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PEHSU Factsheet: Recommendations on Management of Childhood Lead Exposure > Lead Exposure and Risk Factors

Lead Exposure and Risk Factors

posted on Sep 21, 2021
  • The ultimate key to prevention and treatment is removal of the source. If a child’s blood lead level (BLL) is elevated (see below), hospitalization may be necessary until the source is identified. Families should be counseled about potential sources. If the source is still not identified, referral to local services for in-home assessments may be necessary.
  • A child’s BLL depends on his/her environment, habits, parental occupations, and nutritional status. Each of these can influence lead exposure and absorption. Therefore, in a household with multiple children, not all children will have the same lead exposure. Be aware that when families move, lead exposure risk may vary.
  • Any detectable blood lead levels, even below 3.5 µg/dL, are associated with subclinical effects such as inattention and hyperactivity, as well as decreased cognitive function on a population level. Clinically evident effects such as anemia, abdominal pain, nephropathy, and encephalopathy can be seen at levels >40 µg/dL.  Levels above 100 µg/dL may result in fatal seizures and cerebral edema.
  • Lead exposure can be viewed as a lifelong body burden, even after a decline in the BLL. For instance, bone acts as a reservoir for lead over an individual’s lifetime. Childhood lead exposure has potential consequences for adult and prenatal health, and is linked to hypertension, renal insufficiency, and increased cardiovascular-related mortality.
  • Since lead shares common absorptive mechanisms with iron, calcium, magnesium, and zinc, nutritional deficiencies in these minerals promote lead absorption. Acting synergistically with lead, deficiencies in these minerals can increase lead absorption and lead-related neurotoxicity.
  • Provide anticipatory guidance on common sources of environmental lead exposure: leaded paint and dust in homes built prior to 1978, lead in drinking water (see bullet below), lead in soil (usually legacy contamination from leaded gasoline, but possibly from previous exterior home renovations), take-home exposures related to adult occupations, imported food, spices, cosmetics, jewelry, folk remedies, toys, and cookware.
  • Although less common than lead from paint and dust, lead may arise in drinking water from water mains, service lines, or plumbing within individual buildings. EPA sets standards for drinking water; municipalities can provide further information on local water quality and filtration.
  • Additionally, there are hobbies and occupations that are associated with lead “take-home” exposure (i.e., lead-containing dust contaminating work clothes worn home after work), including (not a comprehensive list): construction, welding, metal work/recycling and those involving boatyards, firearms, and art materials (especially those who work with metals). Contact your local health department for specific screening and testing recommendations for your area.