Childhood lead poisoning is preventable. Before some uses of lead were restricted, approximately 88% of preschool children in the United States had lead levels high enough to cause serious health effects. With less lead in the environment, lead poisonings have decreased and become less severe. However, lead poisoning still occurs. Approximately 310,000 U.S. children aged 1- 5 years have blood lead levels greater than 10 micrograms of lead per deciliter of blood (mcg/dL), the level at which the Centers for Disease Control and Prevention (CDC) recommends public health interventions.
Lead Poisoning and Health
The health effects associated with lead are the same whether it enters the body through breathing or swallowing. Lead can affect almost every organ and system in the body. The main target for lead toxicity is the nervous system. Lead poisoning can cause learning disabilities, behavioral problems, and, at very high levels, seizures, coma, and even death. Because lead poisoning often occurs with no obvious symptoms, it frequently goes unrecognized.
The Centers for Disease Control and Prevention (CDC) considers a blood lead level (BLL) of 10 micrograms of lead per deciliter of blood (mcg/dL) or greater to be elevated and to require individualized case management. However, recent studies suggest that adverse health effects exist in children at blood lead levels less than 10 mcg/dL. No safe level of lead exposure has been identified
Children are more vulnerable to lead poisoning than adults. The first 6 years of life, particularly the first 3 years, is the time when the brain grows the fastest and when the critical connections in the brain and nervous system that control thought, learning, hearing, movement, behavior, and emotions are formed. The normal behavior of children at this age--crawling, exploring, teething, putting objects in their mouth--puts them into contact with any lead that is present in their environment.
The key to preventing lead poisoning in children is to stop them from coming into contact with lead; those children who have been poisoned by lead must also be tracked and treated. By tracking children with lead poisoning and sources of lead, we can:
- identify children at risk in order to target testing and resources;
- make case management services available to each child with lead poisoning;
- monitor progress towards eliminating childhood lead poisoning;
- identify and monitor trends in lead sources that are exposing children to lead;
- remove and reduce sources of lead; and
- develop and evaluate lead poisoning interventions and programs.
Childhood Lead Poisoning and the Environment
Lead occurs naturally in the Earth's crust. It is released in the environment during some activities such as mining, manufacturing, and burning fossil fuels. Lead was once used in paints, gasoline, and some vinyl products, such as mini-blinds. It is still used to make batteries, ammunition, some metal pipes, and devices to shield X-rays. Lead from paints, ceramic products, caulking, and pipe solder has been dramatically reduced in the United States due to health concerns, and in 1978, lead-based paints were banned from use in homes. Lead has also been removed from gasoline. However, lead can still be found in the environment. People, especially children, are still being exposed.
Exposure and Risk
People may be exposed to lead by breathing or swallowing lead or lead dust. Once it enters the body, lead can become a health hazard. In the United States, the main source of childhood lead poisoning is from lead-based paint and lead-contaminated dust in older homes. Twenty-four million housing units in the United States have peeling or chipping lead-based paint and high levels of lead-contaminated house dust. Young children live in more than 4 million of these homes.
Houses and other buildings built before 1978, especially those built before 1950, may contain lead-based paint. If you live in or regularly visit homes built before 1978, you may be at risk for lead poisoning. This includes grandparents’ or other family members' homes and in-home daycares. Deteriorating paint (chipping, flaking, and peeling) and paint disturbed during home remodeling contribute to lead dust, contaminate bare soil around the home, and make paint chips and dust-containing lead accessible to children. Children can be exposed to lead by eating lead-based paint chips, chewing on objects painted with lead-based paint, or swallowing house dust or soil that contains lead.
Lead from sources other than housing may also present a hazard. Other sources of lead poisoning are related to:
- hobbies that include the use of lead (making stained-glass windows, hunting, fishing, target shooting);
- work that includes the use of lead (recycling or making automobile batteries, painting, radiator repair);
- drinking water (lead pipes, solder, brass fixtures, and valves can all leach lead); and
- folk medicines and remedies (azarcon and greta, which are used for upset stomach or indigestion; pay-loo-ah, which is used for rash or fever).
Children under the age of 6 years are at risk for lead poisoning because they tend to put their hands or other objects into their mouths. Any child who lives in or frequently visits houses and buildings built before 1978, especially houses and buildings with deteriorating or disturbed paint, is at risk for lead poisoning. Children from all social and economic levels can be affected by lead poisoning, but children whose families are low income and who are of minority race and ethnicity, especially non-Hispanic black children, are at most risk. For example, 3% of black children, compared with 1.3% of white children, have elevated blood lead levels.
Reduce Your Risks
- Ask a doctor to test your child if you are concerned about him or her being exposed to lead.
- Talk to your state or local health department about testing paint and dust from your home for lead if you live in a house or apartment built before 1978, especially if young children live with you or visit you.
- Damp-mop floors, damp-wipe surfaces, and frequently wash your child's hands, pacifiers, and toys to reduce exposure to lead in houses with lead.
- Use only cold water from the tap for drinking, cooking, and for making baby formula. Hot water is more likely than cold water to contain higher levels of lead, and most of the lead in household water usually comes from plumbing in the house, not from the local water supply.
- Avoid using home remedies (such as azarcon, greta, and pay-loo-ah) and cosmetics (such as kohl and alkohl) that contain lead.
- Take basic steps to decrease your exposure to lead if you remodel buildings built before 1978 or if your work or hobbies involve working with lead-based products. For example, shower and change clothes after finishing the task.
A blood test is available to measure the amount of lead in your blood and to estimate the amount of your recent exposure to lead. Blood tests are commonly used to screen children for lead poisoning and can be easily conducted in your physician's office.
The most important treatment for lead poisoning is to prevent or reduce lead exposure. Properly removing the lead from a person's environment helps to ensure that their blood lead levels will decline. The longer a person is exposed to lead, the greater the likelihood that developmental problems or illness will occur. At very high blood lead levels, physicians may prescribe medications to lower blood lead levels in a treatment known as chelation therapy.
Childhood Lead Poisoning Data
The EPHT Program monitors childhood lead poisoning by tracking two indicators: blood lead levels by birth cohort (link) and blood lead testing and housing age. Data about childhood lead poisoning in New Hampshire is available on the Environmental Health Data Integration Network (EHDIN). For more information about childhood lead poisoning data for environmental public health tracking.
For more information about childhood lead poisoning:
- NH Childhood Lead Poisoning Prevention Program (CLPPP)
- CDC Lead Poisoning Prevention Program
- U.S. Environmental Protection Agency
- Agency for Toxic Substances and Disease Registry
- The Alliance for Healthy Homes
- National Institute of Environmental Health Sciences
- U.S. Department of Housing and Urban Development