Lead poisoning is one of the most common and preventable pediatric health problems in the United States today. No level of lead in the blood has been shown to be safe Studies have shown an association between blood lead poisoning and diminished intelligence, delayed or impaired neurobehavioral development, lower IQ, decreased hearing acuity, speech and language handicaps, growth inhibition, poor attention span, and antisocial and delinquent behaviors. At very low levels, the effects may occur without overt clinical symptoms. The effects of low-level lead poisoning in childhood may be irreversible. Children who are under the age of six are the most susceptible.

Estimates from the 1991-1994 National Health and Nutrition Examination Survey (NHANES), conducted by CDC, suggest that in the United States, as many as one million children under the age of six years of age, have blood levels over 10 µg/dL. Lead poisoning in children is found in all socioeconomic boundaries.

Because children can be exposed to lead from many sources, and because there may be no safe threshold for lead poisoning, CDC is recommending that:

	All children be screened for lead as part of their routine pediatric care
	Physicians use a blood lead test for that screening
	Children with lead poisoning need follow-up that can range from educational and nutritional counseling to environmental intervention to pharmacologic therapy.

Where Lead is Found

*In general, the older your home, the more likely it has lead-based paint.*

Paint: Many homes built before 1978 have lead-based paint. The federal government banned lead-based paint from housing in 1978. Some states stopped its use even earlier. Lead can be found:

In homes in the city, country, or suburbs.

In apartments, single-family homes, and both private and public housing.

Inside and outside of the house.

In soil around a home. (Soil can pick up lead from exterior paint, or other sources such as past use of leaded gas in cars.)

Household dust. (Dust can pick up lead from deteriorating lead-based paint or from soil tracked into a home.)

Drinking water: Your home might have plumbing with lead or lead solder. Call your local health department or water supplier to find out about testing your water. You cannot see, smell, or taste lead, and boiling your water will not get rid of lead. If you think your plumbing might have lead in it:

Use only cold water for drinking and cooking.

Run water for 15 to 30 seconds before drinking it, especially if you have not used your water for a few hours.

The job: If you work with lead, you could bring it home on your hands or clothes. Shower and change clothes before coming home. Launder your work clothes separately from the rest of your family's clothes.

Old painted toys and furniture.

Food and liquids stored in lead crystal or lead-glazed pottery or porcelain.

Lead smelters or other industries that release lead into the air.

Hobbies that use lead, such as making pottery or stained glass, or refinishing furniture.

Folk remedies that contain lead, such as "greta" and "azarcon" used to treat an upset stomach.

Health Effects of Lead

In the United States, about 900,000 children ages 1 to 5 have a blood-lead level above the level of concern.*
Even children who appear healthy can have dangerous levels of lead in their bodies.*

People can get lead in their body if they:

• Put their hands or other objects covered with lead dust in their mouths.
• Eat paint chips or soil that contains lead.
• Breathe in lead dust (especially during renovations that disturb painted surfaces).
• Lead is even more dangerous to children than adults because:
  
• Babies and young children often put their hands and other objects in their mouths. These objects can have lead dust on them.
  
• Children's growing bodies absorb more lead.
  
• Children's brains and nervous systems are more sensitive to the damaging effects of lead.

If not detected early, children with high levels of lead in their bodies can suffer from:

• Damage to the brain and nervous system
• Behavior and learning problems (such as hyperactivity)
  
• Slowed growth
  
• Hearing problems
• Headaches

Lead is also harmful to adults. Adults can suffer from:

• Difficulties during pregnancy
• Other reproductive problems (in both men and women)
  
• High blood pressure
  
• Digestive problems
  
• Nerve disorders
  
• Memory and concentration problems
  
• Muscle and joint pain
  

Who is at Risk?

Virtually all children are at risk for lead poisoning. Children who are six months to six years of age are at the highest risk. CDC conducted a study between 1991 and 1994 known as the National Health and Nutrition Examination Survey III Phase 2. The study data indicate that about 4.4 percent of U.S. children under the age of six, or about one million children, may have blood lead levels above 10 µg/dLL. In the U.S., children in poor inner-city neighborhoods have the highest risk, because of the complexity of the sources and behaviors.

Screening for Lead: Because virtually all children are at risk for lead poisoning, CDC recommends screening all children for lead using a blood lead test. There are three blood lead test methods. Two use blood obtained by a finger-stick, the other uses a tube of venous blood. The finger-stick specimen is easy to contaminate, and so all positive test results should be retested with a venous blood test.

Children who are at high risk for lead poisoning should be screened beginning at six months of age. If the blood lead levels are <10 g/dL, the child should be re-screened every six months after that, until the age of seventy-two months. If the blood lead levels are 10-14 µg/dL, the child should be re-screened every 3-4 months, and actions should be taken to reduce the lead until the blood lead level is <10 µg/dL. If any blood lead level is 15 µg/dL then intervention action should occur.

Children who are at low risk for lead poisoning should be screened at 12 and 24 months of age.

Checking Your Family and Home for Lead

*Get your children and home tested if you think your home has high levels of lead.*
*Just knowing that a home has lead-based paint may not tell you if there is a hazard.*
To reduce your child's exposure to lead, get your child checked, have your home tested (especially if your home has paint in poor condition and was built before 1978), and fix any hazards you may have.

" Your Family
o Children's blood lead levels tend to increase rapidly from 6 to 12 months of age, and tend to peak at 18 to 24 months of age.
o Consult your doctor for advice on testing your children. A simple blood test can detect high levels of lead. Blood tests are important for:
" Children at ages 1 and 2.
" Children and other family members who have been exposed to high levels of lead.
" Children who should be tested under your state or local health screening plan.
o Your doctor can explain what the test results mean and if more testing will be needed.
" Your Home
o You can get your home checked in one of two ways, or both:
" A paint inspection tells you the lead content of every different type of painted surface in your home. It won't tell you whether the paint is a hazard or how you should deal with it.
" A risk assessment tells you if there are any sources of serious lead exposure (such as peeling paint and lead dust). It also tells you what actions to take to address these hazards.
o Have qualified professionals do the work. There are standards in place for certifying lead-based paint professionals to ensure the work is done safely, reliably, and effectively. Contact the National Lead Information Center (NLIC) for a list of contacts in your area.
o Trained professionals use a range of methods when checking your home, including:
" Visual inspection of paint condition and location.
" A portable x-ray fluorescence (XRF) machine.
" Lab tests of paint samples.
" Surface dust tests.
Note: Home test kits for lead are available, but studies suggest that they are not always accurate. Consumers should not rely on these tests before doing renovations or to assure safety.

Simple Things You Can Do
To Prevent Exposure To Lead

	Have your children tested for lead; if the child's blood lead level is 10-14 µg/dL or above, you should use housekeeping measures to reduce lead exposure. If blood lead levels of 15-19 µg/dL persist, you should arrange for an environmental inspection.
	Wash your children's hands frequently, especially before meals and bedtime.
	If your home was built before 1978, you may want to have the house tested for lead-based paint. You should take care of peeling and chipping paint. Water damaged, peeling or chipping paint, or paint that is scrapped on a friction surface creates lead contaminated paint dust. If you decided to renovate or abate the lead-based paint, you should consult an expert first.
	Test for lead before remodeling or repairing older homes. If the home contains lead-based paint, you should hire a trained contractor to do the work. If you plan to do the work, you should consult an expert first.
	Consider replacing windows if they are covered with lead paint. Friction bearing surfaces on windows can be an important source of lead dust.
	Avoid using lead-glazed pottery or pewter dishes to store or serve foods.
	Plant grass and shrubs over bare soil in the yard.
	Keep children's play areas away from heavy traffic and buildings painted with deteriorating lead-based paint.
	In high-exposure areas, take off shoes before entering the house, wet mop floors, and wash window wells often to get rid of lead dust. Do not vacuum unless you have a HEPA vacuum; vacuuming can spread lead dust. A HEPA vacuum has a special filter in it that prevents microscopic particles of lead and dust from escaping.
	Wash fruits and vegetables (especially those grown close to or in soils contaminated with lead) before eating.
	Always wash hands before meals.
	Adults should shower or change clothes as soon as possible if exposed to lead at work or through such hobbies as ceramics or stained glass making.
	Eat a well-balanced diet containing large amounts of Vitamin C, calcium and iron.
	Use only water from the cold water tap for drinking and cooking. Flush faucets for 2-3 minutes when water hasn't been used for more than 6 hours.
	Have tap water tested for lead by a state-approved laboratory if the house is over 40 years old, or has plumbing over 10 years old.
	Don't use leaded gasoline. Replace engines (lawn mower, chain saw, etc.) that require leaded gasoline.
	Don't store food in opened cans.

For additional information, call the National Lead Information Clearinghouse toll-free at 1-800-424-LEAD (1-800-424-5323). or your child's pediatrician.

Reproduced in part from the Utah Department of Health, Bureau of Epidemiology, Environmental Epidemiology Program. revised 2004

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All about Lead Poisoning - From Sources to Who is at Risk