PEHSU Factsheet on Lead and Drinking Water: Information for Health Professionals Across the United States (2016) > Addressing Health Impacts of Lead Exposure
posted on Aug 1, 2019
- According to the CDC and the American Academy of Pediatrics (AAP), routine blood lead screening is recommended for high-risk populations and for children insured by Medicaid at age 1 and 2 years.
- These screening criteria were chosen because of children’s oral-exploratory and motor developmental milestones important at those ages. These guidelines may not adequately capture the risk of lead in water, as formula-fed infants are at highest risk.
- The most effective treatment for lead poisoning is removal of the source. Oral chelation in children who continue to be exposed can be dangerous. Chelation therapy is not recommended and has not been shown to be effective in mitigating adverse neurodevelopmental health effects in the setting of BLLs < 45 µg/dL.
- Lead shares common absorptive mechanisms with iron, calcium, and zinc. Nutritional deficiencies in these minerals promote lead absorption. Ensure iron sufficiency with laboratory testing and treatment per AAP guidelines. Consider starting iron supplementation, as indicated. Manufacturers of dietary supplements are not required to demonstrate that a product is lead-free prior to marketing so caution should be exercised with “dietary supplements.”
- Perform structured developmental screening evaluations at child health maintenance visits per the recommendations in Bright Futures (https://brightfutures.aap.org). Refer to therapeutic programs such as Early Intervention Programs and Individualized Education Programs as appropriate, since the effect of lead on development may manifest over years.
- Public health, environmental, housing and school policies are needed to ensure protection from lead exposure. Doctors and other healthcare providers are in a unique position to promote safe and healthy environments for children in their homes and throughout their communities.