Lead Poisoning
A Preventable
Health Problem
| For information about Hartford's lead problem, click
here. |
How
does lead poisoning affect my health and the health of my children?
What are the symptoms of lead
poisoning?
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Children
Children with lead poisoning
may not look or act sick. Even if the children do show some signs of
lead poisoning, these symptoms can often be mistaken for other illnesses,
such as the flu.
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Children with lead poisoning may:
- Be tired, restless, irritable,
or weak
- Have headaches, poor appetite,
stomachache and cramps, constipation, or vomiting
- Have trouble sleeping
- Be more clumsy
- Lose skills already learned
- Be anemic
| Many of these symptoms, however, may also indicate other health conditions
or learning and behavior problems. In addition, children who are not
lead poisoned may also show some of these symptoms from time to time. |
For example, all babies may be
fussy occasionally, but a baby with lead poisoning may be fussy most of the
time. Therefore, if children seem to have these symptoms to an unusual extent,
there may be cause for concern. The parents, guardians, or other adults responsible
for the children's well-being should always consult a doctor immediately if
they suspect lead poisoning and should ask for a blood test.
What
behaviors may be associated with lead poisoning?
Infants and Toddlers
-
Cry, whine, or
fuss excessively
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Have feeding
problems
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Have sleep problems
-
Seem very sensitive
to, and unhappy about, touch, tastes, noises, smells, or sounds
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Seem irritable,
cranky, uncooperative, difficult to care for
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Are difficult
or impossible to soothe or comfort
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Seem to be late
in babbling and saying first words
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Preschoolers
- Seem excessively active,
fidgety, squirmy
- Are very uncooperative,
refusing to follow requests or directions
- Have difficulty following
directions
- Act impulsively
- Are easily distracted
- Talk excessively and interrupt
others frequently
- Have difficulty in toilet
training
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Elementary School Children
- Perform poorly in school
- Disrupt their classes
- Have difficulty staying
seated
- Have problems learning
- Are easily distracted
- Cannot tolerate frustration
- Have problems with other
children
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Some of these symptoms may make the
parents, guardians, or caregivers feel annoyed or resentful and therefore less
affectionate toward the child. They may feel like talking less and spending less
time with that child. Understanding that these problems are caused by lead poisoning
may help the adults to handle the children more effectively.
Above material adapted
with permission from
"Symptoms of Lead Poisoning," by Maureen T. Mulroy, in What You Should Know
about Lead Poisoning: A Resource Manual for Childcare Providers, developed
by Maureen T. Mulroy, Karen Filchak, and Mary-Margaret Gaudio, Storrs: University
of Connecticut Cooperative Extension System, 1997.
 |
Adults
Adults, especially those who work in lead-related industries such as
radiator repair, smelting, and battery manufacturing and those who maintain,
renovate, or remodel older housing, are also at risk for lead poisoning.
|
In adults, symptoms may include:
- Fatigue
- Headache
- Irritability, anxiety, or depression
- Dizziness, weakness, numbness
- Reproductive problems: loss of
sex drive, infertility, impotence
- High blood pressure
- Anemia
- Digestive disorders: nausea,
vomiting, constipation, diarrhea, abdominal pain
- Nervous system problems
- Hearing loss
- Difficulty with memory and concentration
- Muscle and joint pain or soreness
Unborn
children
Lead in the mother's blood can pass
to the unborn child. Lead poisoning in unborn children can cause:
- Stillbirth and miscarriage
- Premature birth
- Low birth weight
- Brain and nerve damage
- Learning disabilities
- Behavioral problems
How can you tell if someone has
lead poisoning?
Lead poisoning is rarely obvious,
and people who are lead poisoned often show no symptoms. If you suspect that
children or adults may be lead poisoned, they should be tested immediately.
They should not wait for symptoms to appear. The only way to detect lead poisoning
is through a simple blood test.
Testing
Blood tests can determine a person's
lead level. There are two ways to collect blood for testing:
- The first, a fingerstick, screens
for the presence of lead. The person's finger is pricked to obtain a blood
sample, which is sent to a laboratory for analysis.
- If the lead level is high, the
results must be checked with a second test, called a venipuncture, which involves
taking blood from a vein. This second sample is also sent to a laboratory
for analysis.
The Connecticut Statewide Screening
Committee recommends that all children between the ages of one and six years,
especially children between the ages of one and two years, be screened. Children
between one and two years old are very susceptible to lead poisoning, especially
if they live in high-risk areas or housing. Children between three and six years
old who live in these areas and have not yet been tested should also be screened.
If any one person in the household is diagnosed with lead poisoning, all other
members of the household should also be tested.
Note that
Medicaid requires that all one- and two-year-old children who are Medicaid beneficiaries
be tested.
Assessing
a child's risk
The American
Academy of Pediatrics 
recommends that you talk to your health-care provider about screening your child
if you can answer "yes" to any of the following questions, especially numbers
1, 2, and 3.
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Yes
|
No
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| 1.
Does your child live in or regularly visit a house that was built before
1950? Be sure to include a home childcare center, a babysitter's home,
or a relative's home. |
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| 2.
Does your child live in or regularly visit a house built before 1978 that
has been remodeled in the last 6 months? Are there any plans to remodel
the house where the child lives or visits? |
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| 3.
Does your child have a brother, sister, housemate, or playmate who is
being treated for lead poisoning? |
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| 4. Has a health-care
professional ever told you that your child has high levels of lead in
his or her blood or that your child has lead poisoning? |
|
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| 5. Does any adult
who lives with your child have a job (for example, lead smelting or battery
recycling) or hobby (for example, using fishing sinkers or making bullets)
that involves exposure to lead? |
|
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| 6. Does your
child live near an active lead smelter, battery recycling plant, or other
industry that is likely to release lead into the environment? |
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| 7. Does your
child live within one block of a major highway or busy street? |
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| 8. Do you use
hot water from the tap for cooking or drinking? |
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| 9. Has your child
ever been given the home remedies azarcon, greta, or pay looah, which
may contain lead? |
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| 10. Has your
child ever lived outside the United States? |
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| 11. Does the
family use imported pottery or ceramics for cooking, eating, or drinking?
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| 12. Have you
ever seen your child eat paint chips? |
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| 13. Have you
ever seen your child eat soil or dirt? |
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| 14. Have you
ever been told that your child has low iron? |
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Questions
to ask the doctor
If you suspect that your child may
be lead poisoned, here are some questions that you should ask your doctor.
1. How will you test my child
for lead?
2. What are the differences between lead tests?
3. What are the symptoms of lead poisoning?
4. What are the effects of lead poisoning?
5. What is my child's blood lead level?
6. What do the test results mean?
7. If treatment is needed, what treatment do you recommend?
8. What are the side effects of the treatment?
9. When should my child be tested again?
10. What foods should my child be eating at this time?
11. When can other family members be tested?
12. Is there anything else we can do to help our child?
13. Who should we call if we later have more questions about our child's health?
Adapted, with permission,
from "What to Do If You Suspect Lead Poisoning," by Maureen T. Mulroy, in
What You Should Know about Lead Poisoning: A Resource Manual for Childcare
Providers, developed by Maureen T. Mulroy, Karen Filchak, and Mary-Margaret
Gaudio, Storrs: University of Connecticut Cooperative Extension System, 1997.
Screening
Agencies
Family doctors and pediatricians
can provide lead poisoning screening. Other agencies that may offer these
services include local health departments, health clinics, Head Start programs,
community health fairs, hospital pediatric outpatient departments, visiting
nurse associations, and well-child clinics.
Results
In Connecticut, a child is considered
to have an elevated blood lead level if tests show between 10 and 20 micrograms
of lead per deciliter (usually written as µg/dL) of blood. Any level
above 10 µg/dL requires careful follow-up. A child is considered lead
poisoned if the blood lead level is 20 µg/dL or higher. The higher the
blood lead level, the more severe the health effects.
Connecticut's standards are in
accordance with recommendations of the U.S. Centers for Disease Control and
Prevention, but it should be noted that some experts believe that these levels
are still too high for safety.
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Blood Lead
Level in Children (µg/dL)
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How Health
Workers Interpret Results
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What Parents
or Guardians Should Do
|
| 0-9 |
Not a level of concern |
- Especially if level is above 5, continue to be alert for lead hazards
and test again if necessary
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10-19
|
Elevated blood lead level |
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| |
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- Follow up with further testing in 3 months
- Learn about ways to prevent further exposure
- Learn about foods that may help reduce lead's harmful effects
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20 and above
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Lead poisoned |
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| 20-44 |
|
- Follow up with further testing in 1 week to 1 month (the higher
the level, the sooner the retesting)
- Learn about ways to prevent further exposure
- Learn about foods that may help reduce lead's harmful effects
- Make sure child has full medical evaluation, including:
- Detailed behavioral and environmental history
- Physical examination
- Tests for iron deficiency
- Get help from Health Department to investigate home and either reduce
lead hazards or remove family from hazardous living area
- Child may require medicine to reduce blood levels
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| 45 and above |
|
- Get immediate medical follow-up
- Retest within 24-48 hours, depending on blood lead level
- Child requires medicine to reduce blood lead levels
- Child may need to be hospitalized and
- All of the above preventive measures
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| 70 and above |
Medical emergency |
- Retest immediately
- Child must be hospitalized immediately and
- All of the above preventive measures
|
Reporting
Once a child
has been tested, the laboratory must report all blood lead levels to the Connecticut
Department of Public Health. If the level is 10 µg/dL or greater, it
must be reported to the Department of Public Health and the Hartford Health
Department within 48 hours. According to state law
-
If the child's
lead level is 10 µg/dL or above, the local health department must
provide information to the parent or guardian regarding lead dangers, ways
to reduce the risks of lead poisoning, and laws and regulations concerning
lead abatement.
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If the child's
lead level is 20 µg/dL or above, the health department must provide
all of the above information, inspect the home for sources of lead exposure,
and, if necessary, relocate the family (if housing is available).
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If a child's
blood lead level is 20 µg/dL or above and lead hazards are found,
the property owner receives an order to eliminate the hazard and has 45
days to begin work. If the child's blood level is below 20 µg/dL,
the property owner is not required to act.
Source: Connecticut Department of
Public Health, Report on the Status of Lead Poisoning in Connecticut,
1998
How is lead poisoning treated?
If a person has an elevated blood
lead level, he or she should be evaluated by a medical professional. Depending
on the lead level, treatment may include several components.
Getting
medical treatment
Adults and children with high blood
levels of lead in their blood usually need to take a drug, called a chelating
agent, that helps the body get rid of lead. The Centers for Disease Control
and Prevention recommend chelation for children with blood lead levels of 45
µg/dL or higher. This treatment is often done in the hospital and usually
is given as a series of shots.
Some people with lead poisoning
need several types of treatment and several months of careful follow-up.
Eliminating
the sources of lead in the environment
Environmental controls help to reduce
further exposure to lead. Because lead paint is the most common source of exposure,
children should be removed from areas with deteriorating lead paint until the
lead hazard has been carefully eliminated. (Improper removal of lead paint can
create a hazard where none existed or can increase an existing hazard.)
Changing
behavior
Parents need to learn about
the sources of lead in their environment and how to protect their children.
For example, dust and flakes from deteriorating lead paint must be cleaned
up using detergent and a damp cloth or using a HEPA (high efficiency particle
air) vacuum. Children should wash their hands before they eat and after
they play. If workers are exposed to lead on the job, they must receive
training and proper equipment to handle these materials and must be careful
not to bring lead home to their families.
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Ensuring
proper nutrition to help reduce the effects of lead
People who eat foods that are rich
in calcium, iron, and zinc and low in fat may be better able to avoid lead's
harmful effects. Your health professional may recommend that you change your
child's diet and/or give your child some dietary supplements.
Calcium-rich
foods
- Dairy foods, such as milk, cheese,
and yogurt
- Leafy green vegetables, such
as collard greens, kale, and broccoli
- Canned sardines or salmon (bones
are a choking hazard for young children, though)
Iron-rich
foods
- Lean red meat, chicken,
turkey, fish, seafood (clams, mussels), eggs
- Canned sardines and tuna
- Dried beans, split peas,
and lentils
- Dried fruit (raisins, prunes,
figs) (could be a choking hazard for young children)
- Peanut butter (could be
a choking hazard for young children)
- Leafy green vegetables
- Note: to help your body
use the iron in many of these foods more effectively, eat them with
foods high in vitamin C, such as oranges, grapefruit, strawberries,
cantaloupe, green peppers, broccoli, and potatoes
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Zinc-rich foods
- Lean red meat, chicken, turkey,
fish, seafood, eggs
- Milk and cheese
- Dried beans and lentils
Lowfat foods
- Note: children under two years
old should not be given lowfat milk. After babies are weaned from breast milk
or formula, they should drink whole milk until age two
- Children over two can be fed
lowfat milk, yogurt, cheese, and other dairy products
- Limit high-fat fast foods, like
hamburgers, fried chicken, hot dogs, french fries, fried fish and ice cream.
- Limit high-fat snack foods like
doughnuts, potato chips, corn chips, cookies, pies, cakes, and chocolate
- Use less oil, butter, lard, and
margarine in cooking and on foods
Sufficient
food
It is also important for people,
especially children, to eat adequate amounts of food. An empty stomach absorbs
lead more readily.
Above information adapted,
with permission, from "Foods That May Help to Fight Lead's Harmful Effects"
and "A Healthy Diet to Fight Lead's Harmful Effects," by Linda Drake, in What
You Should Know about Lead Poisoning: A Resource Manual for Childcare Providers,
developed by Maureen T. Mulroy, Karen Filchak, and Mary-Margaret Gaudio, Storrs:
University of Connecticut Cooperative Extension System, 1997.
Getting
educational and behavioral help for children
Children who have been lead poisoned
may need special educational help. Their parents or guardians may need help
in dealing with challenging behaviors. Click
here (this requires the Acrobat
Reader )
for suggestions about how to help young children with such behaviors.
