Lead in Children

When is a child considered “lead poisoned”?

The Centers for Disease Control (CDC) warns that it takes only a tiny amount of lead to poison a child. Children’s rapidly growing bodies absorb more lead than those of adults or older children do, and their developing brains and nervous systems are more sensitive to the damaging effects of lead.

Ohio recently adopted a new approach to determining when a child is lead poisoned. Instead of using a fixed number for the level of lead in a child’s blood to define lead poisoning, the Ohio Department of Health (ODH) adopted a “reference value” for lead poisoning of 5 µg/dL. In other words, a blood lead level of 5 µg/dL and above indicates a child has lead poisoning. Ohio previously had a “level of concern” of 10 µg/dL. For more information on this new approach to childhood lead poisoning, see the Centers for Disease Control and Prevention (CDC) Blood Lead Levels in Children.

When it set the new level for lead poisoning at 5 µg/dL, the Ohio Department of Health (ODH) was following the guidance of the Centers for Disease Control and Prevention (CDC). The CDC’s guidance was based on recommendations made in Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention by the Advisory Committee on Childhood Lead Poisoning Prevention of the Centers for Disease Control and Prevention.

Are children with blood lead levels below 5 considered safe from lead poisoning?

The answer is “no” because there is no safe level of lead in blood. One of the reasons the reference level was set at 5 µg/dL is because most laboratories cannot precisely measure lead in blood at levels lower than 5 µg/dL. Parents may receive results that indicate their child’s lead level is under a certain amount, such as “less than 2 µg/dL,” because that’s the lowest level the laboratory can measure. While a report like this is good news for parents, it’s wise to keep in mind the laboratory’s margin of error. The actual level could be higher or lower.

What are the symptoms?

You may not be able to tell if your child has lead poisoning because sometimes the symptoms are mistaken for more common illnesses. The only way to know if a child is lead poisoned is through a blood test.

According to the National Institutes of Health, symptoms of lead poisoning can include:

  • Abdominal pain and cramping
  • Aggressive behavior
  • Constipation
  • Difficulty sleeping
  • Headaches
  • Irritability
  • Loss of previous developmental skills (in young children)
  • Low appetite and energy
  • Reduced sensations

What are the effects of lead poisoning?

The effects of lead poisoning may not be immediately apparent but can show up later in life, causing lifelong health effects. Lead poisoning can build up slowly over time over repeated exposure to lead. Young children are more vulnerable because lead damages their developing nervous system and other organs before they are fully developed. Unborn children are the most vulnerable. The National Institutes of Health identifies the following effects or complications:

  • Behavior or attention problems
  • Failure at school
  • Hearing problems
  • Kidney damage
  • Reduced IQ
  • Slowed body growth

Who’s at risk of lead poisoning in Ohio? Who should be tested?

Children should be tested at age 1 and 2 years, or up to 6 years if no previous test has been done according to the Ohio Department of Health. Pregnant women and children up to six years who fit into any of the categories below are at risk and should be tested:

  • Receiving Medicaid. Children are required to have lead tests at 12 and 24 months.
  • Live in a high risk zip code.
  • Live in or regularly visit a home, child care facility or school built before 1950
  • Live in or regularly visit a home, child care facility or school built before 1978 with deteriorated paint and lead-related issues. Some areas and items in the home, facility or school of particular concern: painted, original windows and doors, floors. (Lead dust is created when painted surfaces meet through the opening and closing of doors and windows. Also the walls and trim of kitchens and bathrooms may contain lead paint because of its durability); exterior painted porches, siding, windows, doors; older claw foot style bathtubs; older ceramic tile; plumbing, pipes and faucets. Check to see if pipes were connected with lead solder. If so, your water quality could be affected; soil near homes and highways
  • Live in or regularly visit a home, childcare facility or school built before 1978 with recent, ongoing or planned painting, repairs or renovation. Engaging in renovation when you are pregnant can put the unborn child at risk of lead poisoning as well.
  • Are in households who use products made in the USA before lead levels were reduced in products used by children and/or imported/brought from countries that don’t have systems in place to keep lead out of consumer products. These include toys, furniture painted before 1976, pewter pitchers and dinnerware, make up, candy, pottery and toys.
  • Come into contact with adults with a lead-related hobby or occupation
  • Live near an active/former smelter, battery recycling plan or other industry known to generate airborne lead dust. This also applies to land once used for these purposes.

What tests are used?

  • Filter paper tests that use a finger prick
  • Blood drawn through a vein (venous test)

If the initial filter paper test shows an elevated lead level (5 µg/dL and above), a venous test is required by the Ohio Department of Health to confirm the lead level.

What treatment options are available?

While there is no treatment known to reverse the effects of lead poisoning, parents should ask for affordable, high quality early education for their children as soon as they are identified as lead poisoned. This type of education can improve cognition and school performance.

  • The Children with Medical Handicaps Program (BCMH) is a health care program in the Ohio Department of Health that links families with special health care needs to a network of quality providers and helps families obtain payment for the services their children need. Local health department public health nurses can provide a referral to start the enrollment process.
  • Other services parents may want to access are Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and Help Me Grow.
  • The Ohio Department of Health has adopted medical management recommendations that describe the steps medical personnel should take to assist the child and family at different levels of poisoning. Medical providers and case managers work with the family to lower the child’s blood lead level and improve the child’s overall health. Blood lead levels are monitored until lead levels are under 5 µg/dL.
  • One of the quickest way to lower a child’s blood lead level is for the family to move out of the lead contaminated home to one that has been made lead safe. While no special funding is available at the state level to relocate families with lead poisoned children or help with security deposits, county Ohio Job and Family Services offices may provide assistance to children with higher lead levels.
  • For very high lead levels, (45 µg/dL and over) the chief medical treatment is chelation, which binds lead to a substance that can be expelled from the body.
  • While chelation may prevent serious complications such as seizures, it can’t reverse the damage caused by lead poisoning. Because lead poisoning builds up slowly over time and health problems get worse as the level of lead in the blood rises (National Institutes of Health), it is important to reduce the child’s exposure to lead in the home through lead hazard control. Lead hazard control activities may include removing lead dust and peeling paint, window repair or replacement, and addressing conditions causing paint to degrade. All repairs are conducted in a lead safe manner while the household is out of the home. If a child’s lead level is 5 µg/dL or above, lead hazard control activities must be conducted by a state licensed lead contractor.
  • No license is required for cleaning. Families are encouraged to carefully and thoroughly clean the home to remove lead dust using a HEPA VAC. Most counties in the state will loan HEPA VACs free of charge through the state’s HEPA VAC loaner program.

Can lead poisoning be prevented?

Yes. See Protecting Your Family from Lead.

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