
  • Anemia
  • Constipation
  • Difficulty sleeping
  • Headaches
  • Irritability
  • Developmental skill regression
  • Low appetite, energy
  • Reduced sensations

If there is exposure to a very high level of lead, your child could experience vomiting, staggering walk, muscle weakness, seizure, or coma.

If you’re concerned about the presence of lead in your home (or anywhere in your child’s environment), or if you think that your child may have experienced lead exposure, don’t hesitate to consult with your child’s physician to determine whether your child should be tested and what steps you should take to protect him or her from further harm.

References: Centers for Disease Control and Prevention, U.S. Food and Drug Administration, New York State Department of Health, Parents.com, National Institutes of Health Medline Plus

Brian Sheridan, MD
About the Author

Brian Sheridan, MD, joined CDPHP in April 2014 as a medical director, assisting in the utilization management of programs that offer premium health care at an affordable price. Prior to working at CDPHP, Dr. Sheridan’s experience includes his work in clinical practice as a pediatrician at Schoolhouse Road Pediatrics. Dr. Sheridan is an executive board member for the Guilderland YMCA and is the president of the Bus Stop Club, an organization dedicated to the siblings of children with chronic illness. Dr. Sheridan is a medical graduate from the Royal College of Surgeons in Ireland and completed his residency in pediatrics at Albany Medical Center Hospital. He holds board certification in General Pediatrics. He earned his Bachelor of Science in psychology/biology from Binghamton University, Binghamton, NY.

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