Elevated blood lead levels mean your child may have been exposed to environmental lead that may pose a hazard to his/her health. Even low levels of lead in blood have been shown to affect IQ, ability to pay attention, and academic achievement. And effects of lead exposure cannot be corrected. The most important step parents, doctors, and others can take is to prevent lead exposure before it occurs.
Lead is a soft metal found throughout the environment in air, soil, household dust, food, some drinking water and certain types of pottery, porcelain, and pewter. Children are usually exposed when they put paint, soil, dust or other materials containing lead into their mouths.
Blood tests are used to find out how much lead is in a child's blood. These tests may show a blood lead level that is:
What Are The Symptoms Of Lead Poisoning?
Symptoms of elevated lead levels are difficult to distinguish from other common illnesses. Common signs include: poor appetite, stomach aches, vomiting, constipation (not diarrhea), crankiness, loss of energy, anemia, headaches, and trouble sleeping.
Very high lead levels may cause coma, convulsions, and death.
Repeated exposure to small amounts of lead can also cause lead poisoning because the lead accumulates in the body. The brain is most sensitive to lead exposure during the first 6 years of life. Exposure to low levels of lead can harm a child's brain and nervous system. The brain damage results in such problems as lowered IQ scores (an average of 7 IQ points lost), decreased attention span, decreased hearing, speech delays, and other developmental delays.
However, some children with only slightly elevated lead may not have any obvious symptoms. This is why it is necessary to perform lead screens on all children.
How Is A Screening Blood Lead Level Obtained?
Lead poisoning is diagnosed by a blood test. Routine screening lead levels are first drawn in our office by a finger stick (easier for child). A level of < 5 mcg/dl is normal. If your child's lead level is found to be > 5 mcg/dl, it will be necessary to repeat the lead level by taking blood from a vein. An elevated lead level obtained by finger stick does not mean your child has lead poisoning. Most children (who are not in the high risk category), will have a normal lead level when repeated by blood taken from a vein. It is not known why some lead levels, obtained by finger stick, are reported back as being falsely elevated.
Lead levels >5 and less than 14 need to be repeated in 3-4 months. Lead levels between 15-19 require a repeat lead level in 3-4 months with evaluation of the environment for possible lead exposure.
Lead levels 20 - 45 (blood taken from a vein) may require medical treatment in a hospital.
When Should Children Be Screened?
All children should be screened at 9-12 months of age and again at 2 years of age, unless they are identified as being at "high risk" (see below).
Children, aged 3 to 6 years, with no prior record of lead screening, should also be screened.
Some cities and states have very specific screening requirements and follow-up recommendations, based on the prevalence of high risk factors (see below). Philadelphia has a very high estimated prevalence of elevated lead levels and predominantly older housing with high levels of lead base paint (see below).
The Centers for Disease Control and Prevention consider the following situations as "high risk" for increased lead exposure:
Children who remain at high risk for lead exposure should be tested for lead at least every year until their sixth birthday. The lead levels when a child is 9-12 months old and 24 months old are especially important.
Is There Ways To Tell If My Child Has Been Exposed?
Check the following lists to determine if your child may be exposed to lead. The only way to determine the actual lead exposure is by having a blood lead test done.
Have any of the following activities occurred at your residence within the last year?
Do Your Children:
Sources of Lead Exposure
Paint: The most common source of lead exposure for children is lead-based paint. This paint was also used on some older toys and furniture. Lead was finally banned from house paint in 1978. Three quarters of all houses built before 1960 contain lead-based paint. When paint chips or peels, young children can pick up these particles and chew them.
Dust: More commonly, children swallow dust and soil contaminated with lead paint. Home remodeling and sanding especially, put a great deal of lead powder into dust and soil. Be aware of remodeling being done near your home.
Soil: may have lead in it from exterior lead paint chips and dust, lead-based insect sprays and highway pollution (due to past use of lead in gasoline).
Food: Food may be contaminated if it is:
Air: The almost complete phasing out of leaded gasoline in the U.S has markedly reduced the amount of lead present in the air from automobile exhaust.
Folk Remedies and Cosmetics Containing Lead:
Occupational and Recreational Lead Sources:
Water: may pick up lead as it flows through plumbing with lead pipes, fixtures or solder. Lead is found in low levels in some drinking water because lead-based solder on old water pipes may add lead to water. Lead-based solder was not banned for use with water pipes until 1986.
Only a small amount of human lead ingestion is believed to come from drinking water. The Environmental Protection Agency (EPA) sets drinking water standards and has determined that lead is a health concern at certain levels of exposure.
If lead is present in drinking water, it usually has entered the water after leaving the local water treatment plant. The most likely source for lead contamination is the home. It is commonly caused by corrosion which results from the interaction between the water and the lead pipes or lead-based solder.
All water treated by Philadelphia Suburban Water Company (PSW) has no detectable level of lead. Water samples from customers throughout the system are tested because customer plumbing (from the curb to the residence or business) in some cases does contain lead. Test results still show lead concentration far below the level permitted by the EPA.
Lead levels in your drinking water may be elevated if:
Federal law for use on new household plumbing and repairs now requires lead-free solder and lead-free materials. PSW employees use only lead-free solders and flux to repair, replace and maintain all plumbing.
If drinking water is determined to have high levels of dissolved lead, or if there is even a suspicion of lead contamination, there are ways you can minimize your exposure:
Important Facts about Prevention of Lead Poisoning
The best prevention of lead poisoning is to eliminate your child's exposure to lead in the environment.
Children naturally place fingers and thumbs in their mouth. It is important to know that this is the primary way that children are exposed to lead. They also teethe on objects, eat non-food items (this activity is called pica), and place objects, such as toys, paint chips, plaster, or soil in their mouth.
Keep a careful watch over your child. Educate babysitters and child care workers to encourage children to wash their hands.
Does Diet Play A Role In Lead Poisoning Prevention?
Make sure your child's diet contains adequate iron and calcium. Both of these minerals make it harder for your child's body to absorb lead.
fried food such as French fries, fried chicken and potato chips
pastry, cakes, and other baked goods
butter, oil, and lard
hamburgers, bologna, salami, and bacon (fatty meats)
Treatment of Lead Poisoning
Children with high levels of lead in their blood or symptoms of lead poisoning need to start taking a medication (called a chelating agent) that binds with the lead and carries it out of the body.
All children with elevated levels of lead need to be protected from re-exposure to the lead until it is removed. A public health agency or housing agency should carefully inspect the child's home environment for lead hazards. The family should take all of the recommended precautions for preventing lead exposure.
For more information on lead in drinking water, you can call the EPA toll-free hotline at 800/426-4791 or call the Customer Service Department at the number printed on your bill.
To learn more about preventing lead exposure, visit CDC’s Web site at www.cdc.gov/nceh/lead/
Learn more at EPA's Renovation, Repair, and Painting rule Web page:
Childhood Lead Poisoning Prevention Questionnaire
Under recent federal clarification, a child, whose parent has answered "yes" to one or more of the risk assessment questions is determined to be at "high risk." A child, whose parent has answered "no" to all questions, is determined to be at "lower risk."