Lead Poisoning

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Lead Poisoning

Topic Overview

What is lead poisoning?

Lead poisoning occurs when you absorb too much lead by breathing or swallowing a substance with lead in it, such as food, dust, paint, or water. Too much lead in the body can cause irreversible problems in growth and development in children, including:

  • Behaviour problems.
  • Hearing problems.
  • Learning problems.
  • Slowed growth.

In adults, lead poisoning can cause serious health problems, including high blood pressure and damage to the brain, nervous system, stomach, and kidneys.

Although it is not normal to have lead in your body, a small amount is present in most people. Lead can damage almost every organ system, with the most harm caused to the brain, nervous system, kidneys, and blood.

What causes lead poisoning?

Lead poisoning is usually caused by months or years of exposure to small amounts of lead at home, work, or daycare. It can also happen very quickly with exposure to high concentrations. The most common source of lead exposure for children is lead-based paint and dust and soil that are contaminated by it, especially in older homes and buildings. Toys and jewellery made in other countries can sometimes contain high lead levels. For a list of recalled products, see Health Canada's Consumer Product Safety Web site at www.hc-sc.gc.ca/cps-spc/index-eng.php.

Adults are most often exposed to lead in the workplace or while doing hobbies. Those who work with lead—such as metal smelters, welders, or pottery makers—are at a higher risk of lead poisoning.

Other sources of lead exposure include:

  • Contaminated air (including industrial emissions), water, and soil.
  • Certain hobbies, such as working with stained glass, building lead-based models, reloading ammunition, or shooting at indoor ranges.
  • Some alternative medicines and supplements, such as certain vitamins from India.
  • Eating food or juice stored in cans made with lead or glazed with lead-based glazes, which are not manufactured in Canada or the United States.

Most people are exposed to some amount of lead in their lifetime. Although environmental regulations have reduced lead exposure in Canada, it is still a significant health risk, especially for young children.

What are the symptoms?

There may be no noticeable symptoms of lead poisoning because the effects are subtle or may mimic other conditions. When lead poisoning levels are severe, some general symptoms can include digestive problems, fatigue, and headaches.

Children with chronic lead poisoning may show slightly lower intelligence and may be smaller in size than children their age who do not have lead poisoning. Behavioural problems can include irritability or aggressiveness, hyperactivity, learning difficulties, lethargy, and loss of appetite.

In adults, behavioural symptoms can include irritability, mood and personality changes, changes in sleep patterns, difficulty concentrating, and memory loss.

At high levels, lead can affect the central nervous system, leading to poor coordination, weakness in hands and feet, headaches, and in severe cases, convulsions, paralysis, and coma.

How is lead poisoning diagnosed?

The doctor will ask questions and do a physical examination to look for signs of lead poisoning. If your doctor suspects lead poisoning, he or she will do a blood test to find out the amount of lead in the blood.

Diagnosing lead poisoning is difficult, because the symptoms can be caused by many diseases. Most children with lead poisoning do not have symptoms until their blood lead levels are very high.

How is it treated?

Treatment for lead poisoning includes removing the source of lead exposure and eating a balanced diet. Good nutrition, especially sufficient iron intake, may help prevent absorption of lead. Often this treatment approach is enough to reduce lead levels in the body. If this is not successful or if lead levels are very high, chelation therapy may be used. Chelation therapy involves taking medicines that bind to lead in the body and help speed its elimination through the kidneys.

It is important to make sure that children are not exposed to lead. The most effective means of prevention is to keep children out of buildings that contain lead-based paint until the lead has been either removed or sealed away and the environment is certified by professionals to be free of lead residues.

Who is at highest risk of lead poisoning?

Lead poisoning can occur at any age, but children are most vulnerable to contamination. Children who are at highest risk for lead poisoning include those who:

  • Live in or regularly visit homes or buildings built before 1976, especially if built before 1950 when lead-based paint was commonly used.
  • Are immigrants, refugees, or adoptees from other countries.2
  • Are up to 6 years old. Babies and young children are the most vulnerable to lead poisoning because they:
    • Often put their hands and objects in their mouths.
    • Sometimes swallow non-food items.
    • Have higher gastrointestinal absorption of lead.
    • Have brains that are rapidly developing.

Also, lead exposure or lead poisoning may occur in:

  • People whose drinking water flows through lead-soldered pipes.
  • Adults who work with lead either in their occupation or as a hobby, such as metal smelters, pottery makers, or stained glass artists.
  • People who eat food from cans made with lead solder, which are manufactured outside Canada and the United States.
  • People who use ceramic containers for cooking or storing food or beverages. Some ceramic glaze contains lead that may have been improperly fired or cured.
  • People who eat or breathe traditional or folk remedies that contain lead, such as some herbs and vitamins from India.
  • People who live in communities contaminated by industrial emissions.

Frequently Asked Questions

Learning about lead poisoning:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with lead poisoning:

Cause

Lead poisoning is caused by swallowing or breathing lead-contaminated substances or by skin contact. Small children may get lead poisoning by licking, chewing, or eating lead paint on toys, jewellery, or woodwork such as windowsills. Small children also may be exposed by breathing, swallowing, or playing in lead-contaminated dust, soil, or smoke.

Although lead poisoning can sometimes result from a single large dose of lead, it usually is caused by months or years of exposure. Because lead cannot be seen, tasted, or smelled, people usually do not know when they are being exposed. Nearly everyone has some lead in his or her body.

A pregnant woman who is exposed to lead can pass it to her unborn baby.1 Lead can also be passed to a baby through the mother's breast milk.

Before its harmful effects were realized, lead was used in most gasolines, paints, water pipes, food and drink cans, and many other products. For example, house paint made before 1950 often contained as much as 50% lead. Paint manufactured up until 1976 still contained lead.

Environmental regulations have reduced sources of lead pollution, significantly reducing lead in paint, gasoline, plumbing systems, and food and drink cans. For example, in 1990 the Canadian National Plumbing Code restricted the use of lead solder in new plumbing and in repairs to plumbing for drinking water supplies. But lead does not break down, so any lead already present in soil or water will stay there unless it is physically removed.

Common sources of lead are:

  • Lead-based paint and lead in dust and soil, especially from renovation, remodelling, or repainting of homes and buildings built before 1976.
  • Drinking water in homes with lead or lead-soldered pipes.

Other sources of lead include:

  • Jobs, hobbies, or work settings that involve exposure to lead.
  • Soil that has been contaminated with lead from smelters, hazardous waste, or gasoline.
  • Polluted air, particularly near lead smelters or other industries that use lead.
  • Alternative medicines and supplements, such as some herbs and vitamins made outside of Canada or the United States.
  • Cosmetics made outside of Canada or the United States.
  • Food that is stored in leaded crystal, lead-glazed pottery, or cans made outside of Canada or the United States.
  • Vegetables grown in soil that contains lead.
  • Imported toys, crayons, and candies.
  • Some printing materials, such as ink used in print on plastic bags.
  • Homemade liquor made in stills built with lead solder.
  • Some vinyl plastic items, such as mini-blinds manufactured outside of Canada or the United States before 1996.
  • Some artificial turf used on sports fields.

Symptoms

Lead poisoning usually does not cause symptoms until the level of lead in your blood is very high. Most lead poisoning comes from low levels of exposure over a long period of time. The major organ systems affected are the central nervous system, digestive tract, and the renal system (urinary tract).

Chronic lead exposure may cause the following symptoms.

General physical symptoms in children and adults (usually seen when lead poisoning levels are severe)

  • Stomachaches, cramping, constipation, or diarrhea
  • Nausea, vomiting
  • Persistent, unexplained fatigue
  • Headache
  • Muscle weakness

Children with chronic low blood lead levels who may not have obvious symptoms of lead poisoning may have learning problems and be smaller in size than children their age who do not have low to moderate levels of lead poisoning. Studies have shown that declines in IQ can even be seen in children with blood lead concentrations below 10 micrograms of lead per decilitre of blood (10 mcg/dL), the level of concern defined by the U.S. Centers for Disease Control and Prevention and the World Health Organization.7 Chronic exposure to lead may also cause behavioural problems in these children.

Behavioural symptoms in children

  • Irritability or aggressiveness
  • Hyperactivity, being easily distracted, impulsiveness
  • Learning problems
  • Lack of interest in play
  • Loss of appetite

Behavioural symptoms in adults

  • Irritability
  • Unexplained changes in mood or personality
  • Changes in sleep patterns
  • Inability to concentrate
  • Memory loss

Neurological symptoms (caused by effects of lead on the nervous system)

  • Poor coordination
  • Weakness in hands and feet
  • Headaches
  • Seizures
  • Paralysis
  • Coma

Diagnosing lead poisoning can be difficult, because many other conditions cause similar symptoms.

Severe symptoms of acute lead poisoning can include seizures, unconsciousness, paralysis, or swelling in the brain. But exposure to such a high level of lead is not common. If you experience these symptoms, get emergency medical care.

What Happens

People are exposed to lead if they swallow or breathe lead-contaminated substances. Lead poisoning can be caused by a single large dose of lead, although it is usually the result of exposure to small amounts of lead over a long period of time.

Lead is slowly eliminated from the body in urine, bowel movements, and, to a very small extent, sweat. When the body is exposed to more lead than it can get rid of, it stores the extra lead in the blood, organs, bones, and teeth, and lead poisoning results. Lead can damage the kidneys, central nervous system (brain and spinal cord), and reproductive system. And it can cause high blood pressure. Lead is especially harmful to a child's developing brain.

Blood lead levels are measured in micrograms per decilitre (mcg/dL) or micromoles per litre (mmol/L).. There are different opinions among scientists and doctors on what is a safe level of lead in the blood. Lead has no known function in the body—its natural level in people before the industrial revolution in the 1800s and early 1900s was near zero.

Health effects of high blood lead levels in children

Children are more easily and significantly affected by high blood lead levels than adults. High levels of lead in the blood are caused by lead poisoning. There are five classes of lead levels, according to the United States Centers for Disease Control and Prevention (CDC). These levels range from class 1 (no lead poisoning, less than 10 mcg/dL) to class 5 (a medical emergency of at least 70 mcg/dL).

Lead blood level classes
Class Blood lead level Possible effects in children

1

1–9 micrograms per decilitre (mcg/dL)

or less than 0.48 micromoles per litre (mcmol/L)

Learning problems

2A

10–14 mcg/dL or 0.48–0.68 mcmol/L

Hearing problems, slowed growth, learning problems

2B

15–19 mcg/dL or 0.70–0.96 mcmol/L

3

20–44 mcg/dL or 0.97–2.1 mcmol/L

Headache, weight loss, nervous system problems

4

45–69 mcg/dL or 2.17–3.33 mcmol/L

Severe stomach cramps, poor production of red blood cells (anemia), seizures

5

More than 69 mcg/dL or more than 3.33 mcmol/L

Severe brain damage leading to death

Children who were exposed to lead before birth may be underweight and have low intelligence, attention-span problems, and other signs of nervous system damage.

Declines in IQ can be seen in children with blood lead concentrations below 10 mcg/dL, the level of concern defined by the U.S. Centers for Disease Control and Prevention and the World Health Organization.

Health effects of high blood lead levels in adults

High blood lead levels affect adults in several ways.3

  • Blood lead levels above 14 mcg/dL may affect blood cell development.
  • Blood lead levels above 39 mcg/dL can affect the function of:
    • The blood and the body's ability to form hemoglobin.
    • The nervous system, causing symptoms such as fatigue, irritability, memory loss, and slow reaction time.
    • The kidneys, causing chronic kidney disease and kidney failure.
    • The reproductive system, causing decreased sperm counts and increased numbers of abnormal sperm. Very high levels can cause miscarriage or stillbirth.
  • High blood lead levels may also cause high blood pressure.

Unfortunately, people may not have noticeable symptoms until blood lead levels are high enough to cause serious damage to body systems.

What Increases Your Risk

Children

Age and environment determine a child's risk for lead poisoning. Young children who live in housing built before 1976 (before lead paint was banned) are at risk. Lead paint was used even more in housing built before 1950.5 Recent or ongoing house renovation can increase the risk of lead exposure if lead paint is being removed. Very young children are more likely to ingest lead by touching or playing in lead-contaminated soil or dust and then putting their hands in their mouths. They may also chew on or lick toys, jewellery, or woodwork (such as windowsills) painted with lead-based paint.

In 2007, Health Canada and the U.S. Consumer Product Safety Commission (CPSC) found high lead content in many children’s toys and jewellery made in other countries. For a complete list of recalled products, see Health Canada's Consumer Product Safety Web site at www.hc-sc.gc.ca/cps-spc/index-eng.php.

Children who come from low-income families are more likely to have high levels of lead in the blood, because they are more likely to be exposed to lead-contaminated soil and dust or deteriorated paint in older housing. Children who are immigrants, refugees, or adoptees from other countries may also be more likely to get lead poisoning.2

Babies, toddlers, and young children up to 6 years old are more likely to have problems from lead poisoning because of their:

  • Behaviour. Babies and toddlers explore their world by handling, mouthing, chewing, or tasting whatever they find, which may include paint chips or dirt with lead in it. Children also play close to the ground, where they may breathe in lead-contaminated dust. Also, children who have ongoing pica (a condition in which a person craves substances that are not food) are at risk.4
  • Growth stage. Babies and toddlers are easily affected because of their small body size and because their brains and bodies are growing and developing rapidly.

Inadequate iron intake is being studied for links to increased absorption of lead. It's possible that increasing iron intake in children at high risk for lead poisoning may slow the absorption of lead.5

Adults

The risk of lead poisoning for adults depends mostly on whether they have jobs or hobbies that involve exposure to lead. It may not always be obvious when there is lead in the workplace. For example, people who work in construction or do remodelling may inhale lead while scraping or sanding wood that has lead-based paint on it. People who work with lead can bring it home on their clothes, shoes, and hair, and expose others in the house.

Adults may also be exposed to lead from cups or dishes with ceramic glazes or from natural or traditional remedies or supplements that contain lead. Some cosmetics manufactured outside of the Canada and United States also contain lead.

The risk of lead poisoning increases if you drink homemade liquor made in stills built with lead solder.

When To Call a Doctor

Call your doctor if you know or suspect that you or someone in your family has lead poisoning, has been exposed to lead, or has ingested a large dose of lead (for example, if your child eats any lead-contaminated paint chips).

Call 911 or other emergency services immediately if someone has convulsions or is unresponsive.

Call your doctor if you or someone else has either severe belly pain or frequent forceful, explosive vomiting usually not preceded by nausea (projectile vomiting).

Call your doctor if you live in an older home with peeling or chipping paint and someone in the house has any of the following symptoms:

  • Fatigue or drowsiness
  • Weakness of hands and feet
  • Changes in personality
  • Headaches

Call your doctor for advice if someone in your home has a job or hobby that involves the use of lead.

Chronic (long-lasting) lead poisoning often has no symptoms at all. See the Early Detection portion of the Examinations and Tests section of this topic for guidelines on when to check someone for lead poisoning.

Watchful waiting

Watchful waiting is not appropriate if you think that someone has lead poisoning. Call your doctor.

Who to see

Screening for lead poisoning is usually done by your regular family doctor, general practitioner, or your child's pediatrician.

Treatment for lead poisoning might be done by any of the health professionals above, by a doctor who specializes in the treatment of poisoning (toxicologist), or by a specialist in environmental and occupational medicine.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Examinations and Tests

Diagnosing lead poisoning can be difficult, especially because its symptoms are so general. The doctor will ask questions and do a physical examination to look for signs of lead poisoning. If your doctor suspects lead poisoning, he or she will do a blood lead test to find out the amount of lead in the blood. If the levels are high, the doctor will do a second blood lead test to double-check the levels.

Results need to be reported to the local health unit if two or more blood lead levels are high. A home inspection is needed to find the source of the lead contamination.

Other tests that can be helpful if lead poisoning is suspected include:

If a child has lead poisoning, the people he or she lives or plays with may need to be checked for lead in their blood.

Early detection

Screening programs for lead poisoning check large numbers of children or adults who are likely to be exposed to lead. These programs are set up by Health Canada and give local and provincial agencies information to help find which areas are the most likely to have high lead levels. Age of housing is an important factor in risk, because older homes tend to have lead-based paint. If lead exposure is likely, then blood tests for infants and young children will be recommended to measure blood lead levels.

Talk to your child's doctor about whether your child is at risk. During a routine health examination, the risk for lead exposure can be evaluated by answering questions about family members' living and working conditions. The doctor may then decide whether blood lead levels should be checked.

Children

Children should be tested, no matter what their age, if they have been exposed to lead or if they have symptoms that could be caused by lead poisoning. Screening tests done on 1- to 2-year-olds have shown lead in the environment in most places. When children in an area no longer test positive for traces of lead, routine screening of those children is no longer needed. Screening programs in an area would need to be restarted only if something changed that would increase the risk for lead in that area.

Your local health unit or provincial ministry of health can provide information on screening recommendations in your area. Also, an individual child's risk for lead poisoning can be determined by answering a few screening questions.

Adults

The Canadian Centre for Occupational Health and Safety (CCOHS) requires companies to test the blood of employees who work with lead. CCOHS sets industry standards to protect workers. For more information, see the Other Places to Get Help section of this topic.

Adults who do not work with lead usually are not tested for lead poisoning. If you are pregnant or trying to become pregnant and you or a family member works with lead, you may want to ask your doctor about your risk for lead poisoning.

Treatment Overview

Treatment for lead poisoning begins with removing the sources of lead. Getting balanced nutrition may also help. These measures are usually sufficient to limit exposure to lead and reduce lead levels in the body.

Old paint chips and dirt are the most common sources of lead in the home. Lead-based paint and the dust and dirt that come from its decomposition should be removed by professionals. In the workplace, removal of sources usually involves removing lead dust that is in the air and making sure adults don't bring contaminated dust or dirt into the home on clothes worn for work.

Balanced nutrition includes adequate amounts of vitamins and minerals such as iron, calcium, and vitamin C. A person who eats a balanced, nutritious diet may absorb less lead than a person whose diet is inadequate.

If removing the source of lead and balancing nutrition do not reduce lead levels, or if the blood lead level is very high, chelation therapy may be used. Chelation therapy is a process that lowers the amount of lead stored in the body. Drugs called chelating agents cause metals like lead to bind to them, and then they are eliminated from the body through urine. Because chelating agents may increase the absorption of lead and other metals, it is essential that sources of lead exposure be removed before a person is treated. If you have this treatment, your doctor will closely watch you for side effects.

If blood lead levels do not come down with treatment, the home and work areas need to be rechecked for other sources of lead. Contact your local health unit or provincial ministry of health to see what inspection services are in your area.

Prevention, primarily through screening of both children and adults, is the most effective means of reducing or eliminating the effects of lead poisoning. Damage from lead poisoning, especially to the central nervous system, is often incurable and may not improve with treatment.

Prevention

Lead poisoning may be prevented or limited by removing the source of lead in your home or workplace and by eating a healthful, balanced diet.

You can ask your local health unit or provincial ministry of health to test your home for lead or to give you the names of companies that can do such tests. Home test kits may not be accurate.

To prevent or reduce exposure to lead, try these tips:

  • If your home is contaminated, wipe toys, windowsills, door frames, and uncarpeted floors with a wet cloth or damp mop at least once a week with warm, soapy water. Levels of lead in the blood can be reduced through regular housecleaning.
  • If your drinking water is contaminated, let cold water run for a few minutes in the morning before using it for drinking or cooking.
  • For nutrition and food preparation, make sure children get enough iron in their diet.
  • If you have a job or hobby that involves working with lead, shower and change clothes and shoes at work before getting in your car or before you come home, to prevent bringing home lead dust on your clothes and hair.
  • To help keep lead that is outdoors from getting into your house and food, have your child remove his or her shoes after playing outside. And wash your child's hands after he or she plays outdoors and before eating.

Home Treatment

If you suspect that someone in your family has lead poisoning, consult a doctor right away. The most important thing you can do is remove sources of lead in and around your home.

If you have lead in your house paint, soil, or drinking water, you may want to think about the following:

Good nutrition is important. Make sure your family eats a diet that includes adequate amounts of vitamins and minerals such as iron, calcium, and vitamin C.

Medications

Chelating agents are used for severe lead poisoning. Chelating agents are medicines that bind with lead in blood and both soft and bony tissues and eliminate it quickly from the body, usually through the urine.

The use of chelating agents for lead poisoning is still being studied. And there is no single treatment or drug of choice. In general, drug treatment is recommended when blood lead levels are above 45 micrograms per decilitre (mcg/dL) or when there are symptoms of lead poisoning, especially lead encephalopathy.

Reducing or removing environmental lead sources, correcting iron deficiency, and improving nutrition may be enough to lower lead levels in the blood. The decision to use chelating agents depends on how long a child has been exposed to lead, the child’s blood lead level, and his or her symptoms. It also depends on whether the blood lead level stays high after the child eats a more balanced diet and after the source of lead is removed or reduced.

In theory, chelating agents prevent further damage by reducing blood lead levels. Damage to the blood may repair itself if blood lead levels are lowered. Kidney damage may also heal, unless it has been too extensive. Chelation therapy may not reverse central nervous system (brain and spinal cord) damage that has already occurred.

Medication Choices

Chelating agents are chemicals that bind with lead for the treatment of lead poisoning.

What to Think About

Chelating agents may increase absorption of lead and other metals. A person exposed to lead while taking a chelating agent may absorb more of the lead, thus defeating the purpose of the therapy and possibly doing even more harm. So it is essential that lead sources be removed from your environment before treatment. (This may require that treatment be done in a hospital.) Do not return home or to the workplace until lead sources have been removed.

Results are reported to the local health unit if 2 or more blood lead levels are high. A home inspection is needed to find the source of the lead contamination.

If blood lead levels do not come down with treatment, your home and work areas need to be rechecked for other sources of lead. Contact your local health unit or provincial ministry of health to see what inspection services are available in your area.

Iron deficiency also increases lead absorption. Iron deficiency cannot be treated at the same time as chelation therapy, because the chelating drug will bind to iron and remove it also. Iron deficiency must be treated either before or after chelation therapy.

Chelation therapy does reduce blood lead levels and may slow down problems with kidney function associated with lead poisoning. But it does not appear to improve cognitive damage or other neurological problems already caused by the lead poisoning.6 If chelation therapy is needed, it is best to talk with a doctor experienced with this treatment.

Surgery

There is no surgical treatment for lead poisoning.

Other Treatment

There are no other treatments for lead poisoning.

Other Places To Get Help

Online Resource

CanOSH
Canadian Centre for Occupational Health and Safety (CCOHS)
Web Address: www.canoshweb.org
 

CanOSH is a Web site maintained by the Canadian Centre for Occupational Health and Safety (CCOHS) to provide convenient and efficient access to health and safety information provided by federal, provincial, and territorial agencies responsible for occupational health and safety; by Worker's Compensation Boards; and by CCOHS.


Organizations

Health Canada
Web Address: www.hc-sc.gc.ca/hl-vs/iyh-vsv/environ/index-eng.php
 

This webpage provides direct access to Health Canada's public information fact sheets on noise, toxic and hazardous substances, and other environmental health issues.


KidsHealth for Parents, Children, and Teens
4600 Touchton Road East, Building 200
Suite 500
Jacksonville, FL  32246
Phone: (904) 232-4100
Fax: (904) 232-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


References

Citations

  1. Long H, Nelson LS (2004). Metals and metalloids. In JE Tintinalli et al., eds., Emergency Medicine, 6th ed., pp. 1146–1153. New York: McGraw-Hill.
  2. Committee on Environmental Health, American Academy of Pediatrics (2005, reaffirmed 2009). Lead exposure in children: Prevention, detection, and management. Pediatrics, 116: 1036–1046. Also available online: http://www.pediatrics.org/cgi/content/full/116/4/1036.
  3. Shannon MW (2007). Lead. In MW Shannon et al., eds., Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed., pp. 1129–1146. Philadelphia: Saunders Elsevier.
  4. Woolf AD, et al. (2007). Update on the clinical management of childhood lead poisoning. Pediatric Clinics of North America, 54(2): 271–294.
  5. Markowitz M (2007). Lead poisoning. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 2913–2918. Philadelphia: Saunders Elsevier.
  6. Dietrich KN, et al. (2004). Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics, 114(1): 19–26.
  7. Binns HJ, et al. (2007). Interpreting and managing blood lead levels of less than 10 mcg/dL in children and reducing childhood exposure to lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention. Pediatrics, 120(5): e1285–e1298.

Other Works Consulted

  • Centers for Disease Control and Prevention (2002). Managing elevated blood lead levels among young children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Available online: http://www.cdc.gov/nceh/lead/CaseManagement/caseManage_main.htm.
  • Centers for Disease Control and Prevention (2005). Preventing lead poisoning in young children. Available online: http://www.cdc.gov/nceh/lead/publications/prevleadpoisoning.pdf.
  • Grandjean P (2008). Lead section of Health significance of metal exposures. In RB Wallace, ed., Wallace/Maxcy-Rosenau-Last Public Health and Preventive Medicine, 15th ed., pp. 609–611. New York: McGraw-Hill.
  • Henretig FM (2009). Lead section of Toxins. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 319–321. Philadelphia: Saunders Elsevier.
  • Kemper AR, et al. (2005). Follow-up testing among children with elevated screening blood lead levels. JAMA, 293(18): 2232–2237.
  • McGuigan MA (2008). Lead section of Chronic poisoning: Trace metals and others. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp. 102–103. Philadelphia: Saunders Elsevier.
  • Needleman HL (2006). Lead poisoning. In JA McMillan et al., eds., Oski's Pediatrics: Principles and Practice, 4th ed., chap. 123, pp. 767–772. Philadelphia: Lippincott Williams and Wilkins.
  • Olson KR (2010). Lead section of Poisoning. In SJ McPhee, MA Papadakis, eds., Current Medical Diagnosis and Treatment 2010, 49th ed., p. 1438. New York: McGraw-Hill.
  • Woolfenden YB, et al. (2008). Household interventions for prevention of domestic lead exposure in children. Cochrane Database of Systematic Reviews (2).

Credits

By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Primary Medical Reviewer Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology
Last Revised August 3, 2010

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