Despite progress, lead poisoning remains a threat to children


August 24, 1993|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer Medical Tribune News Service

Although there have been few deaths in U.S. children from lead poisoning since the 1970s, it is a major environmental public health problem.

LTC In some older, larger cities, as many as 60 percent of young children have blood lead levels greater than 10 micrograms per deciliter (mcg/dL), the level of concern established by the Centers for Disease Control and Prevention.

Removal of lead from gasoline, food cans and house paint reduced average blood lead levels in the United States from 15.9 mcg/dL in 1978 to 4 to 5 mcg/dL today. Despite this, we still have a long way to go to prevent lead poisoning.

I spoke to Drs. Julian Chisolm and Mark Farfel of the Kennedy Krieger Institute and the Johns Hopkins School of Public Health and to Dr. Barnaby Starr, a local pediatrician, about this problem.

Q: What are the health effects of lead poisoning?

A: The long-term effects of lead poisoning in children include reduction in IQ, learning disabilities, slowed growth rate and impaired balance. One of the most common effects is reading disability. Severe lead poisoning can be life-threatening. Among survivors, retardation and seizure disorders may result. If detected early, these effects can be limited by reducing exposure to lead or through medical treatment.

Q: What is considered a safe level of lead?

A: The CDC and the Environmental Protection Agency would like to set a goal of no child having a lead level higher than 10 mcg/dL of blood. At lead levels just above 10 mcg/dL, doctors usually recommend repeat testing in several months to determine whether the level is declining. You should also take steps to control any known lead hazards in your child's environment after consulting with your physician and your local or state health/environment department. Levels above 45 are considered serious and a level above 70 is a medical emergency that will require immediate hospitalization.

Q: If we have taken lead out of gasoline, house paint and food cans, why are children still absorbing lead?

A: The main problem today is high levels of lead in paint and dust in and around houses. Nearly all housing built before 1950 and some housing built in the 1960s and 1970s contains some lead-based paint. Paint chips and dust that contain lead are particularly dangerous for infants and toddlers who pick up lead from household surfaces on their hands and then swallow it when they put their fingers in their mouths. Lead also can be found in drinking water, imported cans, glazed ceramics and pottery, but lead in paint remains the primary concern for most of the population.

Q: What can I do to minimize my child's exposure to lead?

A: Because blood levels increase most rapidly between 6 to 12 months of age and peak at 20 to 24 months of age, it is

important to have your child screened during this time period. Your child is at high risk and should be tested right away any time he/she:

* Lives in or spends extended periods of time in a house built before 1960 that has deteriorating paint or ongoing or recent renovation (this includes day-care centers and baby sitters' homes).

* Has a playmate or sibling who is lead-poisoned.

* Lives with an adult who may be bringing lead dust home from the workplace or creating it during hobby activities.

Diets adequate in calcium and iron may minimize the amount of lead absorbed from the intestine. Give your children foods that are rich in iron like lean meats, beans and eggs, and rich in calcium such as milk, cheese and yogurt. Fatty foods like potato chips allow the body to absorb lead faster.

I'm pregnant. Is my baby at risk for lead exposure?

A: Yes. Lead can cross the placenta, so babies are born with lead levels similar to those of their mothers. Slow development in children under 2 years of age may be related to prenatal lead levels. So, if you are pregnant, it is important to protect yourself. Pregnant women should never be involved with, or be present during, home remodeling projects that disturb lead paint until proper cleanup has been done.

Q: What can be done to reduce the amount of lead to which we are exposed?

A: Although resources are not currently available to remove all lead from homes, efforts are under way to reduce this exposure. For example, homeowners who replace lead-painted windows and treat floors contaminated with lead dust can significantly reduce lead exposure.

Recently passed federal legislation will require lead inspections at the time of the sale of properties and disclosure of information about the presence of lead in homes by 1995.

State legislation now requires the training and certification of contractors who undertake lead abatement. Be aware that home remodeling and renovation work that disturbs lead paint can be extremely hazardous for residents and workers. Do not undertake or arrange for such work without proper precautions to protect your family and your belongings.

For more information about lead safety, call the Baltimore City Childhood Lead Paint Poisoning Prevention Program at 396-8575 the Maryland Department of the Environment Lead Program at 410-631-3859.

Dr. Genevieve Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is a founding director of the school's Institute for Women's Health Research and Policy.

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