The recent lead poisoning crisis in Flint, Michigan has returned the spotlight to this dangerous environmental hazard.  The children and families in Flint face an uncertain future due to the persistent high exposure to lead from their water supply.  High lead levels in the body can lead to acute lead poisoning with abdominal pain, anemia, and brain injury.  Even lower levels of long-term lead exposure can lead to learning difficulties and behavior problems in school-aged children.  There is no level of lead exposure that is without risk.  While treatments are available to decrease very high lead levels, the treatments do not reverse the damage that has occurred.  So in the case of lead poisoning, an ounce of prevention really is worth a pound of cure. Thankfully, there are some simple things you can do to protect your children from the harmful effects of lead poisoning.

Unlike the crisis in Flint, where children were exposed to lead through their water supply, most children who have lead poisoning are between 9 months old and 3 years old.  These toddlers are most at risk because they are crawling and spend more time on the floor.  Plus, children this age are very "oral," meaning they put almost everything in their mouth as part of their normal development.  Most children are exposed to lead in the places where they live or are cared for (day care or babysitters' homes including extended family members' homes.)  The source of this exposure is lead dust from lead-based paints.  While this dust can arise with home remodeling or repainting, it also comes from painted surfaces where friction occurs such as doors and windows.  And even though lead-based paints have not been made in America since 1978, any home built before then may have lead paint because lead made the paint brighter and durable.  Finally, some areas of the United States have higher lead amounts in soil.  This is especially true in Greater St. Louis.

The first way to prevent lead poisoning is to make sure your toddler is eating a balanced diet that includes adequate amounts of iron, calcium, and Vitamin C.  Getting adequate amounts of these nutrients can decrease lead absorption in children.  Meats, poultry, and fish and dark green vegetables are good sources of iron.  Calcium is found in dairy products.  A toddler who drinks 2 or 3 glasses of milk each day gets the right amount of calcium.  Vitamin C is found in fruits and vegetables -- all children should get 5 servings of fruits or vegetables every day.  While a well-rounded diet is the best way for your child to get these nutrients, some toddlers become very picky and will refuse to eat some of these important foods.  In that case, a vitamin/mineral supplement is an acceptable alternative.

Regular lead screening is another way to protect your child from lead poisoning.  The CDC and American Academy of Pediatrics recommend universal blood lead testing of all children at 12 and 24 months of age.  This should be done as part of your child's regular check-up schedule.  Children can be checked more often if a parent has concerns or if your pediatrician identifies certain conditions that makes your child more at risk.  For most toddlers, this will be a fingerstick blood draw which can be a little uncomfortable.  The results are available in 1-2 days.  If the level is high, a repeat lead test drawing the blood from a vein is recommended.  If the lead level is still high, your pediatrician will guide you about the appropriate next steps.  The good news is that the vast majority of kids have normal lead levels.

Since most lead exposure is from buildings where children live and play, it is important to check your home for sources of lead if your child's blood lead test is high.  In some cases, for higher lead levels, public health officials (city or county health departments) will come to a home to perform lead testing.  If your child's lead is slightly elevated, or you are planning a major renovation in an older home (that might release lead paint), there are lead testing kits that can be purchased from home improvement stores.  These kits are generally easy to use and are not too expensive.  If you or the health department uncover large amounts of lead exposure in your home, you should hire a professional who is experienced in handling lead to safely remove it from your home.  In addition, some cases of lead exposure come from jobs (welding, truck or auto repair) or hobbies (soldering, fishing or hunting) that involve the use of lead, or from nearby businesses or industries that handle lead.

Due to better awareness of how lead affects children and its removal from the paint and gasoline supply, lead poisoning has decreased almost 90% in the last 40 years.  Still, the CDC estimates that over a half a million children in the US have an elevated lead level that requires further action.  Talk to your pediatrician today if you are concerned your child may be at risk for this dangerous but preventable problem.

Links:
http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm

By: Dr. Peter Putnam