Given what we know about how dangerous lead can be for children, lead poisoning may seem like something that should be a thing of the past, relegated to the time when leaded gasoline fueled the cars we drove and lead paint was the go-to choice for home decor. But to this day, lead poisoning in children persists: The toxic heavy metal can still sometimes be found in drinking water that passes through lead pipes, in older homes with chipping paint and even in contaminated soil. In fact, kids in at least 4 million households are being exposed to high levels of lead, and nearly 500,000 children ages 1 to 5 are diagnosed with high blood lead levels each year, according to the Centers for Disease Control and Prevention (CDC). So how can you recognize the signs of lead poisoning in children, and what can be done to treat—and, more importantly, prevent—it?
In this article:
What is lead poisoning in children?
Effects of lead poisoning in children
What causes lead poisoning in children?
Lead poisoning symptoms
Lead poisoning treatment
How to prevent lead poisoning in children
What Is Lead Poisoning in Children?
Lead poisoning happens when a child ingests enough of the metal over time to raise the level of lead in her blood to a point where it can damage her brain and other internal organs. No amount of lead in the blood is considered safe, but a child doesn’t actually need to be treated with medication unless the lead poisoning is significant. Five micrograms of lead per deciliter of blood is officially considered to be high exposure (the CDC created new, more stringent blood level recommendations in 2012, lowering the standard from 10 or more micrograms per deciliter of lead in blood to 5)—however, medical treatment is only called for when a child’s blood lead levels reach 45 micrograms per deciliter or higher.
The trick, of course, is to catch elevated lead levels before they spike too high. There are lead poisoning symptoms to keep an eye out for, but those symptoms often go unnoticed early on. “Because lead exposure isn’t always easy to see and acute lead poisoning symptoms don’t appear until the level is very high, all children should have their lead levels checked as infants,” says Carrie Brown, MD, a pediatrician at Arkansas Children's Hospital in Little Rock. Kids who are at low risk for lead poisoning typically get an initial blood test at their one-year well visit; babies who are at high risk are advised to get tested at 6 months. The blood test is covered by Medicaid and most private health insurance.
Effects of Lead Poisoning in Children
Lead poisoning can be extremely dangerous for young kids: It can impact every major organ system, causing severe short-term health issues as well as irreversible long-term damage.
In the short term, lead poisoning can lead to weight loss, fatigue and stomach pain. If the exposure is severe enough, lead poisoning can cause convulsions, coma or even death. Long-term effects of lead poisoning include:
- kidney disease
- high blood pressure
- impaired immune system
- diminished vitamin D levels, which can impact cellular growth and bone development
- potential connection with cardiovascular disease and stroke
The most serious concern is the impact of lead poisoning on a child’s brain and nervous system. High lead levels have been shown to permanently damage the brain’s synapses, leading to learning disabilities, developmental issues, attention deficit hyperactivity disorder (ADHD), antisocial or aggressive behavior and lower IQ. A 2017 study found that kids who were exposed to high levels of lead saw a decline in their intellectual abilities as they got older: Researchers tested children’s blood lead levels and IQs at age 11 and again at age 38, and discovered that every 5 micrograms of lead concentration in the blood at childhood corresponded to a drop in IQ of 1.6 points in adulthood, impacting in particular their perceptual reasoning and working memory.
What Causes Lead Poisoning in Children?
Swallowing or inhaling lead particles can lead to lead poisoning.Babies and toddlers are particularly susceptible because they spend a lot of time on the ground, where dust and dirt can be contaminated with lead, and are constantly putting their hands in their mouths. As for lead sources, the most common culprit is still chips and dust from lead-based house paint, which was commonly used in homes built before 1978. Other places where you might come in contact with lead include:
• Your home’s water supply. Lead particles can leach from corroded pipes and into your tap water, especially hot water. Brass or chrome-plated brass faucets and sink fixtures with lead solder are the biggest problems, according to the US Environmental Protection Agency (EPA). Homes built before 1986 are more likely to have lead pipes, fixtures and solder.
• Soil. As a heavy metal, lead often occurs naturally in soil at low levels, but vehicle emissions and waste from mining, smelting, refining and other industrial activities can dramatically increase the amount of lead present in the ground. If you happen to live next to a busy road that’s been around for more than 40 years (before lead began to be phased out of gasoline in 1975), lead from car exhaust has probably contaminated the soil around your home. If you live in a house built before 1978, it likely has lead paint, which may have chipped off the building and also landed in the surrounding soil. But proximity isn’t the only factor—lead particles can actually travel long distances before setting into the ground.
• Your clothes. If you work in industries where lead is used, like auto repair, manufacturing or construction, you may inadvertently track lead dust into the house from your clothes and shoes.
• Toys and other products. Lead was banned in products marketed to children and in dishes or cookware in the US in 1978, but antique toys and other collectibles from before that time may still have traces of lead, the CDC says. Products and children’s playthings that are imported from countries where safety standards are more lax can also contain lead. (The US Consumer Product Safety Commission keeps a lookout for these items and issues recalls when needed. In 2016, only one toy recall was due to the presence of lead.)
• Pottery glaze. Traditionally, pottery is made with glazes that sometimes use lead to help the glaze particles melt. When the ceramic ware is fired in a kiln, the lead is bound into the glaze, and any traces that might migrate to food would be an insignificant amount, according to the US Food and Drug Administration (FDA). But if it’s not fired properly, the lead may not fuse and could contaminate food served in the pottery. Most potters have switched to using non-lead glazes these days, but they could still be using old kilns that might contaminate the lead-free pottery with lingering lead particles.
• Imported foods. In 1995, the US banned the use of lead solder on cans, but other countries still use it. These cans have wide, silver-gray seams that contain lead, which over time can seep into the food. Other non-canned imported foods may also have lead in them: Tamarind and chili candies from Mexico are a known example. But the FDA sets strict limits for the lead content for products made or sold in the US and keeps a watchful eye on imported foods.
Lead Poisoning Symptoms
Because lead poisoning happens slowly over time—and because the symptoms of lead poisoning are often so mild at the beginning—parents often don’t discover the poisoning until lead levels are already high. It’s important to keep a lookout for the following lead poisoning symptoms and contact your child’s pediatrician with any concerns:
- trouble learning or developmental delays
- appetite loss or stomach pain
- weight loss
- hearing loss
Lead Poisoning Treatment
There is lead poisoning treatment available that helps lower blood lead levels, but unfortunately, some of the effects of lead poisoning can be permanent—especially damage to the brain and cognition. “It’s unknown and unlikely that the damage that was already done can be reversed,” says Michelle Davis-Dash, MD, a practicing pediatrician in Baltimore and a doctor with The Mommy MD Guides, an online educational resource for parents.
For elevated levels of lead that haven’t reached the toxic stage (45 micrograms per deciliter), treatment may simply involve avoiding the source of lead; either it’s a matter of cleaning up lead paint dust or using a safer water supply.
For higher levels, a type of lead poisoning treatment called chelation therapy is used. A chemical called EDTA (ethylenediaminetetraacetic acid) is injected into the child’s bloodstream. This chemical binds with heavy metals in the blood and helps expel them from the body. “Treatments—like chelation therapy by mouth and IV, depending on the lead level—can be used to lower a very high lead level to prevent more damage to the child’s brain and other organs, but may not totally repair damage that has already been done,” Brown says.
How to Prevent Lead Poisoning in Children
When it comes to lead poisoning in children, prevention is key. Fortunately, the steps for reducing your child’s risk of lead poisoning are pretty simple:
• Keep your floors clean. “Take your shoes off at the door so as to not track lead dust through the house,” Davis-Dash says. Washing your floors regularly—especially in areas where baby is crawling or playing—will help minimize the odds of exposure.
• Wash hands, toys and surfaces. To minimize dust and dirt—which may be contaminated with lead—make regular washing a part of your routine.
• Watch out for peeling paint. If you live in a home that predates the lead paint ban, there may be layers of lead-based paint beneath your fresh wall colors. Be sure to repair any peeling spots quickly, and clean up thoroughly after your repair to remove any old paint chips from the area.
• Use cold water for cooking. “There’s the potential for lead exposure in using hot water from the sink to cook, prepare formula and other beverages, since hot water leaches more lead from the pipes if it’s present,” Davis-Dash says. You may want to run the cold water for a few minutes before pouring water to cook or drink to help flush out any water that may have been resting in lead pipes.
• Know what’s in your children’s products. Some manufacturers continue to use lead, so if you’re in doubt, check it out. “Glassware, dishware, cookware, cosmetics and some toys may be potential sources of lead—especially some imported items,” Davis-Dash says. Head to the CPSC website to look for any recalls.
• Block access to any contaminated dirt. If you know (or suspect) the ground in your backyard or around the house has medium or high levels of lead, cover it up with some mulch and put up a fence to keep your kids from playing in the area.
• Get your water tested. Since you can’t see, taste or tell lead in water, testing is the only surefire way to know if your water is contaminated. To get your home’s water tested, contact your state or local drinking water authority for a list of certified labs that can do the job; testing usually costs between $20 and $100.
• Get your child tested. This won’t prevent lead poisoning, but it may help you discover it before any permanent damage sets in. “Regular doctor visits and compliance with lead screenings are crucial components in the fight against lead poisoning,” Davis-Dash says.
Published September 2017