Lead Poisoning

By Lynne Padgett, Ph.D.

According to the Atlanta based Centers for Disease Control and Prevention (CDC), approximately 890,000 U.S. children between the ages of 1 and 5 have blood lead levels greater than the CDC recommended level of 10 micrograms of lead per deciliter of blood. Lead poisoning can affect nearly every system in the body, including red blood cells, renal system, reproductive system and cardiovascular system. However, the most severe effects are on the neurological system of the exposed child often resulting in perceptual-motor problems, learning disabilities and behavioral problems.

Among children in the United States, the major source of lead exposure is lead-based paint found in deteriorating buildings and houses. The CDC cites 80 percent of homes built prior to 1978 have lead-based pain. Therefore, children living in older homes are at higher risk for lead poisoning.

Developmental Interventions

Research has indicated that children exposed to lead, even at subclinical levels, are often at risk for developmental delays. These delays typically are not remediated upon receiving medical treatment and achieving lower blood levels. Because children at risk for developmental delay can achieve benefit from early intervention services, a developmental assessment completed at the time of diagnosis is imperative. Medical staff, such as a child’s pediatrician, can assess if a child is achieving normal developmental milestones and can refer the child for more comprehensive assessment by a child psychologist and/or neurologist, if delays are noted. Developmental assessment should not cease after the initial diagnosis. Critical periods in a child’s educational, social, and behavioral development need to be monitored in order to identify problems early.

Developmental interventions occur at the systemic, family, and child level. In order to help ensure future continuity of care, medical staff should prominently note the child’s history of elevated blood lead levels in his or her chart, both in notes and in the problem list. Educating caregivers, including family and daycare providers, is also essential. Caregivers need to be aware of age-appropriate activities and development in their child as well as commonly seen neurobehavioral problems in lead exposed children (e.g., deficits in nonverbal functions, attention problems). Providing education in areas such as behavior management can also be beneficial for caregivers, as can caregiver-child interventions. Like other children at risk for developmental delay, children exposed to lead are thought to benefit from early intervention/stimulation programs to address their developmental deficits.

Educational Interventions

Educating caregivers, both family members, daycare providers and local medical personnel, is essential in the prevention of lead exposure as well as early intervention when lead exposure is suspected. Providing information from environmental investigations as well as resources for obtaining lead abatement services is necessary. Information on modifying a child’s physical environment (e.g., blocking access to rooms with lead based paint, regularly washing children’s hands and toys) is also beneficial to parents. In addition, caregivers should be told of common signs of lead exposure and poisoning in children, as well as specific steps to follow if they suspect lead poisoning. Information regarding testing, damage associated with specific elevated blood lead levels, medical and nutritional interventions, and local resources should also be provided.

Prevention

According to the CDC, lead poisoning is entirely preventable. The CDC provides funding for states, counties, and cities to design and implement prevention and surveillance programs at the local level. The Georgia Childhood Lead Poisoning Prevention Program is part of the Department of Public Health. More information about current prevention programs and services is available from the program’s health education consultant 404-463-3454).

The above information was obtained from the Center for Disease Control and Prevention, NationalCenter for Environmental Health (CDC/NCEH). More information is available at their web-site ( In addition, more detailed information for medical and allied health and public health professionals is available in the publication, “Managing Elevated Blood Lead Levels Among Young Children:

Recommendations from the Advisory Committee on Childhood Lead Poisoning

Prevention,” published in March 2002. It is available at the CDC/NCEH website.

For further information regarding this article please contact the Maternal Substance Abuse and Child Development Project, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1256 Briarcliff Road, N.E., Suite 309W, Atlanta, Georgia, 30306. You can also phone us at 404-712-9800 or visit our website at

The Maternal Substance Abuse and Child Development Project is funded in part by the Georgia Department of Human Resources Division of Public Health