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Frequently Asked Questions - Childhood Lead Poisoning

Why are we tracking childhood lead poisoning?

Childhood lead poisoning is preventable. 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 and become less severe. However, approximately 500,000 U.S. children aged 1-5 years currently have blood lead levels greater than 5 micrograms of lead per deciliter of blood (µg/dL), the reference level at which CDC recommends public health actions be initiated.

By tracking children with lead poisoning and sources of lead, we can:

  • Identify children at risk in order to target lead hazard identification and resources
  • Make case management services available to each child with lead poisoning
  • Monitor progress towards eliminating childhood lead poisoning
  • Identify and monitor trends in lead sources that are exposing children to lead
  • Remove and reduce sources of lead
  • Develop and evaluate interventions and programs

How we do we track childhood lead poisoning?

Massachusetts law requires all children between the ages of 9-12 months, at age two, and at age three to be screened for lead. Children in high risk communities are screened through age four. The Lead Law also requires all childhood blood lead test results be reported to the Department of Public Health by both laboratories and health care providers.

How is a child's lead level determined?

Health care provider offices and local health clinics provide blood lead testing. In a lead test, a blood sample is taken from the child's finger or arm. The test measures how much lead is in a child's blood at that time. Blood taken from the finger is called a capillary sample. Blood taken from the arm is called a venous sample. A venous sample is more exact. If a child has a lead level greater than or equal to 5 µg/dL and the blood was taken from your child's finger, a second test with a venous sample is required.

How do I interpret the screening and blood lead prevalence numbers?

“Screened” refers to a child with at least one test result in a given year.

A confirmed test result is one venous test or two capillary tests (within 84 days of each other) greater than or equal to 5 µg/dL during a given year. For determining prevalence, children can be counted only once per year, but can appear in multiple years. Prevalence is the percentage of confirmed tests in a given category among all the children screened in that year within specific age ranges.

How are children exposed to lead?

In the US, the major source of lead exposure among children is lead-based paint and lead-contaminated dust found in older residential buildings. Lead-based paints were banned for use in housing in 1976. Homes and other buildings built before 1978 and especially those built before 1950 may still contain lead-based paint. Approximately 40% of all housing in Massachusetts was built before 1950, and an estimated 72% was built before 1978.

Deteriorating paint (chipping, flaking, and peeling) and paint disturbed during home remodeling contributes to lead dust in the home and may contaminate soil around a home. Children can be exposed to lead by normal hand to mouth activity, eating lead-based paint chips, chewing on objects painted with lead-based paint, or swallowing house dust or soil that contains lead.

Lead from sources other than housing may also present a hazard to children. Other sources of lead poisoning are related to:

  • Hobbies (making stained-glass windows, hunting, fishing, target shooting)
  • Work (recycling or making automobile batteries, house painting and remodeling, radiator repair)
  • Drinking water (lead pipes, solder, brass fixtures, and valves can all leach lead)
  • Home health remedies (azarcon and greta, which are used for upset stomach or indigestion; pay-loo-ah, which is used for rash or fever)
  • Lead in children's jewelry

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