In 1999, Debbi and Bob Rodak bought their dream house, in Emporia, Kansas: a 7,500-square-foot Victorian built in 1894. When the agent handed them the keys, they knew the house needed some work, but they were looking forward to renovating and creating a home for their children -- 3-month-old Sarah, 18-month-old Ashley, and 10-year-old Philip. However, only two years later, the Rodaks were forced to say goodbye to their beloved home. Why? It was slowly poisoning their two younger children with lead.
Unfortunately, their story is not unique. Experts have known for more than a century that exposure to lead damages the developing brains of young children. Despite the fact that lead paint was banned from the market in 1978, one quarter of all homes in this country still have unsafe lead levels, according to the Department of Housing and Urban Development (HUD). Thirty-eight million homes have at least some lead paint.
Lead poisoning affects more than 434,000 children under the age of 6, estimates the Centers for Disease Control and Prevention (CDC), but recent research suggests that five times that many -- 10 percent of all young children -- may actually be in danger. What's most frightening is that most parents have no clue that their children are at risk -- and that the neurological damage caused by lead is irreversible.
Most people assume that paint chips are the primary culprit in lead poisoning. However, the toxin is much more insidious than we realize. Every time you open a window or a door that was once painted with lead-based paint, the friction can create microscopic lead dust that gets into the air and your lungs, as well as onto clothing, toys, furniture, carpets, and other household surfaces. And every time your child touches the dust and then puts his hand (or any dust-covered object) into his mouth, he is ingesting lead, which builds up in the body. Babies and toddlers -- whose brains are growing the most rapidly and who are most likely to put things into their mouth -- are at the highest risk for ingesting and being harmed by lead.
The elimination of lead gasoline and the removal of lead as a soldering agent in food cans has reduced overall environmental lead levels in this country, but lead used in some kinds of manufacturing is still found in the soil and air, as well as in produce and drinking water. And lead that's in paint on the exterior of your home, as well as on wooden furniture or play sets, can also leach into the soil, where it can be tracked inside your home on the bottom of your shoes, says Lynnette Mazur, M.D., a professor of pediatrics at the University of Texas, in Houston, and a member of the American Academy of Pediatrics' (AAP) Committee on Environmental Health.
Interestingly, there are some regional differences in the prevalence of lead. According to HUD, 40 percent of homes in the Northeast, 33 percent of homes in the Midwest, 17 percent of homes in the South, and 15 percent of homes in the West have unsafe lead levels.
Although lead can be toxic to nearly every organ in a child's body, lead poisoning most commonly causes learning disabilities, speech delays, and behavioral problems, including aggressiveness. Physical symptoms run the gamut from poor appetite to stomach pain to persistent sluggishness. Yet for many kids, lead is never identified as the cause of any of these symptoms. In high doses, lead poisoning can lead to kidney damage, deafness, and coma.
Over the last 29 years, the CDC has repeatedly lowered the blood level of lead that it considers to be dangerous for young children. Its current guidelines say that anything over 10 micrograms per deciliter is harmful. However, a recent study published in The New England Journal of Medicine found that lead levels between 5 and 10 can also cause a drop in a child's IQ score. According to the most recent figures, approximately 1.5 million children under age 6 have these harmful lower blood lead levels, says Richard L. Canfield, Ph.D., a coauthor of the study and a professor at Cornell University, in Ithaca, New York. "There is no normal range for lead, because lead is not part of normal body chemistry in the way some other minerals are," adds Tom Matte, M.D., a medical epidemiologist at the CDC. "Even at very low levels, there's evidence of subtle but adverse effects."
If there were a simple treatment for lead poisoning, the statistics might not be so grim. Chelation therapy, which entails giving lead-binding chemicals orally or intravenously, is sometimes used on children with very high lead levels, but it may not be possible to reverse the damage that has already been done, says Michael Shannon, M.D., an associate professor of pediatrics at Harvard Medical School.
Stay Ahead of Lead
The good news is that there are precautions you can take. Here are the best ways to safeguard your family.
- Test your home. Unless your home was built after 1978, you should assume that it has some lead in it and test the dust on your floor and other surfaces as well as the soil in your yard, advises Eileen Quinn, director of the Alliance for Healthy Homes, a nonprofit organization in Washington, D.C. (see "Rating the Tests," page 100). Unfortunately, even if tests come back negative, you can't always rest assured. Penny Duffy's Concord, New Hampshire, home, which was built in 1914, passed an indoor home-lead test before her son, Samuel, was born. However, at 10 months, Samuel had a routine lead screening test and his blood level was nearly double the CDC's cutoff. After conducting a careful inspection of the house, the Duffys discovered the source of the lead: the porch and the old wood steps leading to the front door. As people came into the house, they were tracking lead dust in with them.
- Ask your doctor to screen your child. The CDC and AAP recommend that kids first be screened between 9 and 12 months if they live in a home (or attend a child-care facility) that was built before 1950 or built before 1978 and recently renovated. However, some states don't mandate testing, and many kids are never screened because pediatricians and parents mistakenly assume that lead poisoning is a concern only in the inner cities. The simple finger-stick blood test is usually covered by insurance. If the test comes back at 10 micrograms per deciliter or higher, your doctor will do a more accurate test with blood taken from your child's arm.
- Keep surfaces clean. Frequently wet-mop your floors and wipe window sills with a wet rag, and steam-clean rugs several times a year. If you have a crawling baby, putting blankets and sheets down on the floor may act as a barrier. And make sure that all family members wash their hands often.
- Landscape wisely. "You should always cover dirt, because bare soil is much more likely to contain accessible lead, especially in areas directly under shingles or gutters," says David L. Johnson, Ph.D., a professor at the State University College of Environmental Science and Forestry, in Syracuse, New York. Plant grass or shrubbery, or cover soil with gravel or bark chips.
- Get rid of old carpets and blinds. Some experts advise removing all carpeting -- especially if you live in an older home and the carpeting has been down for a while. Smooth, cleanable surfaces are best. Otherwise, vacuuming frequently with a machine that has a HEPA filter can help. Vinyl mini blinds, especially those manufactured outside the U.S., can also contain lead, which is released every time you open and close them. In addition, sunlight can break down the vinyl, creating lead-contaminated dust particles.
- Cover painted surfaces. If you know your home has lead paint on any layer, you can help reduce your children's exposure by putting up wallpaper or paneling.
- Check before you drill (or hammer or sand). Disrupting the surface of your walls and floors without knowing whether they contain lead can have serious consequences. The EPA suggests testing your home and using lead-safe renovation practices such as wet scraping -- misting paint before removing it -- to keep dust levels to a minimum.
Debbi Rodak is grateful that her doctor conducted routine screenings. The results of her toddler Ashley's blood test were 43 micrograms per deciliter -- more than four times the level the CDC considers unsafe. "Lead paint didn't just disappear when it was banned in the 1970s," she says. "We're proof that it's out there and it's a real threat."