Lead paint has been banned in U.S. homes since 1978 because of the dangers of lead poisoning, but the heavy metal still threatens children's health. Each year, about half a million children are found to have lead levels at or above five micrograms of lead per deciliter of blood (µg/dL), which is the threshold for lead exposure set by the Centers for Disease Control and Prevention.
Vermont's kids are particularly at risk because the state has some of the oldest homes in the nation; many houses here still contain traces of lead.
October 20 to 26 is National Lead Poisoning Prevention Week, so this month Dr. Lewis First, head of pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care, offers an overview of lead exposure and what parents can do to prevent it.
KIDS VT: Why is lead such a major concern for kids?
LEWIS FIRST: Children tend to absorb lead faster than adults. They also tend to be more curious, so their hands go into their mouths after touching non-nutritional objects. The introduction of lead into their systems is especially harmful when children's brains are still developing.
KVT: Where do kids typically come into contact with lead?
LF: It can be in old toys and dust around old homes. Sometimes lead paint has been painted over and is exposed when the newer paint peels. In older homes, lead is sometimes found in the soldering of pipes and faucets, so it can come out in the water. It can be in the soil and along roads from the days when leaded gasoline was used. If a parent works in construction or demolition, they can expose children to lead dust by bringing it home on their clothing.
KVT: What are the health effects of lead exposure?
LF: The effects in children may not be obvious at first; parents may not even know their kids have been exposed to it. When it becomes symptomatic, it can cause abdominal pain, constipation, anemia, fatigue, weakness, and decreased bone and muscle growth. At higher levels, it can cause seizures or coma and even be life-threatening — though those cases are rare.
More commonly, what we see in kids are behavioral changes, such as difficulty concentrating and paying attention. There are certainly many other causes for these problems, but lead should always be considered a possibility until proven otherwise. Lead can also cause speech and language delays and damage to the kidneys, bones and nervous system. Researchers now believe that lead levels of 5 to 10 µg/dL may result in a drop of five IQ points or more. In short, lead presence may affect children's overall intelligence.
KVT: When should kids be checked for lead?
LF: It's recommended that all children get screened for a blood lead level at ages 1 and 2, no matter their environment. If they have elevated risk — meaning they live in an old home, or have a parent who works in demolition or construction or uses lead chemicals at work — parents may want to check their kids as early as 6 months old. For immigrants who've never been screened for lead and are older than 2, parents may want to check them annually up to age 6.
KVT: How is lead screening done?
LF: Typically, it's with a finger-stick blood test. If the lead level is at or above 5 µg/dL, that will be followed up with a blood test drawn from the vein. We don't start treating to reduce the level of lead in the blood until it's at or above 45 µg/dL. We do that by chelation therapy, but there are risks involved. For 5 to 20 µg/dL, we screen and clear the environment as much as possible to reduce further exposure.
KVT: Are the health effects reversible?
LF: Unfortunately, no. We can work to reduce the amount of lead that continues to be deposited, but once it gets into the brain, there's nothing you can do except reduce future exposure. We can't prove that five IQ points will make a huge difference in your child's development, but it's still significant.
KVT: How do you prevent lead exposure?
LF: Step one is screening. If you find lead in your pipes, something as simple as running the tap water for 30 seconds before drinking it will flush them clean. If you have peeling paint, do wet mopping instead of sweeping or dusting, which can blow lead dust around the house. Maintaining good levels of iron and calcium in a child's diet will block their body's absorption of lead.
KVT: Anything else?
LF: When kids are outside, try to keep them from putting their hands in their mouth. Have them wash their hands when they come inside. If parents work in construction or demolition, they should remove their shoes when entering the house and shower before playing with their kids. Most importantly, if you're doing renovations or major home improvements, get educated on lead prevention.