Lead is a naturally occurring element in our environment, and if it is ingested or inhaled into a child’s body, it can damage brain tissue, leading to decreased IQ, language delays, hearing loss, and nerve problems. Exposure to lead is especially bad for young children because the young blood-brain barrier is more lax and permissive to lead crossing over. It can also affect the kidneys, intestines, and block Vitamin D metabolism, affecting bone health.
That’s why the American Academy of Pediatrics recommends that we screen for lead poisoning. This is done with a finger prick similar to how a diabetic checks blood sugar. Is there still lead out there since it has been removed from paint, gasoline and pencils? The answer is yes. Where are kids exposed to it these days?
Most of the kids I see that have lead in their blood have a Dad who hunts, does target shooting, makes ammunition or otherwise has and uses guns. The dust from the ammunition settles on surfaces and then the child is exposed to it more easily than other family members given that they are closer to the ground, have a habit of mouthing everything, and are blissfully oblivious to hand hygiene. These dads just need to be sure to keep kids away from the guns and ammo (for other obvious safety reasons as well) and be sure to clean up, wash clothes and hands etc after they are done handling those things.
Some of the kids live in old houses with lead pipes. The lead leaches into the drinking water and is ingested. Old paint can peal, releasing dust into the environment or tempting little ones to put the chips into their mouths. Another interesting trend is jelly shoes- some of the kids with positive lead tests in clinic have been wearing jelly shoes. I’m not sure whether it’s the jelly shoes themselves or the holes that allow the children exposure to dirt. I’ve also seen kids who play outside in the dirt have positive lead levels. I want these kids to keep playing outside in the dirt given the real dangers of being sedentary and having excessive screen time. I just tell parents to be sure to bathe them regularly.
Toys and pottery imported from other countries can have lead in them, as well as some herbal and alternative medicine remedies, including Ayurvedic medicines.
An aging infrastructure around the country includes old pipes that carry drinking water that also contain lead. At times this lead can leach out of the pipes and into the water, which caused the Flint, Michigan water crisis of 2014. An attempt to save money lead to the under-testing and under-treating of water from the Flint river, which lead to corrosive waste and pollutants in the water leaching lead out of the soldering of old pipes, exposing around 9,000 children to lead in their drinking water.
Parents who work in certain occupations have a higher risk of bringing lead dust home on their clothes or belongings such as plumbing, ship-building, welders, construction workers, and firing range instructors. See the table below for common current sources of lead.
If a child has any lead detectable in their blood, than we want to find out where it is coming from and eliminate or reduce their exposure to it. Most of the time it’s easy to know where the lead is coming from and then it’s a matter or reducing or eliminating their exposure. If it’s not clear where the lead is in the child’s environment, the public health department can help you test places in your house and your water to see where it’s coming from. Then we test every few weeks or months depending on how high it is to make sure we’re keeping it out of the child’s blood.
We also want to make sure to minimize the ability of the lead to cause problems in case we can’t eliminate on-going exposure. This means making sure they have a diet high in iron, since lead competes with the absorption of iron from food which can cause iron-deficiency. We also have them eat Vit C containing foods or vitamins since it helps promote absorption of iron.
We also want to support the child’s development as much as possible. Early intervention programs like Root for Kids are available to help monitor for developmental delays that could be caused by lead, and provide developmental therapies to help kids learn developmental skills.
If the lead level is super high, the child may need admission to the hospital to quickly lower the lead level through chelation. Fortunately this is not common.
For most parents though, you just need to be aware that your child should be screened for lead exposure at 12 months and 24 months at their regular well child checks. And be aware of potential sources of lead. It’s always good for parents to monitor their child’s development as well using good sources of information about developmental milestones and when a child should be reaching them. I like the Vroom app which also suggests activities you can do together with your child to promote their learning and bonding.
It’s all part of the work we do as parents and pediatricians to protect and promote children’s healthy brain development.
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