Lead poisoning

Lead poisoning is the result of lead, a heavy metal, building up in the body. This often happens over months or years. Even small amounts of lead can cause serious health problems. Children younger than age 6 are especially vulnerable to lead poisoning, which can severely affect how a child's body grows and brain develops. At very high levels, lead poisoning can be fatal.

Lead-based paint and lead-contaminated dust in older buildings are common sources of lead poisoning in children. Other sources include contaminated air, water and soil. Adults who work with batteries, do home renovations or work in auto repair shops also might be exposed to lead.

There is treatment for lead poisoning, but taking some simple precautions can help protect you and your family from lead exposure before harm is done.

Lead poisoning can be hard to detect. Even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until the amount of lead detected in the blood has climbed to a dangerous level.

Lead poisoning symptoms in children

Signs and symptoms of lead poisoning in children include:

• Developmental delay.
• Learning difficulties.
• Irritability.
• Loss of appetite.
• Weight loss.
• Sluggishness and fatigue.
• Abdominal pain.
• Vomiting.
• Constipation.
• Hearing loss.
• Seizures.

Lead poisoning symptoms in newborns

Babies exposed to lead before birth might:

• Be born early.
• Have lower birth weight.
• Have slowed growth.

Lead poisoning symptoms in adults

Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include:

• High blood pressure.
• Joint and muscle pain.
• Difficulties with memory or concentration.
• Headache.
• Abdominal pain.
• Mood disorders.
• Reduced sperm count and abnormal sperm.
• Miscarriage, stillbirth or premature birth.

Lead is a metal that occurs naturally in the earth's crust. Activities related to mining, burning fossil fuels and manufacturing have caused lead to become more widespread. Lead was also once used in paint and gasoline and is still used in batteries, solder, pipes, pottery, roofing materials and some cosmetics.

Lead in paint

Lead-based paints for homes, children's toys and household furniture have been banned in the United States since 1978. But lead-based paint is still on walls and woodwork in many older homes and apartments. Most lead poisoning in children results from eating chips of deteriorating lead-based paint.

Water pipes and imported canned goods

Lead pipes, brass plumbing fixtures and copper pipes soldered with lead can release lead particles into tap water. Lead solder in food cans, banned in the United States, is still used in some countries.

Other sources of lead exposure

Lead sometimes can also be found in:

• Soil. Lead particles from leaded gasoline or paint settle on soil and can last years. Lead-contaminated soil is still a major problem around highways and in some urban settings. Some soil close to walls of older houses contains lead.
• Household dust. Household dust can contain lead from lead paint chips or from contaminated soil brought in from outside.
• Pottery. Glazes found on some ceramics, china and porcelain can contain lead that can leach into food served or stored in the pottery.
• Toys. Lead is sometimes found in toys and other products produced abroad.
• Cosmetics. Tiro, an eye cosmetic from Nigeria, has been linked to lead poisoning. Kohl is another eye makeup that may contain lead.
• Herbal or folk remedies. Lead poisoning has been linked to greta and azarcon, traditional Hispanic medicines, as well as some from India, China and other countries.
• Tamarind candy. Some candies made with the tropical fruit tamarind have been found to contain lead, possibly due to how the candy was processed or stored.
• Lead bullets. Time spent at firing ranges can lead to exposure.
• Occupations. People are exposed to lead and can bring it home on their clothes when they work in auto repair, mining, pipe fitting, battery manufacturing, painting, construction and certain other fields.

Factors that may increase your risk of lead poisoning include:

• Age. Infants and young children are more likely to be exposed to lead than are older children. They might chew paint that flakes off walls and woodwork, and their hands can be contaminated with lead dust. Young children also absorb lead more easily, and it's more harmful for them than it is for adults and older children.
• Living in an older home. Although the use of lead-based paints has been banned since the 1970s, older homes and buildings often retain remnants of this paint. People renovating an older home are at even higher risk.
• Certain hobbies. Making stained glass and some jewelry requires the use of lead solder. Refinishing old furniture might put you in contact with layers of lead paint.
• Living in developing countries. Developing countries often have less strict rules regarding exposure to lead than do developed countries. American families who adopt a child from another country might want to have the child's blood tested for lead poisoning. Immigrant and refugee children also should be tested.

Lead can harm an unborn child. If you're pregnant or planning a pregnancy, be especially careful to avoid exposure to lead.

Exposure to even low levels of lead can cause damage over time, especially in children. The greatest risk is to brain development, where damage that can't be reversed can happen. High lead levels can damage the kidneys and nervous system in both children and adults. Very high lead levels may cause seizures, unconsciousness and death.

There may be some things you can do to help protect you and your family from lead poisoning. Try these measures:

• Wash hands and toys. To help reduce hand-to-mouth transfer of contaminated dust or soil, wash your children's hands after outdoor play, before eating and at bedtime. Wash their toys regularly.
• Clean dusty surfaces. Clean your floors with a wet mop and wipe furniture, windowsills and other dusty surfaces with a damp cloth.
• Remove shoes before entering the house. This will help keep lead-based soil outside.
• Run cold water. If you have older plumbing containing lead pipes or fittings, run your cold water for at least a minute before using. Don't use hot tap water to make baby formula or for cooking.
• Keep children from playing on soil. Provide them with a sandbox that's covered when not in use. Plant grass or cover bare soil with mulch.
• Choose healthy foods. Regular meals and good nutrition might help lower lead absorption. Children especially need enough calcium, vitamin C and iron in their diets to help keep lead from being absorbed.
• Maintain painted surfaces in your home. If your home has lead-based paint, check regularly for peeling paint and fix problems promptly. Try not to sand, which generates dust particles that contain lead.

Your child's healthcare professional may recommend a blood test to check the blood lead level during a routine check-up. Generally, this testing happens at ages 1 and 2. Lead screening also might be recommended for older children who haven't been tested.

To test for lead, a small blood sample is taken from a finger prick or from a vein. Lead levels in the blood are measured in micrograms per deciliter (mcg/dL).

There is no safe blood level of lead. A level of 5 mcg/dL means a possibly unsafe blood lead level for children. Children with this blood level should be watched over time, having blood tests every so often to check for changes. If the blood lead level becomes too high, treatment is needed. A high blood level in children is generally 45 mcg/dL or higher.

The first step in treating lead poisoning is to remove the source of the contamination. If you can't remove lead from your environment, you might be able to lower the chances that it will cause problems.

For instance, sometimes it's better to seal in rather than remove old lead paint. Check with your local health department to learn about ways to identify and reduce lead in your home and community.

If you or your child has a low lead level, avoiding exposure to lead might be enough to reduce blood lead levels.

Treating high blood lead levels

In cases where you have a high level of lead in the blood, your healthcare professional might recommend:

• Chelation therapy. In this treatment, a medicine given by mouth binds with the lead. The lead then passes out of the body in the urine. Chelation therapy might be needed for children with a blood level of 45 mcg/dL or greater and adults with high blood levels of lead or symptoms of lead poisoning.
• EDTA chelation therapy. Healthcare professionals treat adults with lead levels greater than 45 mcg/dL of blood and children who can't tolerate the drug used in conventional chelation therapy with a different type of chelation therapy. This therapy uses a chemical called calcium disodium ethylenediaminetetraacetic acid, or EDTA. EDTA chelation therapy is given by injection, also called a shot.

If you or your child might have been exposed to lead, see your health care provider or contact your local public health department. A blood test can check blood lead levels.

Here's some information to help you get ready for your appointment.

What you can do

Make a list of:

• Symptoms or behavior changes you've noticed.
• Key personal information, including where you live and whether you or your child has been close to any sources of lead.
• All medicines, vitamins or supplements you or your child takes, including doses.
• Questions to ask your healthcare team.

For lead poisoning, basic questions to ask include:

• What's likely causing these symptoms?
• What tests are needed?
• Is this condition likely temporary or will it be ongoing?
• What's the best course of action?
• Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions as you think of them during your appointment.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• Have you recently moved to a different home or changed schools?
• When was your house built? Are you renovating?
• Do you have a new job that might expose you to lead?
• Does your child have a sibling or playmate who has had lead poisoning?