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Clinical Professionals
This Months Featured Article

Lead Poisoning: A Thing of the Past?

Lead poisoning continues to be a risk, especially to young children who are living in poor neighborhoods, near industrial sites and close to major highways. When older homes are allowed to deteriorate and paint flakes and chips, these chips may contain lead and be easily absorbed by children. Research is continuing on the effects of lead poisoning and even small amounts may result in learning problems. More severe neuro-developmental problems such as decreased attention, increased aggression, abnormal balance, poor eye-hand coordination, longer reaction time and sleep disturbance may be seen with higher levels of exposure. Developmental disabilities may be noted in children who have had high levels of exposure.

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) estimate that there a nearly one million children under the age of six who have elevated blood lead levels.

Who is at risk?
When an older building deteriorates, the lead paint may result in dust that is picked up by children on floors and toys. Toys placed in the mouth provide a route for lead exposure. Homes built prior to 1978 are more likely to contain lead paint. Renovation of an older home can create significant amounts of lead dust and while no one should breathe the dust, infants and children especially, should be kept away from the dust. If schools or homes are located near some industrial plants that emit airborne lead or near major highways where years of lead fumes have settled, that lead may have settled into the soil and be nearly impossible to eradicate. Inhaling airborne lead results in the lead settling in the lungs and then entering the bloodstream. Day care centers may also be located in older buildings and present similar risks.

Why are young children most at risk?
Lead can cross the placental barrier and affect the fetus. Lead can also cross the blood-brain-barrier (BBB) which protects the brain from many foreign substances. Children have higher absorption rates and higher respiratory volume that allow larger doses of lead to remain in their gastrointestinal and respiratory tracts. Children are less able than adults to detoxify and eliminate the poisons.

Risk Assessment

Following is a risk assessment questionnaire that may be used as an indicator for testing for lead exposure. When responses are affirmative, it is wise to consult the child's physician for a blood lead level. Other children in the household should also be tested.

Risk Assessment Questionnaire for Lead Exposure
(Based on CDC recommendations)

Three primary screening questions:

    1. Does the child live in or regularly visit a house or child care facility that was built before 1950?
    2. Does the child live in or regularly visit a house or child care facility built before 1978 that is being or has recently been renovated or remodeled (within the last six months)?
    3. Does the child have a sibling or playmate who has or did have lead poisoning?

*Additional questions to assess for risk factors for lead poisoning:

Family and personal history

    1. Have you ever been told that the child has lead poisoning
    2. Is there an occupational, industrial, or hobby-related exposure with someone in the household?
    3. Does the child live with an adult whose job or hobby involves exposure to lead
    4. Does the child live near an active lead smelter, battery recycling plant, or other industry likely to release lead into the environment?
    5. Does the child live within one block of a major highway or busy street?
    6. Is hot tap water used for cooking or drinking?

Cultural exposures

    1. Has the child ever been given home remedies (e.g., azarcon, greta, pay looah)?
    2. Has the child ever been to Latin America?
    3. Has the child ever lived outside the United States
    4. Does the family use pottery or ceramic ware for cooking, eating, or drinking?


    1. Does the family receive medical assistance?
    2. Does the child live in a rented home?
    3. Do the child's family members perform migrant farm work?
    4. Has the child recently moved?


    1. Has the child been observed eating paint chips?
    2. Has the child been observed eating soil or dirt?


    1. Has the child been diagnosed with low iron?

*Based on questions provided by the Brain Injury Law Group

For more information visit


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