Lead Poisoning
What is it and who is affected?
Lead is a highly toxic substance, exposure to which can produce a wide range of
adverse health effects. Both adults and children can suffer from the effects of
lead poisoning, but childhood lead poisoning is much more frequent. Over the many
years since we have known about the hazards of lead, tens of millions of children
have suffered its health effects. Even today, in 2004, there are still at minimum
more than four hundred thousand children under the age of six who have too much
lead in their blood.
Where is it found?
There are many ways in which humans are exposed to lead: through deteriorating paint,
household dust, bare soil, air, drinking water, food, ceramics, home remedies, hair
dyes and other cosmetics. Much of this lead is of microscopic size, invisible to
the naked eye. More often than not, children with elevated blood lead levels are
exposed to lead in their own home.
By far the biggest source of concern is the lead paint that is found in much
of our nation's older housing. Until 1978, lead paint was commonly
used on the interiors and exteriors of our homes. Today, the US Department of Housing
and Urban Development (HUD) estimates that about 38 million homes in the US still
contain some lead paint. While lead paint that is in intact condition does not pose
an immediate concern, lead paint that is allowed to deteriorate creates a lead-based
paint hazard. It can contaminate household dust as well as bare soil around the
house, where children may play. In either situation, a child who comes into contact
with lead-contaminated dust or soil is easily poisoned. All it takes is hand-to-mouth
activity, which is perfectly normal for young children to engage in. All it takes
is the lead dust equivalent of a single grain of salt for a child to register an
elevated blood lead level.
According to HUD, about 25% of the nation's housing stock—some 24 million homes—contains
significant lead-based paint hazards, i.e. deteriorating lead paint or lead-contaminated
dust. These are the homes producing the vast majority of the childhood lead poisoning
cases we see today.
Children and adults too can get seriously lead poisoned when renovation and
remodeling activities take place in a home that contains lead paint.
Anytime a surface containing lead paint is worked on, the debris and the dust created
by the work must be contained and thoroughly cleaned up, and those doing the work
must have adequate personal protection to prevent them from breathing in any lead
dust generated by the work. It is therefore of critical importance that lead painted
surfaces be identified prior to the commencement of any renovation or remodeling
work, and that lead-safe work practices are used during such activities. Of course,
steps must also be taken to ensure that children, pets, and personal belongings
including furniture are protected from exposure to lead while work is ongoing, as
well.
The past use of leaded gasoline, only recently banned in this country, contributed
greatly to the number of cases of childhood lead poisoning in the US during the
last sixty years or so. The lead produced by vehicle emissions continues even today
to present a hazard, as much of that lead now remains in soil where it was deposited
over the years, especially near well-traveled roads and highways. Children who play
in dirt contaminated by lead (whether that lead is from gasoline emissions or from
deteriorated house paint) can end up with lead-contaminated soil under their fingernails
or on their toys, or they can track it into their homes. Even pets can come into
contact with lead-contaminated soil and cause human exposure to lead. In each such
case, an elevated blood lead level can easily result.
Drinking water can also sometimes contribute to elevated blood lead levels. Lead
can leach into drinking water from certain types of plumbing materials (lead pipes,
copper pipes with lead solder, and brass faucets). While water is usually not the
primary source of exposure to lead for children with elevated blood lead levels,
it is nevertheless important to note that formula-fed infants are at special risk
of lead poisoning, if their formula is made with lead-contaminated water.
What are the health effects?
There are many different health effects associated with elevated blood lead levels.
Young children under the age of six are especially vulnerable to
lead's harmful health effects, because their brains and central nervous system are
still being formed. For them, even very low levels of exposure can result in reduced
IQ, learning disabilities, attention deficit disorders, behavioral problems, stunted
growth, impaired hearing, and kidney damage. At high levels of exposure, a child
may become mentally retarded, fall into a coma, and even die from lead poisoning.
Within the last ten years, children have died from lead poisoning in New Hampshire
and in Alabama. Lead poisoning has also been associated with juvenile delinquency
and criminal behavior.
In adults, lead can increase blood pressure and cause fertility
problems, nerve disorders, muscle and joint pain, irritability, and memory or concentration
problems. It takes a significantly greater level of exposure to lead for adults
than it does for kids to sustain adverse health effects. Most adults who are lead
poisoned get exposed to lead at work. Occupations related to house painting, welding,
renovation and remodeling activities, smelters, firing ranges, the manufacture and
disposal of car batteries, and the maintenance and repair of bridges and water towers,
are particularly at risk for lead exposure. Workers in these occupations must also
take care not to leave their work site with potentially contaminated clothing, tools,
and facial hair, or with unwashed hands. Otherwise, they can spread the lead to
their family vehicles and ultimately to other family members.
When a pregnant woman has an elevated blood lead level, that lead
can easily be transferred to the fetus, as lead crosses the placenta. In fact, pregnancy
itself can cause lead to be released from the bone, where lead is stored—often for
decades—after it first enters the blood stream. (The same process can occur with
the onset of menopause.) Once the lead is released from the mother's bones, it re-enters
the blood stream and can end up in the fetus. In other words, if a woman had been
exposed to enough lead as a child for some of the lead to have been stored in her
bones, the mere fact of pregnancy can trigger the release of that lead and can cause
the fetus to be exposed. In such cases, the baby is born with an elevated blood
lead level.
Exposure to lead is estimated by measuring levels of lead in the blood (in micrograms
of lead per deciliter of blood). The US Centers for Disease Control and Prevention
(CDC) has set a "level of concern" for children at 10 micrograms per deciliter.
At this level, it is generally accepted that adverse health effects can begin to
set in. However, recent research published in the New England Journal of Medicine
provides new evidence that there could well be very harmful effects occurring at
even lower levels of exposure, even as low as 5 micrograms of lead per deciliter
of blood. In other words, science is now telling us that there is in fact no level
of lead exposure that can be considered safe.
How can I check my home to see if it contains lead-based paint hazards?
If you live in a home built before 1960, it is very likely that it contains some
lead paint. Homes built between 1960 and 1978 may also contain lead paint, but they
are less and less likely to, the closer you get to 1978, when the Consumer Product
Safety Commission finally issued its ban against lead-based paint. If you live in
a home built before 1978 that also has been allowed to deteriorate for a few years,
you may have a lead-contaminated dust problem. To find out if your home contains
lead paint or a lead-based paint hazard, you should hire a professional.
If all you want to do is find out if there is lead paint in your home, you should
hire a lead inspector to test all the paint. Depending on the size of your home,
this normally takes between one and four hours. You will know the results of the
inspection on the spot. The inspector will be able to tell you whether or not there
is lead paint in the home, where it is, and the concentration of lead in the paint.
(Older homes contain higher concentrations of lead in paint than homes built after
the early 1950s. The higher the concentration, the greater the hazard once the paint
deteriorates.)
If you also want to find out if your home contains any lead-contaminated dust, which
is the most dangerous of all lead-based paint hazards, you should hire either a
risk assessor or a sampling technician. They will take samples of dust throughout
your home and then send them to a laboratory for analysis. You should be able to
learn the results within three to seven days. You will learn whether there is any
lead-contaminated dust in your home and where it was found. A risk assessor can
also tell you what you should do next to take care of the problem. Alternatively,
you can buy a dust sampling kit and carefully do the sampling yourself, send the
samples to an appropriate laboratory for analysis, and get the results directly
from the lab. This is a less expensive way to find out about lead-contaminated dust
in your home. The National Safety Council offers a lead dust test kit that includes
everything a consumer needs to determine the presence of lead dust in their home,
including detailed instructions and a pre-stamped, pre-addressed envelope to the
lab for sample analysis.
Download an order form.
Various manufacturers also offer what is called a "spot test kit," basically a sampling
tool that uses a chemical process to help consumers figure out if there is lead
present in household paint, or even on ceramicware or on toys. However, spot test
kits are not considered completely reliable tools in terms of their accuracy, and
they should not be relied upon for definitive answers regarding the presence of
lead paint.
To locate a lead inspector, a risk assessor, or another certified professional in
lead hazard evaluation and control activities, proceed to the Lead Listing at http://www.leadlisting.org.
What are some simple steps to take to prevent or reduce lead exposure?
Maintain the paint in your home and clean up any lead dust. If
you live in a home built before 1978, the most important step to take to reduce
the risk of exposure to lead is to make sure that the paint is well maintained.
Whenever repainting, renovation, or other work is undertaken that may end up disturbing
a painted surface, it is critical to moisten the surface first, in order to prevent
the work from generating dust. Similarly, all painted debris from the work should
be contained, in other words prevented from spreading beyond the area where the
debris can be carefully gathered and then safely disposed of.
If you think you may have a lead dust problem, you can clean up lead-contaminated
dust yourself by carefully and thoroughly washing the area, using soapy water and
a mop. A three-bucket system is ideal, with one bucket holding the soapy water (a
general all-purpose cleaner is adequate, but dishwasher soap containing phosphates
or a lead-specific detergent may be more effective), a second bucket serving as
the rinse bucket, and the third containing only clean water. After you wash a section
of floor with the soapy water, rinse the mop in the rinse bucket, then dunk it in
the clean water bucket, and finally dip it back in the soapy water bucket before
cleaning the next area. For smaller areas such as window sills, a rag should be
used instead of a mop. Once done, throw the mop or rag away. Whenever cleaning
lead-contaminated dust, vigorous wiping is most effective in removing the lead.
However, wiping should never be done in a back-and-forth manner, but rather from
left to right (or vise-versa), or from the top of a wall downwards.
Once cleaning has been completed for a given room, it is time to rinse, using only
clean water and preferably a new mop head.
Remember that if you do have a lead dust problem, you will also need to address
the source of the lead dust. In many instances, lead dust particles are generated
by friction caused by the opening and shutting of old windows. With old, deteriorating
windows, outright window replacement may be the best option. In addition to solving
your lead dust problem, this also typically results in significantly increased energy
efficiency, higher property values, and lower heating and cooling bills.
If you have a young child in your home and you suspect there may be a lead problem,
take the recommended steps to eliminate any lead-contaminated dust, and make sure
the child washes his/her hands frequently. Also make sure to clean any toys that
have been lying about in areas that you suspect may contain lead-contaminated dust.
Check the water. To ensure your drinking water does not contain
a hazardous level of lead, test the water at your faucets. Call the EPA Safe Drinking
Water Hotline at 800-426-4791 for more information. Kits for testing water, along
with the instructions for doing so, are available from a number of providers.
Eat right. The amount of lead the human body retains can be reduced
if you make sure your child's diet includes plenty of foods that contain iron, calcium
and zinc. Foods rich in iron include eggs, raisins, greens, beans, peas, and other
legumes. Dairy products such as milk, cheese, and yogurt are recommended for their
high calcium content. Lean red meat and oysters are examples of foods that contain
zinc. Avoid giving children fried or fatty foods—although remember that a certain
amount of dietary fat is vital for children under two years of age. And make sure
your children always wash their hands before eating.
Check your ceramic ware. Some pottery may contain lead that can
leach into food and drinks. Avoid eating off any colorfully painted ceramic plates,
and avoid drinking from any ceramic mugs unless you know they do not leach lead.
This is particularly important if the pottery was made in Mexico or another Latin
America country, or in Asia. Generally, pottery made in the US, in Canada, or in
Western Europe tends to be safe.
Do not store alcohol in crystal containers. Crystal decanters and
glasses are often made with lead. When an acidic substance or alcohol is left in
these containers for longer than just a few hours, there is a risk that the lead
could leach into the liquid.
Cover bare soil play areas. You should ensure your child avoids
playing in bare soil areas unless you know they are lead free. Often, bare soil
will contain some lead, either deposited there by vehicle emissions from leaded
gasoline days, or from deteriorated exterior paint. This is frequently the case
in vacant lots, where old buildings once stood, or in a neighborhood where extensive
renovation work may have occurred. If you have a bare soil problem, the easiest
way to reduce the risk is to cover the soil with mulch (for instance, pebbles, shrubbery,
or grass). A child who plays in lead-contaminated bare soil is likely to get some
under his/her fingernails, which will eventually find their way into his/her mouth,
or on toys, or on their shoes, which could track the lead into the home. Similarly,
a dog that rolls around in lead-contaminated bare soil may end up transporting some
of that lead into the home.
What laws help prevent lead poisoning?
At the Federal level, the Lead-Based Paint Hazard Reduction Act of 1992, known as
Title X (Title ten), is the source of much of the law of the land on lead paint.
One of its most important requirements is the disclosure of known lead hazards at
the time of the sale or lease of a home built before 1978. Sellers and landlords
must also provide a pamphlet on lead poisoning to the buyer or renter before the
pre-1978 property is sold or rented.
The Federal lead hazard disclosure laws have been vigorously enforced by the US
Department of Housing and Urban Development (HUD), the US Environmental Protection
Agency (EPA), and the US Department of Justice (DOJ). For the past five years, these
Federal agencies have been working closely together to help ensure that property
owners and real estate agents comply with the Title X disclosure requirements.
Similarly, Title X also requires renovators, remodelers, and others who conduct
such activities for compensation in homes built before 1978 to provide the pamphlet
entitled Protect Your Family From Lead in Your Home to the owners and occupants
of affected housing, prior to beginning the work.
At the state or local level, your state or municipality may have enacted additional
laws to protect you from lead poisoning. Check with your state and local health
and housing departments for details.
Code enforcement is another important legal tool that can be used to prevent lead
poisoning. Most local codes already prohibit chipping, peeling paint conditions.
Generally, under what is called "common law," tenants have a right to live in safe
housing, otherwise known as the implied warranty of habitability. Premises that
contain lead-based paint hazards are inherently unsafe places to live. If you can
demonstrate that your rented home contains a lead-based paint hazard, you should
immediately contact your landlord or property manager and notify them of the presence
of a lead hazard. Do it in writing and keep a dated copy for your records. If they
fail to respond in a timely and effective manner to this notification, you may have
legal recourse against them. Consult an attorney for further information—and take
your own precautions.
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