Childhood Lead Poisoning
What is Lead Poisoning?
- MA children are most often harmed by lead from lead-based paint, but lead can also occurin drinking water and soil.
Lead poisoning is caused by swallowing or breathing lead. Once it gets into your body, it's poison. Lead can stay in your body for a long time. Young children absorb lead more easily than adults. The harm done by lead may never go away. Even low levels of lead can harm the health of a child. There is no safe level of lead exposure.
Lead in the body can:
|Hurt the brain, kidneys, and nervous system|
|Slow down growth and development|
|Make it hard to learn|
|Damage hearing and speech|
|Cause behavior problems|
Most of the lead poisoning in Massachusetts comes from lead paint dust in older homes. Homes built before 1978 may have lead paint on the inside and outside of the building. When old paint peels and cracks, it creates lead paint chips and lead dust. Lead dust also comes from opening and closing old windows. Home repairs and renovations also create lead dust. Lead dust lands on the floor. Lead gets into children’s bodies when they put their hands and toys in their mouths. Children can also breathe in lead dust. Children between the ages of 9 months and 6 years are most at risk.
Why Do We Track Lead Poisoning?
- Additional Resources
The CLPPP has developed an educational tool for pediatric clinicians focusing on childhood lead exposure and screening by community. View progress reports for all Massachusetts communities. Each year, the Department of Public Health identifies communities with a higher risk of childhood lead poisoning to better target resources and reduce health inequities associated with lead exposure in those communities. View high-risk communities in Massachusetts.
Before the use of lead was restricted, approximately 88% of preschool children in the U.S. had levels of lead in their blood high enough to cause serious health effects. With less lead in our environment, the prevalence of lead poisoning has decreased.
In October 2021, the Centers for Disease Control and Prevention (CDC) lowered the blood lead reference value (BLRV) from 5 micrograms per deciliter (µg/dL) to 3.5 µg/dL. The BLRV identifies children with blood lead levels that are higher than most children’s levels, based on the 97.5th percentile of blood lead values among U.S. children ages 1-5 years from the National Health and Nutrition Examination Survey (NHANES). This is the reference value at which the CDC recommends public health actions be initiated.
Most children who have lead poisoning do not look or act sick. A lead test is the only way to know if your child has lead poisoning. The Massachusetts Lead Poisoning Prevention and Control Act is a state law that requires all children to be screened each year for lead poisoning through age three. Children living in high-risk communities must be screened each year through age four. All children must show proof of screening at least once to enter daycare, pre-kindergarten programs, and kindergarten.
By tracking children with lead poisoning, we can:
- Identify children at risk in order to target prevention and outreach activities
- Make case management services available to each child with lead poisoning
- Monitor progress towards eliminating childhood lead poisoning
- Evaluate and monitor trends to identify high-risk populations
- Remove and reduce sources of lead
- Develop and evaluate interventions and programs
How To Prevent Lead Poisoning?
Childhood lead poisoning is preventable. The key to preventing lead poisoning is to stop children from coming into contact with lead and managing the care of those who have been poisoned by lead. In order to do that:
- Homes must be inspected for lead hazards
- Lead in a child's environment must be removed or properly contained
- All public and health care professionals have to be educated about lead poisoning and how to prevent it
- Children who are at risk of lead poisoning need to be tested and, if necessary, treated
- Home renovation and repairs must be done following lead safe work practices
Lead from sources other than housing may also present a hazard to children. Other sources of lead poisoning include:
If you have any questions about lead poisoning, how to test your child for lead, how to interpret your child’s blood lead test result, or the state Lead Law, please visit the Childhood Lead Poisoning Prevention Program (CLPPP) website here. The CLPPP provides a range of prevention and information services to Massachusetts families.
- Understanding the Data
How prevalence is calculated:
Data on childhood blood lead poisoning is presented by calendar year. Data by calendar year provides blood lead screening percentages and blood lead level prevalence rates based on the year in which the child was tested. If a child had multiple tests within the same calendar year, only the highest confirmed test is included for that year. A confirmed test result is one venous test or two capillary tests (within 12 weeks of each other) during a given year. For determining prevalence, children can be counted only once per year, but can appear in multiple years. Prevalence is the number of tests in a given blood lead level category out of all the children screened in that year within specific age ranges, per 1,000 children.
Confirmed versus unconfirmed test results:
Confirmed blood lead levels include both venous and confirmed capillary test results. Unconfirmed blood lead levels include single capillary test results only. Estimated confirmed blood lead levels ≥5 µg/dL include both confirmed results and a proportion of unconfirmed results estimated to be truly elevated based on known capillary test reliability. This measure is used because a single capillary test does not provide adequate precision or reliability to be considered confirmatory of an elevated blood lead level. Until confirmatory testing of preliminary capillary tests 5-<10 µg/dL is uniformly adopted per the 2017 regulation requirements, a calculation is used to estimate the true number of children with blood lead levels ≥5 µg/dL.
Other considerations for interpreting blood lead data:
- Blood lead prevalence results are based on only those children who have been screened. While the percentage of children screened in Massachusetts is one of the highest in the country, the blood lead prevalence results should be interpreted considering the screening percentage for the geographic area of interest.
- When comparing rates across geographic areas, a variety of non-environmental factors, such as screening practices, can impact the prevalence of blood lead levels in children. Prevalence at the state and/or county level will not show the variation in disease burden at a more local level (i.e. community).
- Prevalence is based on the residential location of the child and not necessarily the location of the source of exposure.
- Numbers and rates may differ slightly from those contained in other publications. These differences may be due to file updates, differences in methodology, diagnostic techniques reported, and updates in population estimates.
- Available Data on Childhood Blood Lead Levels
Use the Explore Maps & Tables link on this page to access the following measures for childhood blood lead levels in your community. The most current available data will be shown. Be sure to check the site periodically as new data are added each year.
To protect privacy, no information is shown that could identify an individual.
- Number and percent screened by location and single or range of years
- Number and prevalence of blood lead levels by location and single or range of years
- Maps and charts of screening rates and blood lead levels
- All of the above measures are available by census tract, community, county, EOHHS Region, EP Regional Coalitions, the most recent high-risk community list, and statewide