This article is more than 5 years old. Information may no longer be current.
Additional lead exposure screening needed for certain at-risk children
Pediatricians should be wary of higher blood lead levels in children in at-risk populations, particularly those who have eaten paint, spent time outside the U.S., used imported products or have developmental delays or sickle cell disease, according to recent study findings.
“As the incidence of blood lead levels 10 µg/dL or greater have declined and evidence of health effects at lower blood lead levels has accumulated, attention has been directed increasingly to less severe lead exposures,” Jacqueline Ehrlich, MD, MPH, from the New York City Department of Health and Mental Hygiene, and colleagues wrote. “Although low-level exposures can result in long-term, irreversible cognitive deficits, greater exposures can lead to organ damage and death. Deaths from lead poisoning still occur, with at least two child fatalities in the U.S. since 2000, a Sudanese refugee child exposed to lead paint in New Hampshire and a child who swallowed a charm in Minnesota.”
To determine the blood lead levels of children living in New York City aged 18 years and younger, Ehrlich and colleagues collected data from home visits, environmental risk factors including lead content of paint surfaces, and abdominal radiographs from health care providers. The investigators classified children by age, race/ethnicity, neighborhood and income status. In addition, parents answered a risk assessment questionnaire on children’s behaviors, recent home improvements and use of imported products, including spices, cosmetics and medicines. Between 2004 and 2010, the investigators identified 145 children with blood lead levels 45 µg/dL or greater in New York City. Average age of children was 3.8 years and blood lead levels did not decrease to less than or equal to 10 µg/dL for an average of 3 years. Children had a significant increase in blood lead levels if they ate paint (36%), spent time outside the U.S. (34%), were of foreign born descent (14%), particularly Pakistani (12%) descent, and had sickle cell disease (4%). New York City children with higher blood lead levels were also more likely to be living in a house built before 1940 compared with other New York City dwellers in the same age groups. The highest reported blood lead level in the study was 227 µg/dL.
“Understanding the incidence, sources and treatment outcomes can promote timely identification of cases, as well as help inform clinical practice and public health policy,” Ehrlich said in a press release. “Physicians should be especially vigilant in certain at-risk population, including children who eat paint, spend time outside the U.S., use imported products, or have developmental delays of sickle-cell disease.”– by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
