I am an advocate for bringing more public attention to the critical issue of childhood lead poisoning. It is the number one environmental health threat to children. Lead present in paint, dust, and soil is possibly our most significant toxic waste problem in terms of the seriousness and the extent of human health effects. Lead poisoning is more dangerous than some forms of cancer—yet it is virtually ignored by the American public.
I have been studying and writing about childhood lead poisoning for more than 25 years. During 10 of those years I directed a research center that addressed issues of urban children and youth. Lead poisoning seemed to be implicated in several of the educational issues of these children, especially their academic performance and behavior. Consequently, I see reasons for focusing on lead poisoning beyond the obvious health motives.
Dangerous, yet entirely preventable
Lead poisoning is a serious but preventable childhood condition, caused by exposure to lead, which is found primarily in paint, soil, and household dust. Children come in contact with these sources of lead during normal indoor and outdoor play. Lead is especially dangerous to children under seven years of age because this is a critical phase in the development of their neurological system.
The implications of lead poisoning are vast, as the neurological damage it causes can lead to such problems as learning disabilities, emotional disturbances, reduced IQ, and behavioral disabilities. Consequently, lead poisoning is associated with poor school performance, delinquency, and even violent behavior.
Lead poisoning among children has changed over the past three to four decades. Previously, it was a disease often presented as encephalopathy associated with children ingesting lead from paint chips. Now lead poisoning has become known as a largely asymptomatic condition characterized by an elevated blood lead level linked with many sources of exposure and affecting a broad range of children.
Today, at least 4 million households have children living in them that are being exposed to high levels of lead. There are approximately half a million children in the United States ages 1-5 with blood lead levels above 5 micrograms per deciliter (µg/dL), the reference level at which CDC recommends public health actions be initiated.
Except for severely poisoned children, there is no medical treatment for lead poisoning. Drug therapy can reduce high levels of lead in the body, such as might occur when a child eats paint chips; however, this therapy cannot undo the harm caused to developing organs and systems. Consequently, more focus should be on preventing lead exposure.
Blood lead levels have been steadily decreasing in the past two to three decades. This decline is generally attributed to the discontinuance of the use of leaded gasoline. However, this decreasing rate is expected to slow down, and lead poisoning is expected to continue as an issue, as the bans on lead-based paint and leaded gasoline might have already had the bulk of their effects.
An environmental justice issue
Lead poisoning is of special significance for African Americans as they are much more likely than white children to have elevated levels of lead in their blood. Since some of the principal sources of lead in the environment are flaking paint from old houses, auto emissions, and industrial sources, inner-city neighborhoods have higher rates of child lead poisoning than rural or suburban areas. Because African Americans tend to be the primary inner-city dwellers they are more at risk for lead poisoning than white children.
A small proportion of children are lead poisoned by eating paint chips from the walls of deteriorating inner-city dwellings. These children became ill and usually must be hospitalized. In most instances, however, childhood lead poisoning occurs from an accumulation of low levels of lead from household dust, and there are no immediate symptoms.
Canaries in a coal mine
Despite occasional attention to the professional removal of lead from the household environment through lead abatement, the most prominent prevention activity for lead poisoning is testing. Blood lead level testing is obviously not a primary prevention technique. With testing of children it appears as if they are being used the way miners previously used canary birds. Miners would send a canary down a mine to test for poisonous gases. A returning bird was a signal that there were no poisonous gases and it was safe for the men to enter the mine. If the bird did not come back that was a signal that there were poisonous gases and the bird had succumbed. Similarly with children, if we test them to determine whether their environments have lead we may find out too late, after they have been poisoned already. We need to practice more primary prevention and test and treat the environment—the home and the soil. Then we can get closer to assuring that we can act before children are poisoned.