Why is it still such a problem?
For years, experts have been talking about the dangers of lead. It doesn’t matter where it’s found…paint, water, or somewhere else…it poses a significant health risk. If discovered, it must be removed to make the living environment safe. How do you know if you’re being exposed? What can you do to fix it? Why are we still having to deal with it?
Lead is a metal that is naturally found in the earth’s crust. Lead can be found in all parts of our environment –air, soil, water, and even inside our homes. Human activity, such as mining, burning fossil fuels, and manufacturing, has caused it to become more widespread in the environment. Lead was once used in gasoline and paint, but regulations were passed in 1976 and 1978, respectively, that banned its use in these products. It’s still used in batteries, solder, pipes, pottery, roofing materials, and cosmetics, especially in other countries.
One concern is that lead-based paint is still on walls and woodwork in many older homes and apartments. According to data from the Centers for Disease Control and Prevention (CDC), about 24% of homes built between 1960-1977 contain lead-based paint that increases to 69% for a house built between 1940-1959 and 87% for a house built before 1940. Often, lead-based paint is under layers of newer paint. Most lead poisoning in children results from eating chips of deteriorating lead-based paint or inhaling dust that contains lead particles. Adults who do home renovations also might be exposed to lead. When it comes to homes, other areas of concern are lead pipes, brass plumbing fixtures, and copper pipes soldered with lead because they can release lead particles into tap water. Some soil close to the walls of older houses contains lead from paint flaking. Lead-contaminated soil is still a significant problem around highways and in some urban settings because lead doesn’t degrade, and heavy emissions from the past accumulate in the soil.
Lead can enter drinking water through corrosion of plumbing materials, especially where the water has high acidity or low mineral content that corrodes pipes and fixtures, which is a dissolving or wearing away of metal caused by a chemical reaction between water and your plumbing. In addition, homes built before 1986 are more likely to have lead pipes, fixtures, and solder. In 2011, Environmental Protection Agency (EPA) issued the Lead and Copper Rule (LCR) under the authority of the Safe Drinking Water Act. One requirement of the LCR is corrosion control treatment to prevent lead and copper from contaminating drinking water. Corrosion control treatment means utilities must make drinking water less corrosive to the materials it comes into contact with on its way to consumers’ taps. The changes reduced the maximum allowable lead content to be a weighted average of 0.25% calculated across the wetted surface of pipes, pipe fittings, plumbing fittings, and fixtures and 0.2% for solder and flux. The most common problem is with brass or chrome-plated brass faucets and fixtures with lead solder.
Lead is emitted into the environment from industrial sources and contaminated sites, such as former lead smelters. Lead smelting and refining is still an enormous industry worldwide. While natural levels of lead in soil range between 50 and 400 parts per million, mining, smelting, and refining activities have resulted in substantial increases in lead levels in the environment near these areas and further away. When lead is released into the air from industrial sources, it may travel long distances before settling to the ground and sticking to soil particles. Larger lead particles fall to the ground within about 200 meters of the source, but the smaller particles, about 0.5 microns in size, can remain airborne for a week before they settle out. This is very problematic because winds, especially during droughts, stir up dust, and runoff from heavy rains and flooding can re-suspend the particles in the atmosphere. Trees take up soil particles, too, and when forests burn in wildfires, lead is released back into the air. Fires also release lead from old houses and buildings coated with lead paint before the ban.
Lead solder in food cans is banned in the US but is still used in some countries. Also, lead is sometimes found in toys, cosmetics, candies, herbal/folk remedies, and other products produced abroad. Glazes found on some ceramics, china, and porcelain can contain lead that can leach into the food served or stored in the pottery. Some bullets have lead, so time spent at firing ranges can increase exposure. Certain occupations can increase your risk for exposure. In addition, particles could be brought home on clothing. Some jobs tied to this are auto repair, mining, pipe fitting, battery manufacturing, painting, construction, and certain other fields.
Why should you be worried about lead?
The problem with lead is that it’s toxic at any dose because it serves no purpose in our body, and our body has no way to remove it. Lead can enter the body in a variety of ways. Most commonly, it’s via ingestion or inhalation. It doesn’t matter how it enters your body; the health effects are the same. Once lead enters the body, it flows through the bloodstream, where it slowly crosses into various organs, like the kidneys, muscles, and brain. It interferes with numerous enzymes inside the cells of these organs, resulting in damage. This can lead to hypertension, arrhythmias, anemia, infertility (men and women), impaired cognition, attention deficit disorder, lower academic test scores for children, and psychiatric disorders. Lead is increasingly implicated in dementia in the elderly because we don’t know if the brain can adapt to the higher lead levels in the bloodstream. Next, the lead is deposited in your bones and stays with you for the rest of your life. As we age, our bones demineralize, and the internal exposure may increase due to larger releases of lead from the bone tissue. This is especially of concern for women undergoing menopause.
Lead poisoning can be hard to detect because people can appear healthy but still have high blood levels of lead. The effects are potentially subtle and may be slow to emerge. The timing of symptoms is based on how much is absorbed and the length of time it’s absorbed. Suppose it happens over a short time. In that case, you may have abdominal pain, constipation, tiredness, headache, irritability, loss of appetite, memory loss, pain/tingling in the hands/feet, or weak. A person exposed over a longer period may have abdominal pain, constipation, depression, distractedness, forgetfulness, irritability, nauseous, high blood pressure, joint/muscle pain, difficulties with memory or concentration, headache, miscarriage/stillbirth/premature birth in pregnant women, and reduced sperm count/abnormal sperm. Very high lead exposure can cause death.
Generally, lead affects children more than adults. Children tend to show signs of severe lead toxicity at lower levels than adults. Lead can cross the placental barrier and damage a developing baby’s nervous system. Babies exposed to lead before birth might be born prematurely, have lower birth weight, and have slowed growth. Symptoms of lead poisoning in children include developmental delay, learning difficulties, lower IQs, irritability, loss of appetite, weight loss, sluggishness and fatigue, abdominal pain, vomiting, constipation, hearing loss, seizures, and eating things, such as paint chips, that aren’t food (pica).
Some factors can increase your risk of lead poisoning. The major one is age. Infants and young children are more likely to be exposed to lead than are older children. Babies and young children often put their hands and other objects that can have lead from dust or soil on them into their mouths. Individuals who live in or are renovating an older home are at higher risk. If you have certain hobbies, such as making stained glass and jewelry, they require the use of lead solder. Since developing countries often have less strict rules regarding lead exposure, living there can be a higher risk. You can be exposed by eating and drinking food or water containing lead or from dishes or glasses that have lead. Lead can be found in hunting ammunition, fishing tackle, and weights used in stock cars. So, if you are around these, your risk level is elevated.
When you look at communities, those most affected are low-income neighborhoods, predominately of people of color because they may not have access to safe, affordable housing or face discrimination when trying to find a safe, healthy place to live. This housing inequity puts them at a greater risk of exposure to lead. Other areas impacted are neighborhoods undergoing redevelopment. When people move into these historic houses, the paint has been there for decades, if not a hundred years. As they start renovating, they encounter it.
What should you do if you think you or your child have been exposed to lead?
The first step is to talk to your pediatrician, general physician, or local health agency. Next, you should have your home tested for sources of lead. The good news is a simple blood test can detect lead poisoning. All that is needed is a small blood sample taken from a finger prick or a vein. Lead levels in the blood are measured in micrograms per deciliter (mcg/dL). In children, a level of 5 mcg/dL is used to indicate a possibly unsafe level. Children whose blood tests are at those levels should be tested periodically. A child whose levels become too high (45 mcg/dL or higher) should be treated. It’s estimated that 535,000 preschool-age children across the country have blood lead levels warranting medical management. Per a 2018 special report from Reuters, in over 3,800 neighborhoods throughout the US, children have blood lead levels more than double those found in Flint, Michigan. The city became famous in 2015 because of concerns about childhood lead poisoning from water contaminated due to lead pipes. Despite being the common perception that the source of the issue in Flint is water, experts believe that the significant source of lead exposure comes from old, decaying paint and other combined sources. More of a cumulative effect. The Reuters team obtained their data directly from state health departments and the CDC.
How are high levels of lead treated?
The first step is to remove the source of the contamination. In some cases, it’s better to seal in rather than remove old lead paint. This might be enough for children and adults with relatively low lead levels to reduce blood lead levels. In more severe cases, such as those with high blood levels of lead or those experiencing symptoms, your doctor might recommend chelation therapy. This involves taking a medication given by mouth that binds with the lead so that it’s excreted in the urine. Another option is EDTA (calcium disodium ethylenediaminetetraacetic acid) chelation therapy for those who can’t tolerate the drug used in conventional chelation therapy. EDTA is given by injection.
What can you do to prevent lead exposure?
There are many simple measures you can take to help protect you and your family from lead poisoning. To help reduce the hand-to-mouth transfer of contaminated dust or soil, be sure to wash your and your children’s hands and toys frequently. Check the exterior of your home, including porches and fences, for flaking or deteriorating lead-based paint that may contaminate soil in your yard or be tracked into your house. Cover bare soil with mulch or by planting grass. Plant bushes close to the house to keep children from playing in the soil near your home. Also, remove shoes before entering the house and place dust mats both inside and outside of entryways. Be sure to clean dusty surfaces with a damp cloth and clean floors with a wet mop. If your home has lead-based paint, check it regularly for peeling paint and fix problems promptly. When doing so, try not to sand because it generates dust particles that contain lead. Contact your water utility or a licensed plumber to determine if the pipe that connects your home to the water main (called a service line) is made from lead. If you have older plumbing containing lead pipes or fittings, run your cold water for at least a minute before using it. Address water damage quickly and thoroughly. If you have home renovations, repairs, or painting done, make sure your contractor is Lead-Safe Certified and follows lead-safe work practices. Eating a healthy diet is vital because good nutrition might help lower lead absorption. Children especially need enough calcium, vitamin C, and iron in their diets to help keep lead from being absorbed. Don’t use hot tap water to make baby formula or for cooking. Older playground equipment can still contain old lead-based paint, and artificial turf and playground surfaces made from shredded rubber can have lead. So, be careful when allowing your children to play in these areas.
If you have a job or hobby where you may encounter lead, never put leaded materials in your mouth. Always use proper ventilation and equipment when melting lead to cast your own bullets, sinker, decoys, or other metal items. Avoid handling food or touching your mouth or face while working with lead materials, and wash hands before eating or drinking following such activities. Be sure to shower or change clothes before entering your vehicle or coming home. Wash your work and hobby clothes separately from the rest of your family’s clothes. Keep all work and hobby materials away from living areas.
What is being done to manage lead exposure?
Entities, such as the CDC, the Occupational Safety and Health Administration (OSHA), and local state health departments, are working to decrease adult and child lead exposure. Thankfully, public health initiatives have been successful in lowering our public’s blood lead levels over the past few decades. The CDC’s National Center for Health Statistics monitors blood lead levels nationwide. The Food and Drug Administration (FDA) recommends a maximum level of lead in cosmetic products. The Consumer Product Safety Commission (CPSC) has a comprehensive program on lead in toys. To help protect against that risk, CPSC has put protections in place that ban the use of lead in many children’s products. In 2004, the threat of lead poisoning from toy jewelry led the agency to conduct a voluntary recall of 150 million pieces of metal toy jewelry sold widely in vending machines. In 2007, they issued a press release announcing the Fisher-Price recall of 967,000 toys due to lead poisoning hazard. When it comes to commercially available lead test kits, the CPSC has evaluated whether they can reliably and accurately detect the presence or absence of lead in consumer products. Based on their findings, they don’t recommend them. In January 2016, the Department of Housing & Urban Development (HUD) adopted more stringent standards for triggering protections for children residing in HUD-owned or HUD-assisted housing who have been exposed to lead. Previously, protective actions were required when a child was diagnosed with a blood lead level of 20 mcg/dL. Now measures are triggered at the much more protective level of 5 mcg/dL.
We’ve known that lead is a dangerous toxin, especially for kids, for decades, and while the progress that has been made is promising, there’s more we must do to eradicate lead poisoning for good. We need to shift our focus from the small number of people who have acute exposure to the large number of people who have chronic exposure.