Lead was a common part of American life for much of the twentieth century. Paints, plumbing fixtures, water pipes, and a variety of consumer goods all contained it. To improve engine performance, automobiles guzzled leaded gasoline. Meanwhile, the medical community became increasingly aware of lead’s toxicity, particularly in children. Since the 1970s, strict regulations have reduced lead exposure in our homes, products, and environment.

Unfortunately, the lead poisoning crisis is not yet over. More than half of children tested across the country had detectable levels of lead in their blood, according to a recent study published in JAMA Pediatrics. The Centers for Disease Control and Prevention (CDC) recently reduced the blood lead reference value, which is used to identify the highest-risk patients, due to ongoing concerns.

Here’s what you need to know about the new guidelines, as well as the sources and risks of lead poisoning, and how to protect yourself and your family.

How did I come into contact with lead?

Despite the fact that consumer use was outlawed by the federal government in 1978, lead-based paint is still the most common source of lead poisoning. Peeling, cracking, or otherwise deteriorating lead paint, as well as dust created by frequently touched surfaces such as doors, windows, and stairwells, can be hazardous in homes built before 1978. This exposure is most commonly caused by normal hand-to-mouth behavior in a lead-contaminated environment. Because of differences in how they interact with their environment, young children are more likely to have elevated blood lead levels. Nutrition plays a role as well: children with an iron deficiency absorb more lead from their gastrointestinal tracts than children who do not have an iron deficiency.

Other possible sources are:

Lead can enter the water supply as a result of corrosion of lead-based plumbing and fixtures.
Working with lead in the workplace, such as in manufacturing, construction, and mining, can result in lead being carried home on hands and clothing.
Toys, jewelry, and cosmetics, especially antiques and those imported from other countries, can contain lead.
Importantly, the toll of lead poisoning is not the same for everyone. In comparison to the national average, black, low-income, and immigrant populations are more likely to have elevated lead levels.

What are the ramifications for one’s health?
There is no such thing as a safe amount of lead in the body. Because their bodies are rapidly growing and developing, children under the age of six are the most vulnerable. Although symptoms may not appear right away, even low levels of lead can harm the brain and nervous system. Learning, hearing, attention, and behavior can all be affected in the long run.

Lead can be released from the bones and cross the placenta in pregnant women who have been exposed. This can have an effect on the nervous system and growth of the fetus. There’s also a chance of miscarriage or premature delivery.

What do the new CDC guidelines imply?
The highest 2.5 percent of blood lead concentrations in children aged 1 to 5 are represented by the blood lead reference value. Lead concentrations above the reference value may necessitate further investigation or testing. The CDC announced in October 2021 that the blood lead reference value would be reduced from 5 to 3.5 micrograms per deciliter, the first change in nearly a decade. By lowering the value, more children will be identified as having been exposed to lead’s potentially harmful effects. It also allows public health and environmental officials to concentrate lead-reduction efforts in high-risk areas.

What should I do if my child has been exposed to lead?
Depending on how high the blood lead level is, children who have been exposed to lead may require additional testing. Your doctor may advise a more thorough examination of potential sources of lead in the home and environment, as well as additional testing and nutritional counseling to improve calcium and iron intake. For children with the highest blood lead levels, treatment to remove lead from the body may be required.

Additional resources for families at risk of lead poisoning include local health departments, childhood lead prevention programs, and regional pediatric environmental health specialty units.

When is it appropriate for my child to be tested?
If a child lives in a high-risk community, the Massachusetts Department of Health recommends that all children be tested for lead at 9 to 12 months, 2 years, 3 years, and 4 years (as defined by the local department of health). If a sibling has an elevated blood lead level, children with persistent oral exploratory behaviors, unexplained anemia, and other risk factors, blood lead testing may be recommended.

What can I do to make my house lead-free?
Lead poisoning is common in our environments, and removing it is expensive. Renovations, if not done properly, can increase pediatric lead exposure by generating lead-laden dust. A certified lead inspector should inspect a family’s home if they are concerned about lead exposure. Based on these findings, lead-hazard remediation work should be performed by a lead-certified contractor or by those who have been trained to do so.

Temporary mitigation measures can help reduce lead exposure in the meantime. These include frequent hand washing, dusting/wet mopping of the home (multiple times per week), leaving shoes at the door, and eating an iron- and calcium-rich diet.

Last but not least
While lead poisoning has become less common in recent years, it remains a serious public health concern. You should discuss routine testing for your child with your pediatrician, as well as ways to reduce lead hazards and prevent long-term health effects. To help families and property owners mitigate lead-based paint and other hazards in their homes, more funding is needed. These steps, combined with the efforts of the public health and medical communities, can help to put an end to the lead poisoning epidemic.