Lead exposure: Tips to detect, prevent

A medical toxicologist advises parents about ways to minimize risks and test for exposure.
Get the 411 on lead poisoning and exposure from a doctor who offers practical advice. (For Spectrum Health Beat)
Get the 411 on lead poisoning and exposure from a doctor who offers practical advice. (For Spectrum Health Beat)

As the investigation into lead levels in the Flint, Michigan, water supply stirs national outrage, it also focuses attention on the risk posed by the metal throughout the environment.

For parents worried about possible exposure for their children, a physician advises education and information—but not panic.

Bryan Judge, MD, a medical toxicologist and emergency medicine physician with Spectrum Health, says these are key points parents should understand about lead exposure risks:

A blood test

“If there is a concern for lead contamination, parents can get their child checked through their primary care provider,” Dr. Judge said.

A blood test is needed to detect lead levels, because most children and adults don’t exhibit any obvious signs of symptoms. Tests are available through county health departments as well as pediatricians and family doctors.

The numbers

Children with lead levels of 5 micrograms per deciliter are identified as having been exposed to lead and require case management, according to the Centers for Disease Control and Prevention. 

The level of lead in the blood can vary over time. It binds in tissue and the bone and, during stress or illness, can leach into the blood, Dr. Judge said.

“The half-life of lead is about 20 years,” he said. “That means it takes 10 to 20 years to get rid of half of the lead in your bones.”

The CDC calls for treatment with chelation therapy when the lead level is 45 micrograms per deciliter or higher. The child receives medication that binds with lead in the tissue and bones and causes it to be eliminated through urination.

It can be given intravenously in the hospital or as an oral medication taken at home for three weeks.

Lead levels that high are uncommon, he said. In the past year, Spectrum Health has treated just a few children with chelation therapy.

The impact

Lead levels have been shown to affect children’s IQ and ability to pay attention. No safe blood level has been identified in children, the CDC says.

Clinicians believe children are at greatest risk at age 2, when the most significant brain development occurs, Dr. Judge said. However, he added that a number of factors can affect behavioral and developmental issues, including socioeconomic levels and home stability. He emphasized the importance of a loving, supportive family environment.

“There’s a lot of variables involved,” he said. “I’ve seen many kids with elevated lead levels who have done very well in school and in terms of social adjustment.”

Prevention

The best way to protect children from contamination is to reduce their exposure to lead, Dr. Judge said.

Older homes are a key lead hazard because of the presence of lead-based paint, which was banned for residential use in 1978. According to the CDC, 24 million homes in the U.S. have lead-based paint.

Windowsills are a common trouble spot for lead dust. The soil outside also may be contaminated. Judge advises getting the house repainted and checked by a lead abatement specialist.

Home kits to test for lead are sold in stores. The Environmental Protection Agency and Michigan Department of Health and Human Services provide lists of certified contractors. Financial assistance is available for low- to moderate-income families in Grand Rapids, Michigan, through the Get the Lead Out campaign.

If a house has older plumbing—copper pipes with lead solder—Dr. Judge advises running the water for a minute or two in the morning before use.

The CDC advises using only cold water from the tap for cooking and drinking. Hot water is more likely to contain a higher level of lead.

Eating healthy also helps. A diet rich in vitamin C and low in fat can decrease lead absorption, Dr. Judge added.

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