Definition

Lead is a toxic metal that is common in the environment. Experts believe that no level of lead in the body is safe for children. Concern about lead poisoning in children occurs when lead reaches a level of 10 micrograms per deciliter (mcg/dL) in the blood. Levels of 20 mcg/dL or more represent actual lead poisoning. This can lead to:

• Seizures
• Brain and kidney damage
• Coma
• Death

Lower levels of blood lead below currently accepted safe levels can lead to learning and/or behavioral difficulties. They can also delay puberty in boys.

Causes

Lead can be absorbed into the bloodstream by eating, drinking, or breathing contaminated particles.

Lead is used in many industrial processes and within the home. It can be found in:

• Paint—Most homes built before 1960 contain some lead-based paint. This was banned from residential use in 1978.
• Dust— Dust containing lead can linger on windowsills and in window wells.
• Soil— Lead can become mixed with dirt after it peels from paint on building exteriors.
• Drinking water—Drinking water that travels through lead pipes, or through pipes with lead-based soldering, may also be contaminated.
• Air pollution—Industrial sources and car exhaust also contribute to the problem. Lead levels in the air have dropped since lead additives were banned from gasoline in the 1970s.
• Food—Food produced outside of the US can be contaminated if packaged in lead-soldered cans.

Risk Factors

Children who are 6 years old and younger are at increased risk for lead poisoning. Other factors that may increase your child's chances of lead poisoning:

• Ingesting non-food items, also known as pica—a behavior in most young children and some children with neurodevelopmental disorders.
• Living in a house or apartment built before 1960.
• Living in neighborhoods where homes were built before 1960.
• Living in a home with adults whose work or hobbies put them in contact with lead.
• Receiving transfusions from adults who have relatively high lead levels in the blood. This is a special risk for small infants receiving newborn intensive care.
• Being born to a mother who has high levels of lead stored in her bones. Pregnancy often causes this lead to move from the bones to the bloodstream. It may cross the placenta and affect a developing baby.
• Breast milk may also contain lead. Nursing mothers who live in houses with lead hazards may transmit lead to their babies through breastfeeding.

Symptoms

Children with lead poisoning often show no symptoms. However, the toxic metal can negatively affect nearly every system in the body.

One of the most serious concerns is lead's harmful effect on the nervous system. For every 10 mcg/dL increase in blood lead levels, there is a 2-3 point decline in IQ test scores. Lead poisoning is also associated with neurodevelopment problems such as:

• Attention deficit disorder (ADD) and other behavioral problems
• Learning disabilities
• Motor skill deficits

Other possible signs of lead poisoning include:

• Headache
• Pain or numbness in the extremities
• Muscle weakness
• Nausea and vomiting
• Loss of appetite, abdominal pain
• Impaired hearing
• Memory loss
• Fatigue
• Sleep disturbances
• Mood disorders
• Dental and bone abnormalities

Diagnosis

You will be asked about your child's symptoms and medical history. A physical exam will be done. Lead poisoning is diagnosed with a blood test.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that children at high risk for lead poisoning have their blood levels tested. This should be done until the age of 3 for all children and until the age of 4 to 5 in children who are at higher risk.

Treatment

Treatment depends on the severity of lead poisoning.

Treatment may include:

Prevention

To help reduce your child's chances of lead poisoning: