Public Health Statement
for
Lead
(Plomo)
August 2007
CAS#: 7439-92-1
This Public Health Statement is the summary chapter from the Toxicological Profile for Lead. It is one in a series of Public Health Statements about hazardous substances and their health effects. A shorter version, the ToxFAQs™, is also available. This information is important because this substance may harm you. The effects of exposure to any hazardous substance depend on the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are present. For more information, call the ATSDR Information Center at 1-800-232-4636.
This public health statement tells you about lead and the effects of exposure to it
The Environmental Protection Agency (EPA) identifies the most serious hazardous waste sites in the nation. These sites are then placed on the National Priorities List (NPL) and are targeted for long-term federal clean-up activities. Lead has been found in at least 1,272 of the 1,684 current or former NPL sites. Although the total number of NPL sites evaluated for this substance is not known, the possibility exists that the number of sites at which lead is found may increase in the future as more sites are evaluated. This information is important because these sites may be sources of exposure and exposure to this substance may harm you.
When a substance is released either from a large area, such as an industrial plant, or from a container, such as a drum or bottle, it enters the environment. Such a release does not always lead to exposure. You can be exposed to a substance only when you come in contact with it. You may be exposed by breathing, eating, or drinking the substance, or by skin contact.
If you are exposed to lead, many factors will determine whether you will be harmed. These factors include the dose (how much), the duration (how long), and how you come in contact with it. You must also consider any other chemicals you are exposed to and your age, sex, diet, family traits, lifestyle, and state of health.
1.1 What is lead?
Lead is a heavy, low melting, bluish-gray metal that occurs naturally in the Earth's crust. However, it is rarely found naturally as a metal. It is usually found combined with two or more other elements to form lead compounds.
Metallic lead is resistant to corrosion (i.e., not easily attacked by air or water). When exposed to air or water, thin films of lead compounds are formed that protect the metal from further attack. Lead is easily molded and shaped. Lead can be combined with other metals to form alloys. Lead and lead alloys are commonly found in pipes, storage batteries, weights, shot and ammunition, cable covers, and sheets used to shield us from radiation. The largest use for lead is in storage batteries in cars and other vehicles.
Lead compounds are used as a pigment in paints, dyes, and ceramic glazes and in caulk. The amount of lead used in these products has been reduced in recent years to minimize lead’s harmful effect on people and animals. Tetraethyl lead and tetramethyl lead were once used in the United States as gasoline additives to increase octane rating. However, their use was phased out in the United States in the 1980s, and lead was banned for use in gasoline for motor vehicles beginning January 1, 1996. Tetraethyl lead may still be used in gasoline for off-road vehicles and airplanes. It is also still used in a number of developing countries. Lead used in ammunition, which is the largest non-battery end-use, has remained fairly constant in recent years. However, even the use of lead in bullets and shot as well as in fishing sinkers is being reduced because of its harm to the environment.
Most lead used by industry comes from mined ores ("primary") or from recycled scrap metal or batteries ("secondary"). Lead is mined in the United States, primarily in Alaska and Missouri. However, most lead today is “secondary” lead obtained from lead-acid batteries. It is reported that 97% of these batteries are recycled.
1.2 What happens to lead when it enters the environment?
Lead occurs naturally in the environment. However, most of the high levels found throughout the environment come from human activities. Environmental levels of lead have increased more than 1,000-fold over the past three centuries as a result of human activity. The greatest increase occurred between the years 1950 and 2000, and reflected increasing worldwide use of leaded gasoline. Lead can enter the environment through releases from mining lead and other metals, and from factories that make or use lead, lead alloys, or lead compounds. Lead is released into the air during burning coal, oil, or waste. Before the use of leaded gasoline was banned, most of the lead released into the U.S. environment came from vehicle exhaust. In 1979, cars released 94.6 million kilograms (208.1 million pounds) of lead into the air in the United States. In 1989, when the use of lead was limited but not banned, cars released only 2.2 million kg (4.8 million pounds) to the air. Since EPA banned the use of leaded gasoline for highway transportation in 1996, the amount of lead released into the air has decreased further. Before the 1950s, lead was used in pesticides applied to fruit orchards. Once lead gets into the atmosphere, it may travel long distances if the lead particles are very small. Lead is removed from the air by rain and by particles falling to land or into surface water.
Sources of lead in dust and soil include lead that falls to the ground from the air, and weathering and chipping of lead-based paint from buildings, bridges, and other structures. Landfills may contain waste from lead ore mining, ammunition manufacturing, or other industrial activities such as battery production. Disposal of lead-containing products contribute to lead in municipal landfills. Past uses of lead such as its use in gasoline are a major contributor to lead in soil, and higher levels of lead in soil are found near roadways. Most of the lead in inner city soils comes from old houses with paint containing lead and previous automotive exhaust emitted when gasoline contained lead.
Once lead falls onto soil, it sticks strongly to soil particles and remains in the upper layer of soil. That is why past uses of lead such as lead in gasoline, house paint, and pesticides are so important in the amount of lead found in soil.
Small amounts of lead may enter rivers, lakes, and streams when soil particles are moved by rainwater.
Small amounts of lead from lead pipe or solder may be released into water when the water is acidic or “soft”. Lead may remain stuck to soil particles or sediment in water for many years. Movement of lead from soil particles into groundwater is unlikely unless the rain falling on the soil is acidic or "soft". Movement of lead from soil will also depend on the type of lead compound and on the physical and chemical characteristics of the soil.
Sources of lead in surface water or sediment include deposits of lead-containing dust from the atmosphere, waste water from industries that handle lead (primarily iron and steel industries and lead producers), urban runoff, and mining piles.
Some lead compounds are changed into other forms of lead by sunlight, air, and water. However, elemental lead cannot be broken down.
The levels of lead may build up in plants and animals from areas where air, water, or soil are contaminated with lead. If animals eat contaminated plants or animals, most of the lead that they eat will pass through their bodies.
1.3 How might I be exposed to lead?
Lead is commonly found in soil especially near roadways, older houses, old orchards, mining areas, industrial sites, near power plants, incinerators, landfills, and hazardous waste sites. People living near hazardous waste sites may be exposed to lead and chemicals that contain lead by breathing air, drinking water, eating foods, or swallowing dust or dirt that contain lead. People may be exposed to lead by eating food or drinking water that contains lead. Drinking water in houses containing lead pipes may contain lead, especially if the water is acidic or “soft”. If one is not certain whether an older building contains lead pipes, it is best to let the water run a while before drinking it so that any lead formed in the pipes can be flushed out. People living in areas where there are old houses that have been painted with lead paint may be exposed to higher levels of lead in dust and soil. Similarly, people who live near busy highways or on old orchard land where lead arsenate pesticides were used in the past may be exposed to higher levels of lead. People may also be exposed to lead when they work in jobs where lead is used or have hobbies in which lead is used, such as making stained glass.
Foods may contain small amounts of lead. However, since lead solder is no longer used in cans, very little lead is found in food. Leafy fresh vegetables grown in lead-containing soils may have lead-containing dust on them. Lead may also enter foods if they are put into improperly glazed pottery or ceramic dishes and from leaded-crystal glassware. Illegal whiskey made using stills that contain lead-soldered parts (such as truck radiators) may also contain lead. Cigarette smoke may also contain small amounts of lead. The amount of lead found in canned foods decreased 87% from 1980 to 1988 in the United States, which indicates that the chance of exposure to lead in canned food from lead-soldered containers has been greatly reduced. Lead-soldered cans are still used in some other nations. In the most recent studies, lead was not detectable in most foods and the average dietary intake of lead was about 1 microgram (a microgram is a millionth of a gram) per kilogram of body weight per day. Children may be exposed to lead by hand-to-mouth contact after exposure to lead-containing soil or dust.
In general, very little lead is found in lakes, rivers, or groundwater used to supply the public with drinking water. More than 99% of all publicly supplied drinking water contains less than 0.005 parts of lead per million parts of water (ppm). However, the amount of lead taken into your body through drinking water can be higher in communities with acidic water supplies. Acidic water makes it easier for the lead found in pipes, leaded solder, and brass faucets to be dissolved and to enter the water we drink. Public water treatment systems are now required to use control measures to make water less acidic. Plumbing that contains lead may be found in public drinking water systems, and in houses, apartment buildings, and public buildings that are more than 20 years old. However, as buildings age, mineral deposits form a coating on the inside of the water pipes that insulates the water from lead in the pipe or solder, thus reducing the amount of lead that can leach into the water. Since 1988, regulations require that drinking water coolers must not contain lead in parts that come into contact with drinking water.
Breathing in, or swallowing airborne dust and dirt, is another way you can be exposed to lead. In 1984, burning leaded gasoline was the single largest source of lead emissions. Very little lead in the air comes from gasoline now because EPA has banned its use in gasoline for motor vehicles. Other sources of lead in the air include releases to the air from industries involved in iron and steel production, lead-acid-battery manufacturing, and nonferrous (brass and bronze) foundries. Lead released into air may also come from burning of solid waste that contains lead, windblown dust, volcanoes, exhaust from workroom air, burning or weathering of lead-painted surfaces, fumes and exhaust from leaded gasoline, and cigarette smoke.
Skin contact with dust and dirt containing lead occurs every day. Recent data have shown that inexpensive cosmetic jewelry pieces sold to the general public may contain high levels of lead which may be transferred to the skin through routine handling. However, not much lead can get into your body through your skin.
In the home, you or your children may be exposed to lead if you take some types of home remedy medicines that contain lead compounds. Lead compounds are in some non-Western cosmetics, such as surma and kohl. Some types of hair colorants, cosmetics, and dyes contain lead acetate. Read the labels on hair coloring products, use them with caution, and keep them away from children.
People who are exposed at work are usually exposed by breathing in air that contains lead particles. Exposure to lead occurs in many jobs. People who work in lead smelting and refining industries, brass/bronze foundries, rubber products and plastics industries, soldering, steel welding and cutting operations, battery manufacturing plants, and lead compound manufacturing industries may be exposed to lead. Construction and demolition workers and people who work at municipal waste incinerators, pottery and ceramics industries, radiator repair shops, and other industries that use lead solder may also be exposed. Painters who sand or scrape old paint may be exposed to lead in dust. Between 0.5 and 1.5 million workers are exposed to lead in the workplace. In California alone, more than 200,000 workers are exposed to lead. Families of workers may be exposed to higher levels of lead when workers bring home lead dust on their work clothes.
You may also be exposed to lead in the home if you work with stained glass as a hobby, make lead fishing weights or ammunition, or if you are involved in home renovation that involves the removal of old lead-based paint.
1.4 How can lead enter and leave my body?
Some of the lead that enters your body comes from breathing in dust or chemicals that contain lead. Once this lead gets into your lungs, it goes quickly to other parts of the body in your blood.
Larger particles that are too large to get into your lungs can be coughed up and swallowed. You may also swallow lead by eating food and drinking liquids that contain it. Most of the lead that enters your body comes through swallowing, even though very little of the amount you swallow actually enters your blood and other parts of your body. The amount that gets into your body from your stomach partially depends on when you ate your last meal. It also depends on how old you are and how well the lead particles you ate dissolved in your stomach juices. Experiments using adult volunteers showed that, for adults who had just eaten, the amount of lead that got into the blood from the stomach was only about 6% of the total amount taken in. In adults who had not eaten for a day, about 60–80% of the lead from the stomach got into their blood. In general, if adults and children swallow the same amount of lead, a bigger proportion of the amount swallowed will enter the blood in children than in adults. Children absorb about 50% of ingested lead.
Dust and soil that contain lead may get on your skin, but only a small portion of the lead will pass through your skin and enter your blood if it is not washed off. You can, however, accidentally swallow lead that is on your hands when you eat, drink, smoke, or apply cosmetics (for example, lip balm). More lead can pass through skin that has been damaged (for example, by scrapes, scratches, and wounds). The only kinds of lead compounds that easily penetrate the skin are the additives in leaded gasoline, which is no longer sold to the general public. Therefore, the general public is not likely to encounter lead that can enter through the skin.
Shortly after lead gets into your body, it travels in the blood to the "soft tissues" and organs (such as the liver, kidneys, lungs, brain, spleen, muscles, and heart). After several weeks, most of the lead moves into your bones and teeth. In adults, about 94% of the total amount of lead in the body is contained in the bones and teeth. About 73% of the lead in children’s bodies is stored in their bones. Some of the lead can stay in your bones for decades; however, some lead can leave your bones and reenter your blood and organs under certain circumstances (e.g., during pregnancy and periods of breast feeding, after a bone is broken, and during advancing age).
Your body does not change lead into any other form. Once it is taken in and distributed to your organs, the lead that is not stored in your bones leaves your body in your urine or your feces. About 99% of the amount of lead taken into the body of an adult will leave in the waste within a couple of weeks, but only about 32% of the lead taken into the body of a child will leave in the waste. Under conditions of continued exposure, not all of the lead that enters the body will be eliminated, and this may result in accumulation of lead in body tissues, especially bone.
1.5 How can lead affect my health?
Scientists use many tests to protect the public from harmful effects of toxic chemicals and to find ways for treating persons who have been harmed.
One way to learn whether a chemical will harm people is to determine how the body absorbs, uses, and releases the chemical. For some chemicals, animal testing may be necessary. Animal testing may also help identify health effects such as cancer or birth defects. Without laboratory animals, scientists would lose a basic method for getting information needed to make wise decisions that protect public health. Scientists have the responsibility to treat research animals with care and compassion. Scientists must comply with strict animal care guidelines because laws today protect the welfare of research animals.
The effects of lead are the same whether it enters the body through breathing or swallowing. The main target for lead toxicity is the nervous system, both in adults and children. Long-term exposure of adults to lead at work has resulted in decreased performance in some tests that measure functions of the nervous system. Lead exposure may also cause weakness in fingers, wrists, or ankles. Lead exposure also causes small increases in blood pressure, particularly in middle-aged and older people. Lead exposure may also cause anemia. At high levels of exposure, lead can severely damage the brain and kidneys in adults or children and ultimately cause death. In pregnant women, high levels of exposure to lead may cause miscarriage. High-level exposure in men can damage the organs responsible for sperm production.
We have no conclusive proof that lead causes cancer (is carcinogenic) in humans. Kidney tumors have developed in rats and mice that had been given large doses of some kind of lead compounds. The Department of Health and Human Services (DHHS) has determined that lead and lead compounds are reasonably anticipated to be human carcinogens based on limited evidence from studies in humans and sufficient evidence from animal studies, and the EPA has determined that lead is a probable human carcinogen. The International Agency for Research on Cancer (IARC) has determined that inorganic lead is probably carcinogenic to humans. IARC determined that organic lead compounds are not classifiable as to their carcinogenicity in humans based on inadequate evidence from studies in humans and in animals.
1.6 How can lead affect children?
This section discusses potential health effects in humans from exposures during the period from conception to maturity at 18 years of age.
Studies carried out by the Centers for Disease Control and Prevention (CDC) show that the levels of lead in the blood of U.S. children have been getting lower and lower. This result is because lead is banned from gasoline, residential paint, and solder used for food cans and water pipes. However, about 310,000 U.S. children between the ages of 1 and 5 years are believed to have blood lead levels equal or greater than 10 μg/dL, the level targeted for elimination among young children in the Unites States by 2010.
Children are more vulnerable to lead poisoning than adults. Children are exposed to lead all through their lives. They can be exposed to lead in the womb if their mothers have lead in their bodies. Babies can swallow lead when they breast feed, or eat other foods, and drink water that contains lead. Babies and children can swallow and breathe lead in dirt, dust, or sand while they play on the floor or ground. These activities make it easier for children to be exposed to lead than adults. The dirt or dust on their hands, toys, and other items may have lead particles in it. In some cases, children swallow nonfood items such as paint chips; these may contain very large amounts of lead, particularly in and around older houses that were painted with lead-based paint. The paint in these houses often chips off and mixes with dust and dirt. Some old paint contains as much as 50% lead. Also, compared with adults, a bigger proportion of the amount of lead swallowed will enter the blood in children.
Children are more sensitive to the health effects of lead than adults. No safe blood lead level in children has been determined. Lead affects children in different ways depending on how much lead a child swallows. A child who swallows large amounts of lead may develop anemia, kidney damage, colic (severe “stomach ache”), muscle weakness, and brain damage, which ultimately can kill the child. In some cases, the amount of lead in the child’s body can be lowered by giving the child certain drugs that help eliminate lead from the body. If a child swallows smaller amounts of lead, such as dust containing lead from paint, much less severe but still important effects on blood, development, and behavior may occur. In this case, recovery is likely once the child is removed from the source of lead exposure, but there is no guarantee that the child will completely avoid all long-term consequences of lead exposure. At still lower levels of exposure, lead can affect a child’s mental and physical growth. Fetuses exposed to lead in the womb, because their mothers had a lot of lead in their bodies, may be born prematurely and have lower weights at birth. Exposure in the womb, in infancy, or in early childhood also may slow mental development and cause lower intelligence later in childhood. There is evidence that these effects may persist beyond childhood.
Children with high blood lead levels do not have specific symptoms. However, health workers can find out whether a child may have been exposed to harmful levels of lead by taking a blood sample. They can also find out how much lead is in a child’s bones by taking a special type of x ray of the finger, knee, or elbow. This type of test, however, is not routine.
1.7 How can families reduce the risk of exposure to lead?
If your doctor finds that you have been exposed to substantial amounts of lead, ask whether your children might also have been exposed. Your doctor might need to ask your state health department to investigate.
The most important way families can lower exposures to lead is to know about the sources of lead in their homes and avoid exposure to these sources. Some homes or day-care facilities may have more lead in them than others. Families who live in or visit these places may be exposed to higher amounts of lead. These include homes built before 1978 that may have been painted with paint that contains lead (lead-based paint). If you are buying a home that was built before 1978, you may want to know if it contains lead based paint. Federal government regulations require a person selling a home to tell the real estate agent or person buying the home of any known lead-based hazards on the property. Adding lead to paint is no longer allowed. If your house was built before 1978, it may have been painted with lead-based paint. This lead may still be on walls, floors, ceilings, and window sills, or on the outside walls of the house. The paint may have been scraped off by a previous owner, but paint chips and lead-containing dust may still be in the yard soil. Decaying, peeling, or flaking paint can introduce lead into household dust and the area where this is occurring should be repainted. If your paint is decaying or your child has symptoms of lead poisoning, you may want to have your house tested for lead. In some states, homeowners can have the paint in their homes tested for lead by their local health departments. The National Lead Information Center (1-800-532-3394) has a listing of approved risk assessors (people who have met certain criteria and are qualified to assess the potential risks of a site) and of approved testing laboratories (for soil, paint, and dust).
Sanding surfaces painted with lead-based paint or using heat to peel the paint may cause exposure to high levels of lead. Many cases of lead poisoning have resulted from do-it-yourself home renovations. Therefore, any renovations should be performed by a licensed contractor who will minimize exposure to household members. It is important for the area being renovated to be isolated from the rest of the house because of lead-containing dust. The federal government requires that contractors who test for or remove lead must be certified by the EPA or an EPA-approved state program. Ask to see certifications of potential contractors. Your state health department or environmental protection division should be able to identify certified contractors for you. The National Lead Abatement Council (P.O. Box 535; Olney, MD 20932; telephone 301-924-5490) can also send you a list of certified contractors.
Families can lower the possibility of children swallowing paint chips by discouraging their children from chewing or putting these painted surfaces in their mouths and making sure that they wash their hands often, especially before eating. Lead can be found in dirt and dust. Areas where levels of lead in dirt might be especially high are near old houses, highways, or old orchards. Some children have the habit of eating dirt (the term for this activity is pica). Discourage your children from eating dirt and other hand-to-mouth activity.
Non-Western folk remedies used to treat diarrhea or other ailments may contain substantial amounts of lead. Examples of these include: Alarcon, Ghasard, Alkohl, Greta, Azarcon, Liga, Bali Goli, Pay-loo-ah, Coral, and Rueda. If you give your children these substances or if you are pregnant or nursing, you may expose your children to lead. It is wise to know the ingredients of any medicines that you or your children use.
Older homes that have plumbing containing lead may have higher amounts of lead in drinking water. Inside plumbing installed before 1930 is most likely to contain high levels of lead. Copper pipes have replaced lead pipes in most residential plumbing. You cannot see, taste, or smell lead in water, and boiling your water will not get rid of lead. If you have a water-lead problem, EPA recommends that anytime water in a particular faucet has not been used for 6 hours or longer, you should flush your cold water pipes by running water until it is cold (5 seconds–2 minutes). Because lead dissolves more easily in warm water than in cold water, you should only use cold water for drinking, cooking, and preparing baby formula. You can contact your local health department or water supplier to find out about testing your water for lead. If your water tests indicate a significant presence of lead, consult your water supplier or local health department about possible remedies.
You can bring lead home in the dust on your hands or clothes if lead is used in the place where you work. Lead dust is likely to be found in places where lead is mined or smelted, where car batteries are made or recycled, where electric cable sheathing is made, where fine crystal glass is made, or where certain types of ceramic pottery are made. Pets can also bring lead into the home in dust or dirt on their fur or feet if they spend time in places that have high levels of lead in the soil.
Swallowing of lead in house dust or soil is a very important exposure pathway for children. This problem can be reduced in many ways. Regular hand and face washing to remove lead dusts and soil, especially before meals, can lower the possibility that lead on the skin is accidentally swallowed while eating. Families can lower exposures to lead by regularly cleaning the home of dust and tracked in soil. Door mats can help lower the amount of soil that is tracked into the home; removing your shoes before entering the home will also help. Planting grass and shrubs over bare soil areas in the yard can lower contact that children and pets may have with soil and the tracking of soil into the home.
Families whose members are exposed to lead dusts at work can keep these dusts out of reach of children by showering and changing clothes before leaving work, and bagging their work clothes before they are brought into the home for cleaning. Proper ventilation and cleaning—during and after hobby activities, home or auto repair activities, and hair coloring with products that contain lead—will decrease the possibility of exposure.
Lead-containing dust may be deposited on plant surfaces and lead may be taken up in certain edible plants from the soil by the roots; therefore, home gardening may also contribute to exposure if the produce is grown in soils that have high lead concentrations. Vegetables should be well washed before eating to remove surface deposits. Certain hobbies and home or car repair activities like radiator repair can add lead to the home as well. These include soldering glass or metal, making bullets or slugs, or glazing pottery. Some types of paints and pigments that are used as facial make-up or hair coloring contain lead. Cosmetics that contain lead include surma and kohl, which are popular in certain Asian countries. Read the labels on hair coloring products, and keep hair dyes that contain lead acetate away from children. Do not allow children to touch hair that has been colored with lead-containing dyes or any surfaces that have come into contact with these dyes because lead compounds can rub off onto their hands and be transferred to their mouths.
It is important that children have proper nutrition and eat a balanced diet of foods that supply adequate amounts of vitamins and minerals, especially calcium and iron. Good nutrition lowers the amount of swallowed lead that passes to the bloodstream and also may lower some of the toxic effects of lead.
1.8 Is there a medical test to determine whether I have been exposed to lead?
The amount of total lead in the blood can be measured to determine if exposure to lead has occurred. This test shows if you have been recently exposed to lead. Lead can be measured in teeth or bones by x ray techniques, but these methods are not widely available. These tests show long-term exposures to lead. The primary screening method is measurement of blood lead. Exposure to lead also can be evaluated by measuring erythrocyte protoporphyrin (EP) in blood samples. EP is a part of red blood cells known to increase when the amount of lead in the blood is high. However, the EP level is not sensitive enough to identify children with elevated blood lead levels below about 25 micrograms per deciliter (μg/dL). These tests usually require special analytical equipment that is not available in a doctor’s office. However, your doctor can draw blood samples and send them to appropriate laboratories for analysis.
1.9 What recommendations has the federal government made to protect human health?
The federal government develops regulations and recommendations to protect public health. Regulations can be enforced by law. The EPA, the Occupational Safety and Health Administration (OSHA), and the Food and Drug Administration (FDA) are some federal agencies that develop regulations for toxic substances. Recommendations provide valuable guidelines to protect public health, but cannot be enforced by law. The Agency for Toxic Substances and Disease Registry (ATSDR) and the National Institute for Occupational Safety and Health (NIOSH) are two federal organizations that develop recommendations for toxic substances.
Regulations and recommendations can be expressed as “not-to-exceed” levels, that is, levels of a toxic substance in air, water, soil, or food that do not exceed a critical value that is usually based on levels that affect animals; they are then adjusted to levels that will help protect humans. Sometimes these not-to-exceed levels differ among federal organizations because they used different exposure times (an 8-hour workday or a 24-hour day), different animal studies, or other factors.
Recommendations and regulations are also updated periodically as more information becomes available. For the most current information, check with the federal agency or organization that provides it. Some regulations and recommendations for lead include the following:
CDC recommends that states develop a plan to find children who may be exposed to lead and have their blood tested for lead. CDC recommends that the states test children:
- at ages 1 and 2 years;
- at ages 3–6 years if they have never been tested for lead;
- if they receive services from public assistance programs for the poor such as Medicaid or the Supplemental Food Program for Women, Infants, and Children;
- if they live in a building or frequently visit a house built before 1950;
- iif they visit a home (house or apartment) built before 1978 that has been recently remodeled; and/or
- if they have a brother, sister, or playmate who has had lead poisoning.
CDC considers children to have an elevated level of lead if the amount of lead in the blood is at least 10 μg/dL. Many states or local programs provide intervention to individual children with blood lead levels equal to or greater than 10 μg/dL. Medical evaluation and environmental investigation and remediation should be done for all children with blood lead levels equal to or greater than 20 μg/dL. Medical treatment (i.e., chelation therapy) may be necessary in children if the lead concentration in blood is higher than 45 μg/dL.
EPA requires that the concentration of lead in air that the public breathes be no higher than 1.5 micrograms per cubic meter (μg/m3) averaged over 3 months. EPA regulations no longer allow lead in gasoline. The Clean Air Act Amendments (CAAA) of 1990 banned the sale of leaded gasoline as of December 31, 1995.
Under the Lead Copper Rule (LCR), EPA requires testing of public water systems, and if more than 10% of the samples at residences contain lead levels over 0.015 milligrams per liter (mg/L), actions must be taken to lower these levels. Testing for lead in drinking water in schools is not required unless a school is regulated under a public water system. The 1988 Lead Contamination Control Act (LCCA) was created to help reduce lead in drinking water at schools and daycare centers. The LCCA created lead monitoring and reporting requirements for schools, as well as the replacement of fixtures that contain high levels of lead. However, the provisions in the LCCA are not enforceable by the federal government and individual states have the option to voluntarily comply with these provisions or create their own.
To help protect small children, the Consumer Product Safety Commission (CPSC) requires that the concentration of lead in most paints available through normal consumer channels be not more than 0.06%. The Federal Hazardous Substance Act (FHSA) bans children’s products containing hazardous amounts of lead.
The Department of Housing and Urban Development (HUD) develops recommendations and regulations to prevent exposure to lead. HUD requires that federally funded housing and renovations, Public and Indian housing be tested for lead-based paint hazards and that such hazards be fixed by covering the paint or removing it. When determining whether lead-based paint applied to interior or exterior painted surfaces of dwellings should be removed, the standard used by EPA and HUD is that paint with a lead concentration equal to or greater than 1.0 milligram per square centimeter (mg/cm2) of surface area should be removed or otherwise treated. HUD is carrying out demonstration projects to determine the best ways of covering or removing lead-based paint in housing.
EPA has developed standards for lead-paint hazards, lead in dust, and lead in soil. To educate parents, homeowners, and tenants about lead hazards, lead poisoning prevention in the home, and the lead abatement process, EPA has published several general information pamphlets. Copies of these pamphlets can be obtained from the National Lead Information Center or from various Internet sites, including http://www.epa.gov/opptintr/lead.
OSHA regulations limit the concentration of lead in workroom air to 50 μg/m3 for an 8 hour workday. If a worker has a blood lead level of 50 μg/dL or higher, then OSHA requires that the worker be removed from the workroom where lead exposure is occurring.
FDA includes lead on its list of poisonous and deleterious substances. FDA considers foods packaged in cans containing lead solders to be unsafe. Tin-coated lead foil has been used as a covering applied over the cork and neck areas of wine bottles for decorative purposes and to prevent insect infestations. Because it can be reasonably expected that lead could become a component of the wine, the use of such foil is also a violation of the Federal Food, Drug, and Cosmetic Act. FDA has reviewed several direct human food ingredients (i.e., food dyes) and has determined them to be “generally recognized as safe” when used in accordance with current good manufacturing practices. Some of these ingredients contain allowable lead concentrations that range from 0.1 to 10 ppm.
1.10 Where can I get more information?
If you have any more questions or concerns, please contact your community or state health or environmental quality department or:
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Environmental Medicine
1600 Clifton Road NE, Mailstop F-32
Atlanta, GA 30333
Phone: 1-800-232-4636 / TTY: 888-232-6348
Email: cdcinfo@cdc.gov
Information line and technical assistance:
Phone: 888-422-8737
FAX: (770)-488-4178
ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.
To order toxicological profiles, contact:
National Technical Information Service
5285 Port Royal Road
Springfield, VA 22161
Phone: 800-553-6847 or 703-605-6000
References
Agency for Toxic Substances and Disease Registry (ATSDR). 2007. Toxicological profile for Lead. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
