Childhood Lead Poisoning Is No Longer a Widespread Public Health Threat

Less than one half of one percent of children in the U.S. are now at risk from lead

Lead poisoning has often been cited as the number one environmental health concern for children. That contention lead to the federal Requirements for Disclosure of Known Lead-Based Paint and/or Lead Based Paint Hazards in Housing (24 CFR Part.35. 40 CFR Part 745) and extreme overreaction by many state regulators.

Regulators Regulate

The federal regulation calls for the disclosure of information concerning lead-based paint and lead-based paint hazards in virtually all real estate transactions involving pre-1978 housing. Its purported purpose is to help inform approximately 9 million renters and 3 million home buyers each year about potential hazards from lead based paint, and what they might do to protect themselves and their children. Owners of more than four dwelling units were to begin implementing these requirements on September 6, 1996, whereas owners of one to four residential dwellings were given until December 6, 1996 to do so.

The regulations require that before ratification of a contract for housing sale or rental, sellers, lessors, and real estate agents are responsible for ensuring compliance with the following rules: 

• Sellers and landlords must give buyers and renters the pamphlet entitled "Protect Your Family From Lead in Your Home," which provides basic information on lead poisoning, its causes, and prevention.
• Sales contracts and leases must include certain notification and disclosure language
• Homebuyers get 10 days to conduct a lead-based paint inspection or risk assessment at their own expense. 

Massachusetts state law prohibits even renting a dwelling containing lead paint to a family with children under 6 years of age.

Lead poisoning has ceased to exist as a widespread public health threat

A panel of physicians and scientists affiliated with the American council on Science and Health (ACSH) has recently concluded that for the majority of American children, lead poisoning is a condition of the past.

According to a new report from ACSH titled, Lead and Human Health, symptomatic childhood lead poisoning, that was often seen until the 1970's, has ceased to exist as a widespread public health threat in the United States. The U.S. Centers for Disease Control and Prevention (CDC) have confirmed that only 0.4% of all children 1-5 years of age in the U.S. may be at greater risk for health complications due to lead exposure.

The blood lead levels (the principle indicator of lead exposure) of the general population have declined significantly within the past decade due to the removal of environmental lead exposure from paint, soldered cans, gasoline and plumbing systems. Already the mean blood lead levels in children have fallen from 15 micrograms of lead in 100cc of blood (ug/dL) in 1976 to 2.3 ug/dL in 1994.

Iron-deficiency possible culprit

Problems in localized areas continue to exist, however. And certain sociodemographic factors (e.g., young children, race/ethnicity and low-income) continue to be associated with higher blood levels. A critical review of the literature on lead toxicity in children from paint ingestion reveals that most of the effects observed were in poor families with iron-deficient diets.

Canadian physician, Boris Gimbarzevsky, wrote on the subject of lead poisoning in an article published on the Internet: "I would not be surprised that most, if not all, of the US cases of lead poisoning were actually associated with iron deficiency.

W hat is significant, when one considers environmental exposure, is that there is a huge variability in how much lead one absorbs depending on the means of exposure and the lead compound one is exposed to. Consider the physiology of lead absorption. Lead may be absorbed through the skin, the lungs, or through the gastrointestinal (GI) tract. The bulk of lead absorption is through the GI route in the pediatric population. Children absorb up to 50% of ingested lead, whereas adults absorb only 5-10% of ingested lead. So, in order to absorb lead, one has to ingest material with a high lead content. Is a child more likely to chew on a toy or a porch?

A peculiarity of iron deficiency is that individuals have bizarre cravings for various foods. Children will commonly eat ice, although iron deficiency anemia has also been associated with cravings to lick venetian blinds, eat cigarette ashes, or even feast on clay. The reason that children absorb more lead is that they have higher iron requirements than adults and consequently iron-deficient children are at much higher risk of lead poisoning.

Dr. Gimbarzevsky believes that it would be simpler to supplement poor children's diet with adequate iron than, "to make the unwarranted (and very expensive) assumption that no level of environmental lead is safe." He believes that topic to be crucially important, but ignored by those government departments, which apparently consider their primary purpose the incitement of panic among the population.

Confused by misinformation

Unfortunately, the general public remains confused about the risk of lead exposure and poisoning. For example, Sesame Street Lead Away, a $1.2 million lead poisoning awareness campaign unveiled recently by the Prudential foundation, cites lead poisoning as the number one environmental health concern for children.

Misinformation such as this and the ability of scientists to monitor ever-smaller amounts of trace elements in the environment add to the confusion. Compounded to this is the CDC's practice of continually lowering the blood action level for lead based on speculative and inconclusive finding of potential effects.

Today, the recommended action level, the blood lead level at which the CDC advises some intervention or monitoring, as been set at 10 ug/dL; a level which nearly 9 of every 10 American children during the 1970s and 1980s.

"It is imperative that parents understand that a blood lead level of 10 ug/dL does not mean that your child is lead poisoned," says Dr. Elizabeth Whelan, president of ACSH. "Classical symptoms of lead poisoning in children are associated with levels greater than 70 ug/dL. While lead clearly can be toxic to humans, and other adverse effects can occur at levels lower than 70 ug/dL, one must not forget that the level of exposure and absorbed dose are critical determinants in the potential occurrence of adverse effects. Trace amounts of lead to which humans are exposed are not believed to be toxicologically significant and should not pose a health risk to humans."

"For the majority of Americans," adds Dr. Whelan, "lead poisoning is not a concern. However, elevated levels continue to exist for certain population groups. For these children, an intervention approach based on education and lead exposure reduction and prevention is recommended."

The pamphlet entitled "Protect Your Family From Lead in Your Home, is available in the RHOL Forms Web , copies are also available from the EPA by calling 800 - 424-LEAD.