Marin Mommies is pleased to present the second in a series of guest posts by pediatricians Dr. Steven Martel and Dr. Oded Herbsman. Drs. Herbsman and Martel are the founders of Child’s Light Pediatrics, Inc., an innovative, house-call based pediatric practice that serves Marin and San Francisco.
There has been a lot of media attention regarding the risk of lead exposure from children’s toys. Most of this attention has been focused on the risk of exposure from lead paint in toys made in China.
What is lead poisoning?
Lead is a toxic metal that affects the nervous system. It is absorbed primarily through the inhalation of lead dust and ingestion of lead products. Lead poisoning generally occurs slowly after repeated exposures.
Exposure Routes
- The most common source of lead exposure for children is deteriorated lead paint from older housing.
- The primary route of exposure for children is ingestion of house dust or soil contaminated by leaded paint.
- Young children have a higher risk for exposure because of frequent hand-to-mouth activity, and the ease with which they absorb lead.
- Children, who mouth, suck or eat non-food items are at risk for lead poisoning regardless of the age of their housing.
High Lead Content Sources
Lead-based paint chips, interior and exterior paint (before 1977)
Old window glaze
Medium Lead Content Sources
Soil, especially in dense urban areas
Dust and debris from older building renovation
Low Lead Content Sources
Drinking water
Playground soil
Household dust
Common Symptoms of lead poisoning in children
- Children with lead poisoning are usually asymptomatic. These symptoms often are subtle and may mimic other childhood illnesses. The degree of symptoms varies from child to child.
- Mild lead poisoning can be associated with hyperactivity, irritability, sleeplessness, lack of concentration, behavioral problems, and learning disabilities.
- Severe lead poisoning may be accompanied by hearing problems, headaches, nausea and vomiting, abdominal pain, loss of appetite, constipation, muscle soreness, anemia, and neurologic impairments such as stumbling or loss of concentration, seizures, encephalopathy, and coma.
Who is at risk for lead poisoning?
It is commonly believed that lead poisoning affects only the urban poor. While exposure risk is higher in deteriorating inner-city neighborhoods, this disease occurs in all social and economic groups. Middle-class children can become exposed to lead dust during renovations of older homes.
In any case, children under the age of 3 are especially at risk because they crawl or play at ground level. They also put everything into their mouths and they absorb and accumulate toxic lead amounts more quickly than adults.
Screening for Childhood Lead Poisoning
While primary prevention of lead hazards remains the essential public health goal, the only way to identify individual lead-poisoned children is by screening for blood lead. Children are at the greatest risk from the time they begin to crawl until six years of age. Under California law and consistent with recommendations of the CDC, children with identified risk factors should be screened by a blood test at age one and at age two. You should discuss with your child’s medical provider whether screening is appropriate in your circumstance.
Treatment
Treatment varies on the degree of lead toxicity. It may range from removal of the exposure to chelation therapy. Chelating agents are medications that bind to lead so that it can be excreted in the urine.
How do I protect my child from lead poisoning?
The best protection is to avoid common exposures such as chipping paint or lead dust during a renovation. In addition, consider testing silver or gold-plated jewelry that young children may place in their mouths. For example, necklaces and pendants may contain lead as the primary metal beneath the exterior plating.
As recent news accounts have reported, children’s toys may also contain excess lead. If you are concerned that your children’s toys may contain lead, you can get the toys tested by the San Francisco Department of Environment. If you are interested, go to the Ecocenter at 11 Grove Street in San Francisco next Tuesday, December 11, or Thursday, December 13 from 10 am to noon.
Dr. Steven Martel
Dr. Oded Herbsman
Drs. Herbsman and Martel are the founders of Child’s Light Pediatrics, Inc. an innovative, house-call based pediatric practice that serves Marin and San Francisco Counties. For more information, please contact them at www.childslightpediatrics.com
