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While no amount of lead in the blood is safe, lead poisoning is especially dangerous for children because their bodies are still growing. The chemical can damage their developing brains and nervous systems, harm their kidneys, cause cardiovascular issues, and even slow their skeletal growth.
Nearly 9,000 Pennsylvania children younger than 16 tested positive for elevated lead levels in 2022, according to a report from the state Department of Health. Lead can enter the body in many ways, but people are at greater risk if they live in homes built before 1978 — the year the federal government banned consumer use of lead-based paint.
Pediatrician Amy Nevin of UPMC Children’s Hospital of Pittsburgh served on Allegheny County’s lead task force in 2017, and is familiar with common exposure sources. When kids have elevated lead levels, she said, it’s often due to chipped and peeling lead paint that creates fine, odorless dust. Dust particles settle on surfaces and can be ingested or breathed in.
Contaminated soil can also expose people to lead, as can drinking water that travels through corroded pipes. Other sources might include pottery from foreign countries, cosmetics, or even older toys.
In the following conversation, which has been edited for clarity and length, Nevin explains that parents and caregivers can take many actions to protect children from lead. The issue is systemic, but knowing how lead exposures can happen provides at least one layer of protection.
Spotlight PA: How do you know if your child has been exposed to lead? Are there physical symptoms?
Amy Nevin: Unfortunately, we don’t know until there is a blood test if a child has been exposed to lead. That’s why the focus really needs to be on preventing lead exposure before it happens as much as possible.
In pediatrics, we typically screen kids for lead between the ages of about 9 to 12 months. That’s when kids are crawling around. If the floor is dusty, if there’s any old dust, it’s common for kids to get exposed.
Peeling paint on windows is a pretty common exposure. So you have little children pulling up to stand and look outside, and then they’ll find paint chips. Something people don’t always know is that lead paint tastes sweet. So once kids taste it, they’ll keep tasting it.
Outdoor porches with old peeling paint are also an issue. So we really need to think about that when kids are playing outside as well. And we want to make sure that shoes are staying outside the house, or in the vestibule, because those shoes bring in dust, which also might be contaminated with lead.
I’m also a big fan of mopping floors regularly with a high phosphate-containing detergent. But then, get that water out of the house. And don’t put it down the kitchen sink. Flush it down the toilets.
And then I suppose it’s also important to make sure you have filtered water if you have lead pipes?
Took the words right out of my mouth. There’s a lot of concern around that as well.
The best way to probably address that is to use a water filter. There are some filters that go on the tap itself. But people need to make sure that they’re changing the filters as recommended.
Are there treatments for kids who have prolonged lead exposure? Can you reverse the damage?
So that’s really tough. One option is chelation, which is a complicated treatment that removes
metals from the body. Though the research shows that if the child doesn’t have levels that are extremely high, chelation does not change the outcome.
The main thing you want to do is stop continued exposure because, as research shows, there really is no safe level of lead. Lead is an essential element. It’s in the environment. It’s out there. But we want to decrease the exposure as much as possible.
Also, if a pediatrician refers a child for early intervention services due to elevated blood lead levels, families can help their child by getting that support for screening and development.
Is there anything else that caregivers or parents should be doing to protect children from lead exposure?
Yes … when renovating a house, we need to be thoughtful about how to do that safely. Also, be aware of the yard and the grounds — is there any potential for lead in the soil?
Then, I have to touch on nutrition. Lead can “outcompete” calcium and iron in the body in the cellular processes. So it’s important to make sure that children have a really good diet, specifically a good intake of iron and calcium.
One of the mistakes that I always worry about is that when people are concerned about lead in the water is that they’ll trade out water for juice, sodas, or other things that are not healthy. What you really want to do is drink water, but do as much as you can to ensure that’s a safe water source.
We’ve been talking a lot about what individuals and families should be doing, but lead is a systemic problem. What sorts of policy changes would you like to see?
This is challenging. At this moment, I’d like to see policies that ensure that people know what they’re getting into with a house, especially when so many houses are older; whether it’s water, paint, or anything else.
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