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How lead poisoning affects children

Flint water crisis shines light on dangers of lead- contaminated water – but water is not the most common source of lead exposure for kids

lead-poisoningThe Flint water crisis has captured national headlines after reports that the city’s water had been contaminated with dangerously high levels of lead – and that children and other residents had unknowingly been drinking this water for more than a year.

This is upsetting and concerning news to pediatricians like me. We know lead is a neurotoxin. We know children are experiencing major brain development. Science tells us that this toxin could hinder learning, long term achievement, classroom performance and cause behavior and other issues for young people.

There is simply no safe level of lead, period.

What some people may not realize; however, is that water is not the most common source of lead exposure in our country. Lead from water accounts for an estimated 10-20 percent of elevated lead levels in children. The bigger risk for lead exposure is found in the buildings where children spend most of their time, usually their home, and sometimes a family member’s home, daycare, or school.

8 other facts on childhood lead poisoning           

Paint is the most common source of lead exposure  

Chipping or peeling paint in old homes is the biggest culprit for childhood lead exposure. If your home was built before 1978, the paint may have lead in it. Deteriorating paint can create lead-containing dust, especially in areas around windowsills and door frames. Little ones known for picking up toys and putting them into their mouths are especially at risk of ingesting lead this way. Exterior paint in homes may also land on the soil kids play on in their yards. There have also been cases of children eating lead paint chips, which reportedly have a “sweet” taste.

Lead is also found in water, with older homes most likely to have lead pipes and fixtures. Even newer “lead-free” plumbing may contain as much as 8 percent lead. Old toys and furniture may also have lead-based paint.

See this checklist from the Environmental Protection Agency on whether your home may be putting your family at risk for lead poisoning.

You can get your home checked for lead

By law, house sellers must disclose whether their home has been tested for lead. If the answer is no, a buyer may ask for it to be tested but they often waive that option.

If you do live in an older home and are worried about lead exposure, you may get your house tested. Make sure testing includes windowsills and door and window frames. If there is lead in the paint, find a lead-abatement certified builder to help strip and replace it. Never do this yourself or with a child in the home.

The Flint water crisis may affect every child differently

The effects of contaminated water will likely vary, depending on how each child’s body absorbs and responds to the toxin. Babies whose only source of nutrition is formula made from tap water are of particular concern because of the sheer volume of water they consume relative to their little bodies. Children under the age of six and those with iron deficiency or poor nutrition are also at higher risk, as greater amounts of lead may be absorbed.

Research shows that even low levels of lead have been associated with developmental issues, such as school difficulty, poor attention span, impulsiveness, and lower IQ scores. However, factors such as good nutrition, a stimulating learning environment, developmental support, access to quality preschool programs, and academic support may act as buffers to the potential long-term effects in some children.

Lead poisoning usually has no clear symptoms

Some children may have stomach pain, constipation, headaches, or seem irritable. However, there are often no overt symptoms of lead poisoning. That doesn’t mean there’s minimal harm. Children’s developing brains and nervous systems are susceptible to toxins and even small amounts of lead exposure add up over time, increasing risk of developmental effects.

The risks of bathing in lead-contaminated water are likely low

The risk of lots of lead absorption through intact skin is low, though greater for those with eczema or other skin conditions that may leave skin open. Our main concern over young children bathing in lead-contaminated water stems from the possibility that they may swallow water in the tub and that this may add to others sources of exposure.

As for cooking with potentially contaminated water, guidelines recommend using cold tap water that has been ideally flushed for several minutes before using. Hot tap water may increase chances of leaching.

Your pediatrician should be screening for lead exposure risk

It’s important for pediatricians to identify children who may have higher risk of lead exposure by asking families questions about their home environments. This is especially true for industrial cities, families remodeling older homes, low income communities that may have older homes in poor repair, families who are changing housing more regularly and may not know the lead status of the homes, or even areas with unresponsive landlords. If risk for exposure is identified or parents are concerned, children should get a blood test to check for lead.

In fact, it was an astute pediatrician who ultimately identified increasing blood-lead levels in Flint children. I applaud Dr. Mona Hanna-Attisha, a colleague of mine at the Michigan Chapter of the American Academy of Pediatrics, for taking a deep look at childhood lead levels before and after the city changed its water source.

There is no good treatment for lead poisoning in kids

Research shows that removing a child’s exposure to lead will help stop the progression of effects, but we don’t have any medicine that reverses the harm that’s occurred. A chemical process called chelation therapy helps remove heavy metals like lead from the blood, but it is reserved for very high levels of lead poisoning. It is not used for the vast majority of exposed children due to the risks of side effects.

When it comes to childhood lead poisoning, prevention is key.

We’ve come a long way in reducing lead exposure but it’s still a risk

Public health measures over the years have made a significant difference in minimizing the risk of lead exposure for kids. Blood lead levels have dramatically decreased over the decades because of stricter federal laws, such as preventing builders from using lead paint in building interiors and in pipes and restricting leaded gasoline. Pediatricians are also more aware of the need to identify children at risk of lead exposure and who should be tested.

See the most recent county-by-county breakdown of childhood lead levels in Michigan (2013) here.

What has happened in Flint is a devastating and disappointing scenario, and many communities will undoubtedly learn from this. I’m hopeful the state will respond appropriately on behalf of the children who have experienced lead poisoning. This means facilitating the careful monitoring of their development, supporting early education, providing good nutrition, and guaranteeing healthcare access to ensure they have the opportunity every child should have – to be as healthy as possible and to reach their full potential.

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Dr. Sharon SwindellDr. Sharon Swindell is a pediatrician and childhood lead poisoning expert at C.S. Mott Children’s Hospital. She is also an assistant professor of pediatrics at the U-M Medical School and holds a master’s degree in public health. She has expertise in the sources of lead exposure, preventive measures, possible impacts on children and guidelines regarding management if lead exposure is identified.

 

mott blog - logo thumbUniversity of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.