Lead Exposure at Any Level is Unsafe For Children, Pediatricians Say

A leading group of pediatricians is warning that there are no safe levels of lead exposure for children, highlight the severe risks and life-long health problems that may be caused by lead poisoning. 

The American Academy of Pediatrics (AAP) issued a policy statement this month in the medical journal Pediatrics, indicating that while blood lead concentration levels have plummeted among U.S. children in recent decades, the belief that there is any safe level of lead in their blood is false.

The group warns that even the 5 micrograms per microliter blood lead concentration limit set by the U.S. Centers for Disease Control and Prevention (CDC) does not accurately represent a safe lead exposure level. At that level, an estimated 535,000 U.S. children between ages 1 and 5 have blood levels considered unsafe, or about 2.6%.

“Low-level lead exposure, even at blood lead concentrations below 5 µg/dL (50 ppb), is a causal risk factor for diminished intellectual and academic abilities, higher rates of neurobehavioral disorders such as hyperactivity and attention deficits, and lower birth weight in children,” according to the statement. “No effective treatments ameliorate the permanent developmental effects of lead toxicity. Reducing lead exposure from residential lead hazards, industrial sources, contaminated foods or water, and other consumer products is an effective way to prevent or control childhood lead exposure.”

The AAP determined that focusing on children with lead levels above the CDC limit will “fail to preserve the majority of lost IQ points in U.S. children” and said that children who are actually at low-to-moderate risk is actually where most disease and disability occurs, which the AAP refers to as the “prevention paradox.”

“Children who have blood lead concentrations ≥5 µg/dL (≥50 ppb) will, on average, experience a lead-associated IQ deficit of 6.1 points, an IQ deficit much larger than that of children who have lower blood lead concentrations,” the AAP reports. ” Still, if the focus is only on reducing exposures for children who have a blood lead concentration ≥5 µg/dL (≥50 ppb), we will fail to preserve more than 20 million (>80% of total) of the 23 million IQ points lost among US children with lower lead exposure because there are so many more children who have low to moderate blood lead concentrations.”

At higher levels, lead toxicity can cause extreme vomiting, encephalopathy, and even death, the AAP warns.

The group said that while lead poisoning prevention measures such as hand washing or dust control have failed to reduce children’s blood lead levels, regulations to screen or test older housing units and federal standards to reduce allowable levels of lead in homes, water, soil and consumer products does help.

According to the statement, blood lead concentration levels in U.S. children have dropped dramatically over the past four decades, primarily due to the elimination of lead from gasoline, paints and other products.

“The key to preventing lead toxicity in children is to reduce or eliminate persistent sources of lead exposure in their environment,” the AAP determined.

Lead poisoning for children is already known to increase the risk of nervous system injury, brain damage, seizures or convulsions, growth or mental retardation, coma and even death.

One of the more common causes of of lead poisoning is lead-based paint, which was banned in the United States in 1978 due to the risk of severe and permanent brain damage and developmental problems, particularly in children. However, a number of older homes still contain the toxic paint on the walls, and if it flakes or peals off, young children could ingest the paint chips or breathe dust that comes from the paint, resulting in lead poisoning.

The majority of those children are poor and live in older urban areas, mainly in the inner city. Most are minorities, meaning such exposures add to numerous problems already plaguing inner city black and Latino youths, such as poverty, high crime and poor schools.

While the CDC has set a goal of eradicating child lead poisoning by 2020, many experts say that will be unlikely given the deficiencies in testing.

A report published last week found that only 41% of children between the ages of 1 and 2 who should be getting tested for blood lead levels actually receive such testing.