Lead Exposure – Rare But Important

Heavy metals are a prominent part of our environment. These heavy metals include lead, mercury and arsenic. Unfortunately, most of them also have significant negative effects if ingested in large amounts, or even in smaller amounts that accumulate over time. These heavy metals enter the body through ingestion of food, drinking water or nutritional supplements. They can also absorb through the skin or be inhaled through the lungs in jobs in which heavy metals are frequently handled or in environments contaminated by heavy metal sources (for example, ship building, welding, metal recycling, construction). Parents who engage in hobbies such as stained glass work, metal working, and going to the gun range may also bring increased lead into the home on their skin or clothing. 

Children are at a higher risk of poisoning from heavy metals because they are smaller and still developing and therefore more sensitive to exposures. Lead is probably the most common heavy metal exposure. 

Common sources of lead exposure

Lead-based paints were no longer used in homes starting in 1978, but children in older homes with original paints or that are going though renovations could be at risk for exposure. Older plumbing in these homes also elevates the risk of exposure. 

Imported toys and spices also have a history of higher than acceptable lead levels. Soil contaminated by old gasoline or other industrial waste can contain higher levels of lead.  In 2015, there was a serious public health crisis involving high levels of lead in the drinking water in Flint, Michigan. 

This month, there has been a recall of certain brands of cinnamon-flavored applesauce pouches (please see a list of recalled products here). In this case, it is suspected that the increased levels of lead came from contamination of the cinnamon that was added. 

Prevention

Avoidance of high levels of lead exposure is key. Knowing the environment and the risks of certain jobs and hobbies as discussed earlier, can help parents to change their routines to include removal of clothing and immediate showering upon arrival at home. Homeowners of older homes should be certain of the age of the home and when any renovations have been done in the past. 

Watch for alerts regarding recalls on toys and foods, as the Food and Drug Administration attempts to monitor imported goods for increased lead levels. Such as the case with the cinnamon applesauce pouches, large scale recalls will be recommended when lead levels are shown to be toxic. 

Treatment

A simple blood test is necessary to check for lead exposure and/or lead poisoning. Most of the time children do not show outward effects of high lead levels, but even small amounts can cause harm. Behavioral outbursts, headaches, irritability and constipation can occur with small to moderate exposures, and severe exposures cause seizures and coma. Treatment of moderate to severe cases of lead poisoning may include medications or intravenous therapy to removed the excess lead from the blood. 

Final thoughts

As I have said many times before, prevention is one of the most important parts of pediatrics. If we can make changes in lifestyle, environment, parenting, or exposures and effectively avoid a negative outcome, the child will benefit immensely. This is particularly true for lead exposures. It is not common in the United States but definitely needs to be considered when screening for environmental exposures in our young patients. The effects of missed exposures can be devastating, even more so when you realize they are completely preventable. 

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