Lead Toxicity with Children

Children exposed to lead are at high risk for cognitive, motor, behavioral, and physical disabilities. The CDC has established a toxic dose for children at greater than 10 ug/dl. Exposure below 10 ug/dl. is still undetermined, and therefore, equally unhealthy. Although children are at greatest risk for neurological damage, all ages are adversely impacted.

Once levels rise above 10 ug/dl, it can take months, even years to rid the body of lead. This inordinate amount of time includes the children we medically intervene with to reduce toxic levels. What is especially disarming is that lead is not distributed within the body evenly; 70% of lead resides in the bone and it might be decades before bone levels decrease to normal.

Since 1976, blood lead levels in U.S. children have decreased substantially. However, many children continue to be exposed to lead, primarily in their homes. The rash of toys laden with lead from China was especially frightening. Overt clinical symptoms are absent in children; which alarms the medical community, as how can they suspect lead exposures, when no symptoms exist?

As individual testing is not helpful, lead exposures can best be handled by reviewing the entire community. The major sources of lead exposure among U.S. children are:

• lead-contaminated dust,

• deteriorated lead-based paint (68% of U.S. homes built before 1940 have lead hazards; this figure is reduced to 8% by the 1960s. However, the problem remains significant, as 25% of American homes have lead hazards),

• lead-contaminated soil,

• Water contamination is possible (NOTE: Typically, lead contamination of water contributes less to a child's lead burden than home and soil sources; however, if additives to water, for instance, those used in disinfection processes, are changed, the contribution of lead contamination might be greater.)

• foods,

• cosmetics,

• pottery,

• folk remedies, and

• toys).

As toys imported from foreign countries has made the headlines recently, an entire article will be devoted to this topic (See Lead: Toys May Be Dangerous in www.medicine.org).