“When you detect (lead) in a kid … that means primary prevention has failed. And that’s what we need to be doing for lead: primary prevention. It should never reach a child.”
— Flint, Michigan pediatrician, Mona Hanna-Attisha, M.D., M.P.H., F.A.A.P. (AAP News)
“As Fellows [of the American Academy of Pediatrics], we are responsible for not just the health of the children who come into our office, but the health of our community. We cannot always assume that the guidelines and regulations that are followed by agencies take into consideration the particular needs and health risks for children.”
— Flint, Michigan pediatrician, Lawrence Reynolds, M.D., F.A.A.P. (AAP News)
We’ve spent the past three days on The PediaBlog asking some important questions: What is lead? What are the adverse effects of environmental exposure to lead on the human body, particularly on young children’s developing brains? And, what the heck happened in Flint, Michigan? The answers, we found out, were not very pretty.
What happened in Flint should serve as a loud wake-up call for those who care about the impact of all types of toxic exposures on public health — especially on children who don’t have a say, don’t have a hand, and don’t have a vote. The events in Flint should make us all ask: How can we prevent lead exposure in our homes and communities? And, how can we prevent lead poisoning in our children?
To answer those questions, we turn to the CDC:
A child’s environment is full of lead. Children are exposed to lead from different sources (such as paint, gasoline, solder, and consumer products) and through different pathways (such as air, food, water, dust, and soil). Although there are several exposure sources, lead-based paint is the most widespread and dangerous high-dose source of lead exposure for young children.
In 1978, the U.S. government responded to the persistent problem of childhood lead poisoning with regulations banning the use of lead-containing paint. As the graph from the Environmental Protection Agency below indicates, houses built before 1978 are likely to have at least one coat of lead-containing paint.
The problem with lead paint is that it peels and chips over time. Young children tend to put things into their mouths, and paint chips that fall from walls, door jams, and window sills are particularly inviting since the lead contained in old paint — lead acetate — has a sweet taste. Deteriorating lead paint also leads to house dust which can be inhaled and ingested by newly-mobile infants and toddlers who scoot, crawl, cruise, and toddle their way around their homes. Remodeling older homes also presents a risk from the dust created when walls or ceilings with a coating of lead-containing paint are demolished. Also remember that older toys and furniture may have been painted with leaded paint. For children who live in homes built before 1978, the following measures should be taken to reduce the risk of lead poisoning from old paint, even if that old paint is covered by newer, lead-free layers:
- Make sure painted surfaces are in good shape, with no peeling or chipping from walls, door jams, and window sills.
- Keep paint in excellent shape and repaint areas in disrepair.
- Vacuum floors and wipe down furniture regularly to pick up any dust related to deteriorating paint.
- Avoid creating lead-containing dust when remodeling or rebuilding. Isolate rooms being renovated from the rest of the living areas to prevent dust from settling there.
- Keep your child’s hands and toys clean since both may end up in their mouths along with lead-containing dust and dirt.
- Lead dust can also be tracked into the home from soil outdoors that is contaminated by deteriorated exterior lead-based paint and other lead sources, such as industrial pollution and past use of leaded gasoline. Remove shoes upon entering the house, and vacuum and mop floors regularly.
Child care centers and schools can also be dangerous environments if they are housed in older buildings. The EPA suggests that parents investigate for the presence of toxic hazards:
- Interior painted areas— Examine walls and interior surfaces to see if the paint is cracking, chipping, or peeling, and check areas on doors or windows where painted surfaces may rub together.
- Exterior painted areas— Check exterior paint as well; it can flake off and contaminate nearby soil where children may play.
- Surrounding areas— Be sure there are no large structures nearby with peeling or flaking paint that could contaminate the soil around play areas.
- Cleaning practices— Make sure the staff washes any pacifiers, toys, or bottles that fall on the floor. Also, make sure the staff has the children wash their hands thoroughly after playing outside and before eating or sleeping.
- Play areas— Look to see if areas where children play are dust-free and clean. Outside, check for bare soil and test for lead.
- Playground equipment— Older equipment can contain lead-based paint.
- Painted toys and furniture— Make sure the paint is not cracking, chipping, or peeling. Inquire about whether a childcare center’s toys comply with the requirements of the Consumer Product Safety Commission (CPSC).
- Also, ask about testing all of the drinking water outlets in the facility and on the playground, especially those that provide water for drinking, cooking, and preparing juice and infant formula.
Old, deteriorating lead-based paint remains the dominant threat of lead poisoning to children who live, learn, and play where paint peels, chips, or turns to dust. Tomorrow, we’ll see where other lead dangers lurk and how exposure can be prevented.