Facts about lead and its human effects
Lead is a useful and common metal that has been used by humans for thousands of years. It is also a very dangerous poison, particularly for children, when it is accidentally inhaled or ingested.
Rules and regulations prohibit lead in common products like most gasoline and paint, so lead poisoning has dramatically declined in the United States. However, it is still a real problem that continues to poison thousands of people in the U.S. each year. The following will provide information about sources of lead in the environment, who is most at risk for lead poisoning, how you can reduce the chances that you or your children will become injured by lead, and what Public Health - Seattle & King County is doing about the lead problem.
Though lead is found frequently in our environment, it has no known purpose in our bodies. When lead gets inside the body, the body confuses it with calcium and other essential nutrients. This confusion can cause permanent damage to the health of both children and adults.
In children, lead is most damaging when they are six years and younger. Children are growing at a very fast rate - growing bones, developing stronger muscles and creating many connections in their brain. When lead instead of essential nutrients is "available" to the body to make bones, muscle, and brain connections, permanent harm to health can occur. Even at low levels, lead can be harmful and be associated with:
- Learning disabilities resulting in a decreased intelligence (decreased IQ)
- Attention deficit disorder
- Behavior issues
- Nervous system damage
- Speech and language impairment
- Decreased muscle growth
- Decreased bone growth
- Kidney damage
High levels of lead are life threatening and can cause seizures, unconsciousness, and death.
Lead exposure is a concern for adults, even though they have finished growing. Since an adult's body is much larger than a child's body, more lead is needed to cause injury but the harm lead can do to an adult is very serious. High levels of lead can cause:
- Increased chance of illness during pregnancy
- Harm to a fetus, including brain damage or death
- Fertility problems in both men and women
- High blood pressure
- Digestive issues
- Nerve disorders
- Memory and concentration problems
- Muscle and joint pain
Children are most at risk for lead injuries because their bodies are still developing and because they tend to put things that may have lead dust on it in their mouths. Here's more:
- Children are still developing:
Until about age 6, young children do not have a fully developed "blood brain barrier." The blood brain barrier is the body's way of keeping harmful chemicals out of the brain, but it is not fully formed at birth and takes up to about six years to be fully protective. Without the blood brain barrier, the effects of lead are even more devastating. For more information about the blood brain barrier, see the resource links below.
- Putting things in the mouth:
Children, particularly young children, explore their world by touching and tasting everything they can get their hands on. It's a natural part of their development. Children also spend more time on the floor, outside in the dirt, and playing and exploring. So, if there is lead dust or dirt with lead in it in the environment, children will get it on their hands and fingers and into their mouths. And since children are short, they breathe near the floor and ground, closer to dirt and dust that may have lead in it.
- People with pica
While it is normal for children under 2 to explore by putting everything in their mouth, there is a condition in older children and adults called pica. This is a condition where a person craves and eats non-food substances, including soil or dirt. Children under two eat non-food because they are exploring their world. However, when people over two years old do it and the craving lasts for at least a month or so, it is a condition is called pica.
- Newcomers and refugees
The United States banned lead in most paint and in gasoline by the mid-1980s, which dramatically reduced the amount of lead in the environment. Other countries, however, may still allow lead in these common products. It is very important that new arrivals, particularly children from Africa, the Middle East, and Asia, be tested for the presence of lead in their blood. If the levels are extremely high they may need chelation. Chelation is a process for removing lead from the body.
There are many sources of lead in our environment. Here are a few of the most common:
High lead levels have been found in aluminum cookware brought to the United States from other countries. However, lead-containing aluminum cookware has also been found in cookware from local stores and online. Lead can be present in some imported aluminum pressure cookers as well as typical pots & pans. While the extent of this problem is not clear, when shopping for aluminum cookware, the safest products have labels that say "anodized" or "NSF". Stainless steel cookware also has low lead levels and is a safe choice. If you aren't able to replace your aluminum pressure cookers or pots & pans, avoid cooking acidic foods (like tomatoes, fruits, or sauces with citrus or vinegar) in the cookware. Also, avoid storing cooked food in aluminum pots and always transfer it to a glass or plastic container.
The most common source is lead paint. Lead carbonate [PbCO3/Pb(OH)2)] was added to paint to speed drying, improve durability, and protect the surface from corrosion. Even though the negative health impacts of leaded paint were known as far back as the early 1900s, lead in residential paint was not banned until 1978. If a building was built before 1978 and has older paint, it should be assumed to have lead paint.
Children are at particular risk from lead paint because they occasionally eat paint chips (sometimes on purpose). Lead paint can have a sweet taste, and babies and toddlers will often lick or suck windowsills, crib bars, and other objects that may be coated with lead paint. Leaded dust from peeling, chipping, cracking or otherwise deteriorating lead paint will collect onto floors and other surfaces. Children touch the dust, and then put their fingers in their mouths.
Lead paint will only harm you or your family if it is peeling, flaking, or otherwise coming off of the surface.
Leaded dust from paint can be a big problem during remodeling, when lead dust can become a hazard for the whole family, but particularly children. There are many tips for safe remodeling, which guide the use of sanders, scrapers, heat guns, keeping children and pets out of work areas, and how to clean up afterwards. Visit the Environmental Protection Agency (EPA) for more information.
Lead has been found in candy and candy wrappers imported primarily from Mexico and Asia. Learn how the United States Food and Drug Administration (FDA) is trying to control lead in imported candies.
Hobbies and art
Some art supplies, such as artists' paint, still have lead in them. Buy only non-toxic paints for your children. Some hobbies require the use of lead, such as stained glass, firing guns, making ammunition, and making fishing lures and sinkers. Keep children away from areas where lead is being used. Be sure not to bring lead dust on your clothing into the home.
Another common source of lead. Two possible sources of contaminated soil are leaded gasoline and industrial operations like smelters. While gasoline is generally no longer a major source of lead, decades of leaded gasoline left contamination in the soil next to roadways up to one-quarter of a mile from the road.
While gasoline is generally no longer a major source of lead, decades of leaded gasoline left contamination in the soil next to roadways up to one-quarter of a mile from the road.
Historic smelter operations, such as the ASARCO copper smelter that operated near Tacoma for almost 100 years, may also have contaminated the soil. ASARCO's "Tacoma Smelter Plume" pollution was carried by the wind throughout the Puget Sound, leaving elevated levels of lead and arsenic in the soil in some parts of King County.
- People and pets track the contaminated dirt into their homes. Children play on or near the floor, getting their hands dirty, and then put their fingers in their mouths. To learn how to reduce exposure to contaminated soil, read the Guidelines to reduce exposure to contaminated soils.
Some jewelry is made of lead and can pose a danger to children if they put the jewelry in their mouths. Lead is not absorbed through the skin. Teach children to keep jewelry out of their mouths, or do not allow children to have lead jewelry. Learn more from the CDC.
Lead at work
Adults who work in industries that use lead (battery manufacturing, pipe fitting, firing ranges, demolition, glass production, smelting operations, etc.) should be careful not to bring lead home with them. Shower and change clothes and shoes at work. Do not contaminate your car.
Imported glazed pottery and leaded crystal may also be sources of lead. Minimize the use of these products.
Drinking water may have lead in it, though permitted levels in municipal sources are carefully regulated. The largest source of lead in drinking water occurs through leaching from lead-containing pipes, faucets, and solder, which can be found in plumbing of older buildings. If you have older pipes in your home, be sure to run the water for 60 seconds every morning before using it. Do not use hot tap water for drinking purposes. Learn more about lead in drinking water.
Vinyl mini-blinds imported from China, Indonesia, Taiwan and Mexico before 1997 contained lead, which was used to make them less brittle. Lead dust forms on the blinds, particularly when the blinds are exposed to sun and heat. According to the U.S. Consumer Product Safety Commission, different blinds contained different amounts of lead. While the blinds are no longer imported into the United States, older blinds containing lead may still be in use or available for purchase in thrift shops.
There is evidence that some soft vinyl lunch boxes may contain lead in the lining. The Center for Environmental Health claims that there is a real risk to children. However, the Consumer Products Safety Commission does not believe the amounts of lead present pose a serious risk to children.
Certain activities, hobbies, and environments may put your child at greater risk of lead exposure. To determine if your child may need a blood test, review the lead risk checklist and speak to your health care provider about your concerns. The only way to know for sure if your child has been exposed to lead is to have their blood tested. For more information, please see the Washington State Department of Health recommendations for lead testing in children.
In addition, healthcare providers should assess all children for risk of lead poisoning at 12 and 24 months of age using the clinical algorithm for targeted childhood lead testing developed by the Washington State Department of Health. Federal law currently mandates blood lead screening for all children covered by Medicaid.
There are many steps you can take right now to reduce you and your family's risk of exposure from lead.
Blood lead testing
The only way to know if your child is lead-poisoned is by getting him or her a blood lead test. If your child has Medicaid insurance, testing for blood lead levels is required, especially for children at 12 months and 24 months of age. Children with Medicaid insurance between the ages of 36 months and 72 months of age must receive a lead screening blood test if they have not been previously tested.
To do the test your physician will need to obtain some of your child's blood. The blood can be drawn in two ways - 1) from a vein in the arm or 2) a prick on the finger or heel. If blood is drawn from a prick on the finger or heel and the results are high, your child should be re-tested using the blood collected from the arm to confirm the results. Blood collected from the vein provides the surest results.
If your child has a high blood lead level, some follow up may be necessary. For example, you may be eligible for a visit from Public Health experts who can investigate potential sources of lead in your home that may be contributing to your child's lead level.
Check your house for lead hazards
Conduct routine check of your house looking for lead hazards. One way to do so is by contacting a professional. A professional can check your home in one of two ways, or both:
- A paint inspection tells you the lead content of every different type of painted surface in your home. It won't tell you whether the paint is a hazard or how you should deal with it.
- A risk assessment tells you if there are any sources of significant lead exposurecsuch as peeling paint and lead dust) that will impact your family's health. It also tells you what actions to take to address these hazards.
Reduce the dust levels in your home
- Use a door mat to remove dirt from shoes before taking them off. Clean dust from underneath the matt frequently.
- Take off your shoes before going into your home. Even after scraping off dirt, shoes will track some dust and lead into your home.
- Keep play areas clean. Frequently wash toys, pacifiers, stuffed animals and other objects young children put in their mouths.
- Damp dust and damp mop the house at least once a week. Damp mopping and damp dusting are very effective at picking up dust.
- Keep your sidewalks and porch free of dust and debris. Use a HEPA vacuum if possible but a broom can work as well.
Wash your hand before every meal and snack.
Keep children from eating and chewing on non-food items such as paint chips, window sills, and dirt.
Avoid using imported glazed pottery for food.
Eat foods high in calcium, Vitamin C and iron. Good nutrition helps prevent the body from absorbing lead.
If you enjoy candies imported from Mexico, check the list of candies that have been shown to contain lead, and avoid those candies.
Have qualified professionals do remodeling work such as re-painting. There are standards that professionals must meet to ensure work with leaded paint is done safely, reliably, and effectively.
If you know you have leaded soil or leaded paint take interim steps while you are figuring out a long-term solution. For example, temporarily reduce lead paint hazards by repairing damaged painted surfaces. To minimize exposure to contaminated soil, plant grass or use bark to cover soil. These actions are not permanent solutions and will need ongoing attention.
Public Health - Seattle & King County's Environmental Health Division has been raising awareness about childhood lead poisoning and assisting families of children with identified cases of lead exposure.
Environmental risk investigations
If your child has received a blood lead test and the results exceed the Centers for Disease Control & Prevention "reference level" (5 micrograms per deciliter) your family is eligible to have a free visit from a Public Health - Seattle & King County staff member to look for potential sources of lead present in your home that may be contributing to your child's lead level.
- Part 1:
A set of questions focusing in on housing, behavior of the child(ren), family lifestyle and travel will be asked. These questions are designed to help narrow down the list of potential sources of lead to those relating specifically to your family. After potential sources of lead have been identified a more in-depth look at those sources can take place.
- Part 2:
To further examine potential sources of lead in your house a thorough walk-through will be done. The walk-through occurs inside and outside the house. Key items that will be looked at include paint condition, surfaces and moisture barriers.
- Part 3:
Optional: Samples may be collected to further identify or confirm suspected sources of lead present in the house. Types of samples that may be collected include paint chips, dust wipes, soil, and/or water. Any samples that are obtained will be submitted to a laboratory for analysis.
- Part 4:
Once all of the information has been collected and analyzed, a plan of action will be developed. A plan of action will include a letter summarizing the investigation and a checklist of recommended activities or actions to reduce your child's exposure to lead. Your child will be advised to get additional blood lead test(s) until his/her level of lead is below the Centers for Disease Control & Prevention action limit. This plan of action will be mailed to you and the child's medical care provider.
- Part 5:
Periodically, the Public Health investigator will check in with you to see how things are going and answer any questions that may have come up. We will continue to provide this service until your child's blood lead level has fallen below the Centers for Disease Control & Prevention action limit.
King County Dirt Alert
For almost 100 years, ASARCO operated a copper smelter in Ruston, Washington. Arsenic and lead pollutants from the smelter settled on the surface soil covering over 1,000 square miles of the Puget Sound basin. The extent of contamination is called the Tacoma Smelter Plume and includes parts of King, Pierce and Thurston counties. Left undisturbed, arsenic and lead remain in the soil and continue to be a health risk – especially for young children.
King County Dirt Alert provides education and outreach to help families in south King County protect their children from possible health effects of contaminated soil exposure. Currently, licensed childcare facilities in the plume are being offered free soil testing, and educational information on how to reduce children's exposure to contaminated soils.
For additional information, please call King County Dirt Alert at 206-263-1399 and visit www.dirtalert.info.
The Public Health – Seattle & King County (PHSKC) Lead and Toxics Program has received grant funds from the Centers for Disease Control and Prevention (CDC) Childhood Lead Poisoning Prevention Program since 2017 and receives funding through Best Starts for Kids (BSK). With these funds, Public Health partners with community-based organizations who serve focus communities to increase blood lead testing and protect those most at risk of lead poisoning. Focus communities at increased risk of lead exposure include Medicaid-eligible children and their families, immigrant and refugee families with young children, families of color with young children, and families with young children living in South King County.
The purpose of both funding sources and the objectives of the Lead and Toxics Program include:
- Increasing childhood lead poisoning awareness in focus communities and among medical providers.
- Building community capacity to prevent and address lead exposures.
- Identifying current and emerging sources of lead exposure in King County.
- Improving policies and systems that protect communities from lead.
- Increasing the number of children with lead poisoning who receive culturally responsive developmental services and care.
See Public Health – Seattle & King County's CDC Success Story for an example of one of the many programs offered by the Lead and Toxics Program.
Infographics and checklists
Find out if your child needs a blood lead test. Download and print a checklist in multiple languages:
- Your child needs a blood test if they...
See also: Why testing for lead helps kids, Public Health Insider blog, (Originally posted on August 5, 2019)
NOTE: The Lead Testing events shown in the blog are now over but the information about the importance of testing is still current. Talk to your child's health care provider about getting tested for lead.
Link/share our site at www.kingcounty.gov/lead