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 Yale-New Haven Hospital, New Haven, Connecticut, USA HealthLINK: Pediatrics
April 12, 1999

News this month
Can Damage From Lead Poisoning Be Reversed?

Can a child fully recover from lead poisoning? That was the question posed by researchers studying 375 Australian children with lead poisoning who were followed from birth to age 11 to 13.

For years, physicians have understood the connection between high levels of lead in the blood and impaired cognitive function in children. The hope has been that these effects were only temporary and that treating the lead poisoning could fully restore a child's ability to learn, avoiding lifetime disabilities. But information presented in the Journal of the American Medical Association suggests such effects may be permanent.

Significant reductions in the amount of lead levels in the blood resulted in only slightly better cognition among children seven and 11 to 13 years old.

From May 1979 through May 1982, physicians took blood samples from pregnant women who lived near a smelter. Additional samples were collected from their children at birth, six months, 15 months and 24 months, and annually until age seven. At age 11 and 13 more blood samples were taken. Developmental status and cognitive abilities were assessed by a number of tests given at two, four, seven and 11 to 13 years of age.

The results were disturbing. The researchers, lead by Shilu Tong, MBBS, PhD, of the Queensland University of Technology in Brisbane, Australia, concluded: "There may be no obvious beneficial effect of reducing lead exposure in the latter years of childhood." If this is true, "efforts to reduce the exposure of children to environmental lead from a very early age becomes increasingly important," they wrote.

In the U.S., lead poisoning is a leading environmental health hazard for young children, affecting as many as 1.7 million children age five and under, according to the Centers for Disease Control and Prevention (CDC). Although lead-based house paint was banned from sale in the U.S. in 1978, children living in older homes are threatened by chipping or peeling lead paint and excessive amounts of lead-contaminated dust. In fact, more than 80 percent of homes built before 1978 contain lead paint.

Study Summary
Declining Blood Lead Levels and Changes in Cognitive Function During Childhood: The Port Pirie Cohort Study:
Reductions in blood lead levels after age two on cognitive abilities; 375 patients, followed from birth to ages seven and 11 to 13 years.

Results
Significant reductions in the amount of lead levels in the blood resulted in only slightly better cognition among children seven and 11 to 13 years old. cc



Keeping your home safe

If your home was built before 1980, there are many steps to take to reduce the chances of lead poisoning in your home.

  • Have your home inspected for lead. Lead can be found in paint, dust, dirt or the water supply.
  • Loose lead paint chips can be cleaned up by mixing cleaning detergent with warm water in a spray bottle and wetting the chips and lead dust. Use disposable rags or paper towel to pick them up and wipe the area clean. Throw them in the garbage carefully so children can't get to the paint chips or dirty towels. Do not use a vacuum—that will only make the problem worse by spreading lead dust through the house.
  • Regularly wet mop floors and wet dust windowsills, ledges and other surfaces. Using two buckets—one to rinse and one to clean—is best at removing the lead. Change the water in both often. Dispose of this water safely; down the toilet is usually best.
  • Always use cold water for cooking and mixing infant formula.
  • If you are planning home renovations, hire an experienced contractor who knows how to deal with lead hazards and make sure children and pregnant women do not live in the home during this time. cc

Physician Referral Online

A free and confidential service
of Yale-New Haven Hospital.

Physician Referral Online
Using your own criteria, you can request information from a database of 900 area physicians who have registered to participate.

Request an appointment
We would be happy to assist you in scheduling an appointment with a member of the hospital's medical staff. Use the link above or call:

203-688-2000
or toll free
1-888-700-6543
to talk with a referral coordinator.
David Schonfeld, MD

Is your child affected by lead?

It is easy to feel removed from the plight of children living near one of the largest lead smelting operations in the southern hemisphere. We feel thankful we do not live under such conditions and that such problems do not affect our children.

Lead can damage vital organs and cause learning problems without the child or parent even knowing it.

I must ask you to think again. As director of the Yale Lead Program, I've treated hundreds of lead-poisoned children from all walks of life. The children in South Australia were poisoned by a lead smelter in their neighborhood, an obvious source. But many sources of lead poisoning are more insidious, and often right within our own homes.

Where is lead found?
How many times do parents catch young children chewing or sucking on things? Young children also crawl, play and basically live near the floor or ground where lead hazards tend to be worse. This puts them at higher risk for ingesting lead, usually as a result of ingesting dust contaminated with lead.

Other sources of lead:

  • Renovations of older homes can create large amounts of lead dust if safety precautions are not taken.
  • Dirt or dust contaminated with lead from the prior use of lead paint or from lead from car exhaust before leaded gasoline was banned.
  • Solder used in water pipes of older homes contains lead that can leach out into water, especially if water sits for hours in pipes. Sometimes, the pipe from the road to the house was made of lead in very old homes.
  • Imported dishes and glasses can contain high amounts of lead.
  • Hobbies, such as fishing, stained glassmaking.
  • Jobs. The U.S. Department of Labor has identified 900 jobs that bring people in contact with lead.

By learning simple steps to prevent lead poisoning, combined with regular screening programs, parents take a giant step in tackling this major health risk.

Lead's effect on children
As the JAMA article and previous studies acknowledge, lead poisoning has been associated with reductions in intelligence and even behavioral problems. What's more, no published study has shown that the cognitive defects attributed to lead poisoning are reversible.

Health care providers often screen children for lead poisoning at one and two years of age.

Lead can damage vital organs and cause learning problems without the child or parent even knowing it. Especially vulnerable is the brain. Lead is more dangerous to children than adults because of their small size and because of their rapidly developing nervous systems.

At very high levels, there may be swelling of the brain, which can cause mental confusion, stumbling and speech difficulties. In the worst cases, lead poisoning can cause seizures, coma and even death. Fortunately, these outcomes are rarely seen today because of better screening, earlier identification of children with lead poisoning and earlier intervention.

A simple blood test
Health care providers often screen children for lead poisoning at one and two years of age. This simple blood test is done often right in the office. If your child has not been screened, ask your doctor why. If you live in a newer home, still consider having the test done if your child spends time at friends, relatives or daycare in an older house.

If you are pregnant or considering having a baby, talk to your obstetrician if you have concerns about lead.

If your child has been exposed to lead
If you have noticed chipping and peeling paint in or near your home or suspect your child has been exposed to lead; first, ask your child's pediatrician or local health department about getting a blood lead test. Make sure you understand the results. In children under the age of seven, blood lead levels over 10 ug/dl (micrograms per deciliter) are considered hazardous.cc

Dr. Schonfeld, a pediatrician, is on the medical staff of Yale-New Haven Hospital and is an associate professor of pediatrics at Yale University School of Medicine and the Child Study Center.

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