Q&A: Lead Poisoning and What It Means for Children

Lead poisoning may not have been a condition in the forefront of our minds…until the public health crisis in Flint, Michigan happened. There, thousands of children potentially have been exposed to high levels of lead from the contamination of the city’s water supply.  So, what is lead poisoning? And what should parents know?

Dr. Reginald Washington, Chief Medical Officer for HCA Healthcare-affiliate Rocky Mountain Hospital for Children – a system of six hospitals in Denver, Colo., recently sat down for a Q&A to educate our readers on the sources, symptoms, treatment and prevention for lead exposure.

What is lead exposure?

The first thing that everyone should understand is that lead is not a natural element of the human body. Lead is a toxin. It is not something your body has to have, as opposed to salt. Salt is naturally occurring in your body and you need salt for your body to function properly. But too much salt can be damaging. So, the difference between salt and lead is that you need salt; you don’t need lead.

If someone were to ask what a normal lead level is, the answer would be zero. Anytime someone has lead in their body or blood, that’s a contamination from something. Having said that, almost everybody, at least those who live in North America, are going to have some lead in their system because it’s prevalent in our environment. But there are certain levels of lead that may cause symptoms or diseases. According to the Centers for Disease Control (CDC), public health action should be initiated for children ages one to five with blood lead levels above 5 micrograms per deciliter.

What is a common source for lead exposure?

There was a lot more lead in the environment 10-15 years ago than there is today. We used to have lead in our gasoline. So, there’s lead in the environment from automobiles. Lead used to be a common component of paint. Anytime you painted a house or building, 20-40 years ago, it was lead-based paint. It’s not uncommon for an infant or a toddler to pick up chips of paint and put them in their mouth.  That used to be a common source of blood lead levels and it still is if you’re in an older home or buy an old house and remodel. If there is lead-based paint in that house, you could be exposed to it by removing the paint and sanding it down. The third common source of lead is lead pipes. Again, in the old days, most of the pipes in homes contained lead and that could get in the drinking water. Those are the old sources of lead exposure – gasoline, paint and lead pipes. There are still a lot of homes with lead paint and pipes, usually in older communities.

What are the symptoms of lead poisoning?

Lead poisoning will present different symptoms in different people. It’s like a flu – your neighbor may have chills and you may have muscle pains. Everyone is not going to have all the same symptoms, but here are the most common:

• abdominal pain
• abdominal cramps
• constipation
• headaches
• irritability
• lack of appetite, and,
• fatigue

The most concerning symptoms are those related to encephalopathy – an alteration of brain function – that often will not completely resolve once you’ve treated the lead exposure. Those symptoms include but are not limited to, aggressive behavior, irritability, decreased intelligence, learning and behavioral problems and poor academic achievement.  Many of those symptoms are irreversible.

The effects of lead exposure on children versus adults?

Children are much more susceptible to lead poisoning than adults because their brains are still developing and their bodies are immature. Although adults, if exposed to enough lead, will have symptoms as well.

Treatment for lead poisoning?  

A simple blood test can determine the amount of lead in a child’s body. My recommendation is if the lead level is greater than five micrograms per deciliter, that child ought to be examined routinely, an environmental scan should be conducted on the home and education provided on making the home lead-safe.

For high blood-lead levels (an amount determined by the CDC to be 45 micrograms per deciliter in children), hospitals can administer medication that binds to the lead and help flush it out. But that won’t treat the potentially lifelong neurological problems caused by lead poisoning.

The takeaway is clear. There is no safe level of lead in the body. The more lead you have in your system the more toxic it becomes. The safest outcome is to have no lead at all.

If your family is at risk for lead exposure or if you have any concerns, talk to your pediatrician about blood-lead level testing. You can also request lead level testing for your home and water supply (see EPA).

Lead poisoning is preventable. We must not fail the most vulnerable of us – our children. If you’re at risk, take the necessary steps to become educated and protect them now.

Dr. Reginald Washington is the Chief Medical Officer of the Rocky Mountain Hospital for Children in Denver, and Clinical Professor in the Department of Pediatrics at University of Colorado Health Sciences Center. He has been in Private Practice Pediatric Cardiology for 30 years at HealthONE and has served as the Chief Medical Officer for Rocky Mountain Hospital for Children for the past six years.