Lead
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Protecting children from exposure to lead is important to lifelong good health. Lead is particularly dangerous to children because their growing bodies absorb more lead than adults and their brains and nervous systems are more sensitive to the damaging effects of lead. Health effects can include reduced IQ, learning disabilities, attention problems, executive function disorders, and behavioral concerns.
How Are Children Exposed to Lead?
Children may be exposed to lead by ingesting peeling lead-based paint or lead contaminated soil, from dishes or glasses that contain lead, eating and drinking food or water containing lead (e.g., imported spices or candies), or from playing with toys with lead paint.
Lead can be found in
- household dust,
- soil children accidently ingest,
- water supplied through lead pipes,
- some toy jewelry, old toys made in the United States and some imported toys were painted with lead-based paint, and some vinyl and plastic toys have lead added as a softener, (add recall link)
- some imported ceramics and glazed dishes made in the U.S. prior to the 1990s also contain lead,
- other potential sources include older, vinyl mini-blinds and imported aluminum cans with soldered seams
- occupational take home exposures (e.g., construction jobs).
How Much Lead is Safe?
There is no safe level of lead exposure in children.
What are the Signs of Lead Poisoning?
Most children with elevated lead levels do not have symptoms. As the lead levels rise, children may complain of non-specific symptoms such as
- headaches,
- abdominal pain,
- loss of appetite or constipation,
- signs of clumsiness, agitation, or decreased activity and drowsiness
- vomiting, stupor, and convulsions.
Families and Communities
- Remove any sources of lead in your home.
- Use wet methods to clean up dust with lead.
- Clean often around windows and play areas.
- Wet mop floors often.
- Wash hands and toys often with soap and water.
- If you have concerns about lead in drinking water, contact your local health department
- Flush water pipes for up to 2 minutes before drinking or drawing water, this is especially important when preparing baby formula.
- Use only the cold water tap for drinking, cooking, and especially for making baby formula.
- Regularly clean faucet aerators to clear out particles of lead trapped in the aerator.
- If lead is a concern in your drinking water, use a faucet filter or pitcher to remove lead from water. Families can find specific water filter products and useful sources of information on filtering drinking water. The NSF International provides voluntary certifications on specific water filter products. http://info.nsf.org/Certified/DWTU
- Purchase lead-free faucets and plumbing parts.
- Reach out to your regional Pediatric Environmental Health Specialty Unit (PEHSU) pediatrician expert with any questions.
Heavy metals can occur naturally in soil used to grow food or can get into food through pesticides, food manufacturing, and packaging. This can lead to small amounts of heavy metals in some baby food products such as rice, rice-based foods (e.g., rice puffs, rice cereal), vegetables (e.g., sweet potatoes), and fruit juices.
Parents can reduce heavy metals in their child’s diet with simple steps such as feeding them a variety of foods and limiting rice-based products and fruit juices. Feed your child healthy meals with foods like milk, cheese, green leafy vegetables, peanut butter, beans, cereals, oranges, and peppers. Foods with vitamin C, iron, and calcium may help keep lead out of the body.
Instead of: |
Try these instead: |
Rice snacks and puffs |
Whole or pureed fresh fruits, vegetables, or rice-free snacks |
Rice cereal |
A variety of grains and cereals, such as whole grain, oats, multi-grain, and barley |
Rice-based teething biscuits or rusks |
A damp washcloth that has been twisted and frozen (tie one end in a knot). Massage sore areas with your clean finger. Explore more ideas from the American Academy of Pediatrics.5 |
Fruit juice |
Children under 6 months: breastmilk or formula only. |
Many young children spend significant time in child care settings and schools. According to the Environmental Protection Agency (EPA), child care facilities, schools, among other types of buildings, may have a higher potential for elevated lead levels in their drinking water because they are closed over weekends, holidays, and extended breaks during which lead in pipes and other fixtures can leach into the water.
There are no federal laws requiring lead testing of drinking water in schools that receive water from public water systems, though the public water systems are regulated by the EPA. If you have concerns about lead at your child’s child care or school, contact your child’s pediatrician, the PEHSU, or your local health department.
Head Start programs have a critical role in preventing lead poisoning in children. They work closely with families and health care professionals to make sure children are screened for lead poisoning. Programs are required to maintain a facility that is free from pollutants, hazards, and toxins that are accessible to children and could endanger their safety — and that includes lead in water and paint. The Role of Head Start in Addressing Lead
Factsheet: How to Protect your Family from Lead
Health Professionals
Health professionals play a key role in preventing exposure, identifying and treating lead poisoning in patients, and advocating for public health measures to address the problem.
Lead alters basic nervous system functions, like calcium-modulated signaling, at very low concentrations in vitro. Lead levels often peak at the age of 2 years, the same age at which a major reduction in dendrite connections occurs, among other events crucial to development. It's possible that lead exposure at that time interferes with a critical development process in the CNS, but what that specific process is has not been clearly identified.
Lead also has important non-neurodevelopmental effects. The kidneys are common targets, and children exposed to lead are at significantly greater risk of becoming hypertensive as adults.
Lead also interferes with the body's ability to use the vital nutrients vitamin D and iron. Exposure has been linked to delayed growth.
The AAP 2016 policy statement, Prevention of Childhood Lead Toxicity provides recommendations for child health professionals. In summary health professionals can:
- Partner with local health departments to conduct periodic surveys of blood lead concentrations in a representative sample in their community.
- Recommend environmental assessments of housing built before 1960.
- Advocate for strict legal standards and enforcement of regulations on allowable lead levels in air, water, soil, house dust, and consumer products.
- Test asymptomatic children for elevated blood lead concentrations according to federal, local, and state requirements. Immigrant, refugee, and internationally adopted children also should be tested for lead when they arrive in the United States because of their increased risk.
- Conduct targeted screening of children for elevated blood lead concentrations if they are 12 to 24 months of age and live in communities or census block groups with ≥25% of housing built before 1960 or a prevalence of children’s blood lead concentrations ≥5 μg/dL (≥50 ppb) of ≥5%.
- For children enrolled in Medicaid, blood lead levels should be taken between 9 to 12 months old and at 2 years of age. Lead risks should be assessed through age 6.
- Advocate for environmental inspections in the housing units of children who have blood lead concentrations ≥5 µg/dL (≥50 ppb)
Immigrant children and adoptees, pregnant people should receive a lead risk assessment and a blood lead test conducted if a risk factor is identified.
Additional Resources for Health Professionals
- CDC/ATSDR; Childhood Lead Poisoning Prevention Program
- EPA: Lead
- American Academy of Pediatrics: Lead Exposure
Regional PEHSU Websites
- Region 10 Pediatric Environmental Health Unit: Traditional Sources of Lead Exposures in Immigrant Populations: For Clinicians (2018)
- Region 2: Prescription for Prevention on Lead Paint
Updated July 9, 2024