Dr. Mom: Why blood-lead levels are monitored in kids

06/21/2012 12:00 AM

02/26/2013 8:10 PM

Screening for lead exposure and checking blood lead levels in infants and toddlers is routine preventive health care in pediatric offices across the United States. It's so routine that parents and pediatricians don't give it a second thought, which is good.

But the why of screening is important, and parents certainly need to be in the know. There really is no safe level of lead in children – a sentiment echoed by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. In January, the CDC lowered the threshold for identifying significant blood lead levels in children from 10 micrograms per deciliter to 5.

This lower threshold means more children will be identified as having significant exposure to lead. The hope then will be to identify and eliminate sources of lead exposure in children.

Why are we so worried about lead exposure in children? Because the symptoms are silent and they are irreversible. The only treatment available is chelation therapy, reserved for extremely dangerous lead levels above 45 micrograms.

Even modestly elevated blood lead levels can lower a child's IQ, cause behavior and attention problems, interfere with hearing and speech, affect the kidneys and central nervous systems, and cause anemia, to name a few effects. Hence, the smart move by the CDC to lower the threshold for identifying those children most at risk.

Who is most at risk?

Children under 6 years old, since it's during this time of rapid growth when lead can interfere with essential cognitive and physical development.

Children younger than 3 because they put everything and anything in their mouths.

Children living in homes or buildings built before 1978, when paint still contained lead. This creates an environment where dust and soil in and around the house may be contaminated with lead. Renovations in these homes are particularly dangerous, creating lead dust and contaminated paint chips.

Children in older homes with lead plumbing, which also confers an increased risk of lead exposure through the tap water.

Note that some ceramic dishes may contain lead and should not be used for food consumption.

Toys and children's jewelry may also be contaminated with lead through the paints used on them. It's important for parents to keep abreast of the toy recalls for this very reason. Check the CPSC's website frequently for up-to-date toy recalls. (www.cpsc.gov)

Focus on prevention

If you live in a house or building built before 1978, having it tested for lead is the first step to knowing your lead exposure risk. See the CDC's website for detailed information on reducing lead exposure in these conditions.

Make sure your child receives her routine health appointments and is tested for lead and anemia per your doctor's recommendations. Eating well-balanced meals with enough iron and calcium will decrease your child's absorption of lead should she be exposed to it. So will avoiding consumption of imported candies from Mexico, which may contain lead.

Wash your child's hands after playing outside and before eating to minimize any potential contamination. Also, get in the habit of taking your shoes off at the door, especially when you have infants and toddlers roaming and crawling the floors.

Pay close attention to toy recalls, as toys contaminated with lead-based paint have been recalled in recent years. Again, check the CPSC website for these.

Knowing your child's risk, making sure he's tested as needed and eliminating the sources of lead in his environment will ensure your child remains as healthy and as lead-free as possible.

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