Lead Exposures in U.S. Children, 2008: Implications for Prevention

Abstract

ObjectiveWe reviewed the sources of lead in the environments of U.S. children, contributions to children’s blood lead levels, source elimination and control efforts, and existing federal authorities. Our context is the U.S. public health goal to eliminate pediatric elevated blood lead levels (EBLs) by 2010.Data sourcesNational, state, and local exposure assessments over the past half century have identified risk factors for EBLs among U.S. children, including age, race, income, age and location of housing, parental occupation, and season.Data extraction and synthesisRecent national policies have greatly reduced lead exposure among U.S. children, but even very low exposure levels compromise children’s later intellectual development and lifetime achievement. No threshold for these effects has been demonstrated. Although lead paint and dust may still account for up to 70% of EBLs in U.S. children, the U.S. Centers for Disease Control and Prevention estimates that ≥30% of current EBLs do not have an immediate lead paint source, and numerous studies indicate that lead exposures result from multiple sources. EBLs and even deaths have been associated with inadequately controlled sources including ethnic remedies and goods, consumer products, and food-related items such as ceramics. Lead in public drinking water and in older urban centers remain exposure sources in many areas.ConclusionsAchieving the 2010 goal requires maintaining current efforts, especially programs addressing lead paint, while developing interventions that prevent exposure before children are poisoned. It also requires active collaboration across all levels of government to identify and control all potential sources of lead exposure, as well as primary prevention.

Lead Bullet Fragments in Venison from Rifle-killed Deer: Potential for Human Dietary Exposure

“…The observed elevations in blood lead concentrations, while not considered overtly toxic, would nevertheless contribute to cumulative lead burdens, and would be additive with further meals of contaminated venison. Observed blood lead concentrations of up to 3.8 mg/dL, and daily means of 2.3 and 2.2 mg/dL in the experimental animals, do approach what is considered significant with respect to adverse effects in humans by contemporary assessments [35,36]. Whereas the CDC advisory level for intervention in individual children is 10 mg/dL in blood [37], studies now associate as little as 2 mg/dL with increased risk of cardiovascular mortality in adults [15] and impaired cognitive function in children [38].…”

Lead Exposure from Backyard Chicken Eggs: A Public Health Risk?

“…Sources of exposure include air, water, and soil as well as concentrated lead sources such as lead-based paint, automotive batteries, fishing sinkers, shot gun pellets, sewage sludge, lead mine tailings, oil and gasoline, as well as lead contaminated pottery and jewelry, and lead-based inks used in food packaging such as candy wrappers [2,3]. Much of the emphasis on prevention has been focused on lead-based paints since they are the primary source of childhood lead exposure and, recently, on the lead levels in candy products likely to be consumed frequently by small children [4]. However, the concern for lead exposure through the consumption of eggs was recently made public by the New York Times [5].…”

Prevention of Childhood Lead Toxicity

“…49 The contributions of airborne lead to children's blood lead concentrations are proportionately greater at the lower levels of exposure than at higher levels. 49 Other sources of lead intake for children have been identified, such as nutritional supplements and folk medicines, ceramic dishware, and cosmetics [50][51][52] (Table 3). …”