Lead Poisoning in Children

What's the Problem?

Lead, a naturally occurring element, can be toxic when taken into the body through breathing, eating, or drinking. Lead is most dangerous to children, especially those under six. Nearly one half of a million children living in the United States have levels of lead in their blood that exceed ten micrograms of lead per deciliter of blood, a level at which adverse health effects are known to occur. Lead poisoning can affect virtually every body system; it can damage a child's central nervous system, kidneys, and reproductive system. At high levels, lead can cause coma, convulsions, and death. Even low levels of lead in young children's blood can be harmful and can result in decreased intelligence, impaired neurobehavioral development, decreased stature and growth, and impaired hearing. Because childhood lead poisoning often has no distinctive clinical symptoms, it can go unrecognized.

The most significant sources of lead exposure for U.S. children are deteriorated lead-based paint and dust contaminated with lead. Lead-based paints were banned for use in housing in 1978, but about 85% of U.S. housing was built before the ban. Young children who live in older houses with deteriorating paint may eat paint chips that contain lead or ingest or breathe lead-contaminated dust from floors, carpeting, or their toys. Since the exteriors of houses also may have been painted with lead-based paint, children may be exposed to lead in the soil when they play outdoors. Other sources of lead poisoning include those related to hobbies (e.g., making stained-glass windows) or work (e.g., recycling or making automobile batteries).

Who's at Risk?

Children from all social and economic strata can be affected, although the children at greatest risk of lead exposure are those who live in older housing and are living in poverty. Some racial and ethnic groups (e.g., African-Americans and Mexican-Americans) are disproportionately affected by lead poisoning.

Can It Be Prevented?

Yes. The key is stopping children from coming into contact with lead and identifying and treating children who have been poisoned by lead. Lead hazards in a child's environment must be identified and eliminated. Public and health care professionals need to be educated about lead poisoning and how to prevent it. Children who are at risk for lead poisoning need to be identified, tested, and if necessary, treated. A lack of knowledge about lead poisoning and its causes often delays parents from having their children tested or from taking appropriate safety measures.

The Bottom Line

• People who live in older housing, especially those who have young children who live or visit with them, should consult their state or local health departments about how to get paint and dust from their homes tested for lead.
• Parents or guardians concerned about a child's exposure to lead can ask a doctor to test the child.
• Housekeeping practices such as damp-mopping floors, damp-wiping surfaces, and frequently washing a child's hands, pacifiers, and toys can minimize exposure to lead.
• People need to take steps to prevent lead poisoning of workers and residents before and during renovation of lead-containing structures.
• People whose work or hobbies involve using lead-containing products should take basic precautions to decrease their exposure to lead and to prevent carrying lead home on their clothes, skin, or hair (e.g., showering and changing clothes after finishing the task).

Case Example

A mother brings her two-year-old son to the doctor with complaints of lethargy and abdominal pain. The doctor learns that the father is in the process of remodeling the family's home, which was built in the 1920's. Suspecting lead poisoning, the doctor tests the family and advises the contractor to be tested. The children all have lead poisoning and they are treated, one child requiring hospitalization. The doctor provides the family with information about lead poisoning and its prevention and immediately notifies the local health department. Health officials find that old paint and leaded dust, released during renovation, are the lead sources. The family lives with friends until the renovation is complete, and the workers take special precautions in removing the lead-containing paint and dust.