Lead Poisoning

What Is It?

Lead is a metal that is poisonous (toxic) when breathed in or eaten by humans. Lead gets into the bloodstream and is stored in the organs, tissues, bones and teeth. With increasing or prolonged exposure, this toxin can cause:

• Permanent damage to the central nervous system, especially the brain
• Delayed development in children
• Behavioral changes in children
• Decreased production of red blood cells (anemia)
• Hearing problems
• Damage to the reproductive systems of men and women
• Kidney disease
• Convulsions (seizures)
• Coma

The leading source of exposure to lead is lead-based paint, which was outlawed for residential use in 1978, but remains in some older homes. The main hazard is paint dust, which enters the air when old paint is scraped, sanded or begins to flake.

People can get lead into their bodies in other ways, such as drinking water from pipes that are made of lead or use lead solder, using ceramic dishes made with lead, playing in lead-contaminated soil, using lead in hobbies or crafts such as making stained glass, or by using certain home remedies that contain lead. Even unusual sources, such as lead-contaminiated spices purchased in foreign countries, have been reported.

Children face the most serious risk because their growing bodies absorb more lead. Young children, especially toddlers, play on the floor and tend to put objects in their mouths that may be covered with lead dust. If lead paint is flaking, small children sometimes eat the sweet tasting paint chips or chew on painted surfaces, such as windowsills.

Adults who have high lead levels in their blood usually were exposed in the workplace. Industries with a high potential for exposure include construction that involves welding, cutting, blasting or other disturbances of surfaces painted with lead; smelter operations; radiator repair shops; and firing ranges. Young children can be exposed to lead when parents who work in these areas carry lead dust home on their clothes and shoes.

A woman who had lead poisoning can pass lead on to her fetus if she becomes pregnant, even if she no longer is exposed to lead. This happens because more than 90% of the lead may be stored in the bones and then released into the bloodstream years later.

Since lead was banned in gasoline and residential paint, average blood levels of lead have dropped dramatically in the United States. Nevertheless, 2005 data from the U.S. Centers for Disease Control and Prevention (CDC) showed that nearly 2% of children in the U.S. had levels of 10 micrograms per deciliter in their bloodstream. This level that is thought to be hazardous. Recent studies suggest that even lower levels may be harmful.

Symptoms

Children with blood lead levels of 10 micrograms per deciliter to 25 micrograms per deciliter usually do not show any obvious symptoms of too much lead in the body. The damage may not be obvious and only becomes noticed at school age, when the child shows signs of possible learning disabilities, behavioral problems or mental retardation.

The effect of lead on young children has been estimated as an average loss of 2 to 3 IQ points for each 10 micrograms of blood lead per deciliter. At higher exposures, children may experience:

• Decreased production of red blood cells (anemia)
• Tiredness and fatigue
• Headaches
• Severe abdominal pain and cramps
• Hearing problems
• Slowed growth
• Persistent vomiting
• Convulsions (seizures)
• Coma

Adults with blood lead levels of 40 micrograms per deciliter to 50 micrograms per deciliter may display some of the same symptoms, or any of the following:

• Inability to sleep (insomnia)
• Memory and concentration problems
• Infertility
• Kidney damage
• High blood pressure (hypertension)
• In pregnant women: stillbirths, miscarriages, premature births or problems in fetal neurological development

Diagnosis

A doctor who thinks someone has lead poisoning will do a physical examination and ask about symptoms, medical history, potential environmental exposure to lead, diet and (in children) any learning or behavior problems. Lead poisoning is diagnosed with a simple blood test.

Because there are often no early symptoms, a blood test is the best way to identify children at risk of lead poisoning at an early stage, typically starting at age 6 months to 12 months. Blood lead screening is required at ages 1 and 2 for all children enrolled in the Medicaid program. The CDC and the American Academy of Pediatrics recommend that children under age 6 be tested for lead if they:

• Live in or regularly visit a house or day care center built before 1950, or one built before 1978 that has been remodeled in the last six months
• Have a brother, sister, housemate or playmate who is being treated for lead poisoning
• Live with a parent whose job or hobby involves exposure to lead
• Live near an active smelter, battery recycling plant or other industry likely to release lead into the air
• Have been seen eating paint chips or dirt
• Have low levels of iron in the blood (anemia)

Expected Duration

It may take several weeks, months or years for lead to leave the body, even after there is no further exposure.

Prevention

To prevent lead poisoning, avoid or minimize exposure to lead. Remove lead paint or contain it with frequent cleaning:

• Careful and frequent cleaning has been shown to reduce exposure to lead substantially. Use a mop or sponge with warm water and an all-purpose cleaner or a cleaner made especially for lead to regularly clean floors and other surfaces. Frequently wash a child's hands, toys and pacifiers with soap and water.
• If you have lead paint in your home, do not try to remove it or paint over it yourself. Improper removal of lead paint can make contamination worse by sending lead-containing dust into the air. Hire a professional trained in lead abatement techniques. Call (800) 424-LEAD (5323) for a list of contacts in your area.
• If you have lead pipes or lead solder in your plumbing, or if you have an older house and are not sure about the pipes, call your local health department or water supplier for information on getting your water tested. Meanwhile, use only cold water for drinking, cooking and for making baby formula, and run the water for 15 seconds to 30 seconds before drinking it, especially if you have not used the water from that faucet for a few hours.
• If your job involves potential lead exposure, insist that your employer comply with all federal and state laws to protect workers and to monitor their health. Follow all recommended measures (masks, protective clothing, etc.) to protect yourself. Before coming home, shower and change your clothes. Launder your work clothes separately from those of the rest of the family or from clothes you do not wear for work.
• Avoid storing food in lead crystal or lead-glazed dishes. Do not use folk remedies that contain lead, such as greta and arzacon, which are used for an upset stomach or indigestion, or pay-loo-ah, which is used for rash or fever. Do not use cosmetics that contain lead such as kohl (eyeliner).

Treatment

For all cases of lead exposure, the most important step is to remove the source of lead. When this is done, treatment is not usually necessary if the blood lead level is less than 20. However, repeat blood tests to be sure the amount of lead in the bloodstream stays low. Higher levels of lead in the bloodstream may need to be treated by taking a drug that binds to the lead and helps the body to remove it. This process is called chelation therapy. Doctors decide whether to use chelation therapy on a case-by-case basis. Very high levels of lead (70 or greater), sometimes require hospitalization to begin therapy.

After treatment and/or removal of the environmental lead source, the doctor normally will do more blood lead tests to follow the progress until the blood lead level is no longer too high. Besides recommending a nutritious diet, the doctor also may recommend iron or calcium supplements.

When To Call A Professional

If you are the parent or guardian of a child under age 6, make sure he or she visits a health professional regularly to discuss possible risks of lead poisoning and gets tested if necessary. See the child's doctor immediately if you notice symptoms of lead poisoning or suspect that the child has been exposed to lead.

Prognosis

The outlook for children with lead poisoning depends on the amount of lead in the body, how long the child was exposed and how the child responsed to treatment. Children with brief, low-level exposures usually recover completely. Many children with low to moderate lead exposure for prolonged periods have decreased intellectual function. Even with appropriate treatment, children with high levels of blood lead can have severe, irreversible brain damage.

Additional Info

American Academy of Pediatrics (AAP)

141 Northwest Point Blvd.

Elk Grove Village, IL 60007-1098

Phone: 847-434-4000

Fax: 847-434-8000

Email: kidsdocs@aap.org

http://www.aap.org/

National Institute for Occupational Safety and Health

4676 Columbia Parkway

Mail Stop C-18

Cincinnati, OH 45226

Toll-Free: 1-800-356-4674

Fax: 513-533-8573

http://www.cdc.gov/niosh/

National Safety Council

1121 Spring Lake Drive

Itasca, IL 60143-3201

Phone: 630-285-1121

Fax: 630-285-1315

Email: info@nsc.org

http://www.nsc.org/

U.S. Department of Labor's Occupational Safety & Health Administration (OSHA)

200 Constitution Ave.

Washington, D.C. 20210

Phone: 202-693-1999

Toll-Free: 1-800-321-6742

TTY: 1-877-889-5627

http://www.osha.gov/

U.S. Environmental Protection Agency (EPA)

Ariel Rios Building

1200 Pennsylvania Ave., N.W.

Washington, DC 20460

Phone: 202-272-0167

http://www.epa.gov/