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What’s all this talk about Lead Poisoning?

In the wake of all the recent press and toy recalls, parents have yet another thing to worry about- lead exposure in their young children. So lets review the facts about Lead poisoning:

HOW: How Does Your Child Get Exposure to Lead?
Your child eats Lead that exists in the environment.

Although lead is no longer used in paints, gasoline, water pipes and other products in this country, some lead-based products still exist and may pose a health hazard.

  • In the soil- lead is not biodegradable: Especially near busy streets, in part because lead was an ingredient in gasoline until the late 1970s
  • In older homes-in old paint and pipes Lead pipes, brass plumbing fixtures and copper pipes soldered with lead can release lead particles into tap water. Hot water absorbs more lead than cold water does. The EPA warns against making baby formula with hot tap water from old plumbing systems. Lead paint. In 1978, the Consumer Product Safety Commission (CPSC) banned the sale of lead-based paints for use in residences, children's toys and household furniture. However, lead-based paint is still on walls and woodwork in many older homes and apartments.
  • In house dust- Contaminated soil is a particular concern because it can also introduce lead dust into the home.
  • Food stored in bowls glazed or painted with lead
  • Some imported canned food. In 1995, the United States banned the use of lead solder for sealing food cans, but some foods still are imported from other countries where lead solder may be used.
  • Some folk remedies and makeup: just because its from a heath food store doesn’t mean its healthy and the most recent scare is lead used in lipsticks from name-brand cosmetic companies.

And of course ….TOYS

  • and jewelry, hobby, and sports objects (like stained glass, ink, paint, and plaster) imported from countries with less stringent regulations.

WHO: Who is Most Susceptible to Lead and it's Harmful Effects?
Babies and young children

More vulnerable:
Lead poisoning is more dangerous to fetuses, babies and children than to adults because lead is more easily absorbed into growing bodies and can accumulate in their nervous system as they grow and develop. The tissue of children also is more sensitive to lead's damaging effects.

More Concentrated:Children are also particularly susceptible to the effects of lead poisoning because their intestinal tracts absorb 10x more lead than adults.

More Mouthing behaviors:Babies and young children are also especially susceptible to lead exposure because they have a tendency to put objects in their mouths. They may eat or chew paint chips, or their hands or other objects placed in their mouths may be contaminated with lead dust.

WHY: Why is Lead Harmful?
It settles in your organs and competes with healthy nutrients for growth

Lead gets into a person's bloodstream and is distributed throughout the body just like helpful minerals such as iron, calcium, and zinc.

In the bloodstream, it can damage red blood cells and limit their ability to carry oxygen to the organs and tissues that need it. It also competes with iron absorption so many Children with lead toxicity may also be iron deficient and ANEMIC

Most lead ends up in the bone, where it causes even more problems. Lead can interfere with the production of blood cells and the absorption of calcium that bones need to grow healthy and strong. Calcium is essential for strong bones and teeth, muscle contraction, and nerve and blood vessel function.

The greatest risk is to brain development, where irreversible damage may occur. Very high lead levels may cause seizures, unconsciousness and possibly death. Death by lead poisoning is very rare.fortunately.

WHAT: What Should I Be Looking for if My Child Has Been Exposed?
Lead poisoning may be hard to detect at first, because children who appear healthy can have high levels of lead in their bodies. The accumulation of lead usually is gradual, building up unnoticed until levels become dangerous and cause signs and symptoms.

The signs and symptoms of lead poisoning in children are nonspecific and may include:

  • Irritability
  • Loss of appetite
  • Weight loss
  • Sluggishness
  • Abdominal pain
  • Vomiting
  • Constipation
  • Unusual paleness (pallor) from anemia
  • Learning difficulties

What should I do to be sure my child is safe?

Screening and diagnosis

I recommend to all patients in my practice that their child be tested for anemia and for lead levels on or around their first birthday. However, many clinics ask parents to complete a risk questionnaire for lead exposure and only test those children identified as at risk, rather than screen every child.

The CDC recommends having your child tested for lead poisoning at 6 months and then yearly if your home contains lead paint, or if you're exposed to lead at work or use lead in a hobby. I would agree with that if your child has any of the risk factors outlined above.

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The test is best done with blood work. Again, I recommend a venous test done by a certified lab, and we test for anemia with the same sample and your child is done! Some doctors order a finger stick instead of from a vein. While this is certainly preferable for your child, it is much less accurate, and often returns a report of a falsely ELEVATED lead level. This in turn forces the child to have yet another test done, this time from a vein, delaying the results by yet another two weeks spent worrying. If you choose to have a fingerstick test done for your child, be sure the laboratory personnel is experienced with this test, and washed your child’s hands thoroughly before the test.

Lead levels in the blood are measured in micrograms per deciliter (mcg/dL). An unsafe level is 10 mcg/dL or higher — a guideline set by the CDC. NOTE that since I have been a pediatrician, the unsafe level has dropped from an acceptable level of 40(!!!) down to 10- but most experts would tell you that any exposure is bad exposure. Most labs in Manhattan report levels as <3 as their lowest detectable result.

Lead levels in the blood are categorized into Classes I through V. Class V is the most severe and constitutes a medical emergency. The classes are as follows:

  • Class I: less than 10 micrograms per deciliter (mcg/dL)
  • Class II-A: 10 to 14 mcg/dL
  • Class II-B: 15 to 19 mcg/dL
  • Class III: 20 to 44 mcg/dL
  • Class IV: 45 to 69 mcg/dL
  • Class V: 70 or greater mcg/dL


Exposure to high levels of lead in a short period of time is called acute toxicity. Exposure to small amounts of lead over a long period of time is called chronic toxicity.

Treatment for lead poisoning varies depending on how much lead is in the blood.

MILD: Stop the exposure and remove the source of lead. Gradually, as the body naturally eliminates the lead, the level of lead in the blood will fall. Children in this case may need to be retested a month after being removed from the source of the lead.

If you can't remove the source of lead from the environment, you may have alternatives to reduce the likelihood that lead will cause problems. For instance, sometimes it might be preferable to seal in, rather than remove, old lead paint.
All siblings of a child found to have lead poisoning also should be tested. Doctors will report cases of lead poisoning to the public health department.

Treating higher classes

Class III and IV:
For more severe cases, your doctor may recommend treatment called chelation therapy in addition to removal from lead exposure. In chelation therapy, the medicine (chelating agent) chemically binds with lead to make the lead weaker so the body can get rid of it naturally so that it's excreted in your urine. Doctors may treat some Class III cases and many Class IV cases with the oral drug succimer (dimercaptosuccinic acid).

Class IV and V
Doctors treat lead levels greater than 45 mcg/dL of blood, which fall into Class IV or V, with a chemical chelater called ethylenediaminetetraacetic acid (EDTA). These kids will be hospitalized to receive the chelating agent.
EDTA is administered intravenously and may be combined with the drug dimercaprol (BAL). Depending on your child’s lead level, more than one treatment may be needed. The therapy may not reverse damage that already has occurred in cases of severe lead intoxication.


You can take some simple measures to reduce or offer protection from lead poisoning.


  • Wash your children's hands after they play outside, before eating and going to bed.
  • Clean your floors with a wet mop and wipe furniture, windowsills and other dusty surfaces with a damp cloth.
  • Prepare meals that are high in iron and calcium. A nutritious diet helps prevent lead absorption in your children's bodies.
  • Run cold water for at least a minute before using, especially if it hasn't been used for a while. Don't use hot tap water to make baby formula or for cooking.


  • Lead inspection. A lead inspection checks for lead presence in painted surfaces in your home, but it doesn't determine whether the paint has dangerous levels of lead.
  • Risk assessment. A risk assessment is more comprehensive and tells you if your home contains dangerous lead sources, such as peeling paint, and tells you how to reduce or control the hazards.

If you live in a rental property and your child has an elevated blood lead level, your landlord may be required to take certain actions, depending on your local laws and regulations.

Home renovation :If you're doing minor remodeling or touch-up work in an older house with lead-based paint, take some precautions. Large home renovation projects may require you to move out of your home until the project is complete and a professional can determine whether the lead no longer is a hazard

Product Recall Links:
US Consumer Product Safety Commission recall information
Fisher Price Toy recall
Thomas the Tank Engine recall
Recall of Fun Express Children's Toy Given Away at Libraries

Lead Poisoning Prevention & Information Links:
Centers for Disease Control Lead Poisoning Prevention Program
State and Local Lead Program information
HUD Office of Healthy Homes and Lead Hazard Control
US Environmental Protection Agency Lead Information
Coalition to End Childhood Lead Poisoning </p


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