Lead Poisoning In Children: Symptoms, Causes And Prevention

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Lead poisoning in children is a common public health issue in the US, despite it being the most preventable one. This is because lead is a hidden poison that is found in many daily-use items, including toys.

Read on to know more about this toxic metal and its effects on children. We have also included the symptoms, causes, diagnosis, treatment, and prevention of lead poisoning.

Symptoms Of Lead Poisoning In Children

Children may exhibit different symptoms of lead poisoning; those with a low level of lead poisoning are often asymptomatic. While some children may appear healthy and not exhibit any side effects, others may exhibit the following symptoms of lead poisoning.

  • Irritability
  • Behavior issues (too hyper or aggressive)
  • Learning problems
  • Tiredness or weakness
  • Reduced appetite or energy
  • Headache
  • Unexplained loss of weight
  • Sleep disturbances
  • Constipation
  • Pale complexion

Note: These symptoms may also be present in other conditions, such as autism. Thus, always seek a pediatrician’s help for the correct diagnosis.

Causes And Risk Factors Of Lead Poisoning In Children

Children can be exposed to lead in many ways, and they might inhale or ingest it from their surroundings. The following are the possible sources of lead exposure in children.

  • Lead paint in houses built before 1978
  • Water from old plumbing fixtures and pipes that are soldered with lead
  • Imported candies and candy wrappers
  • Imported cosmetics
  • Consumer products, such as tea kettles and vinyl miniblinds
  • Lead in dust and soil
  • Toys and furniture painted with old lead-containing paints
  • Hobby equipment containing lead products (stained glass windows, ammunition, and lead sinkers used in fishing)
  • Exposure to the parents’ work clothes
  • Adults bringing scrap or waste material home from work
  • Toy jewelry or trinkets made of cheap quality
  • Traditional medicines and home remedies such as azarcon and greta from some countries
  • Imported food cans with lead soldering
  • Pottery and ceramic glazed by lead
  • Kohl from some countries
  • Lead-containing soil due to battery recycling and mining
  • Lead generated from the burning of lead-containing objects
  • Gasoline or aviation fuel loaded with lead. 

Besides these, children who fall under the following categories may be more susceptible to lead poisoning than other children.

  • Children residing in localities with lead-contaminated water lines or poor anti-corrosion control.
  • Children with iron deficiency
  • Children belonging to families below the poverty line
  • Children younger than five years of age are at the greatest risk of developing elevated blood lead levels. 

Diagnosis Of Lead Poisoning 

A blood test is the only way to measure levels of lead in the child’s blood. Lead levels are measured in micrograms per deciliter (µg/dL). The doctor might collect blood from a small prick on the fingers or via a venous sample.

There is no definitive safe blood lead level. Blood lead level higher than five µg/dL is concerning and should be monitored as recent studies have shown that low levels of lead poisoning can impact children’s IQ, growth, development, and hearing.

Ask your pediatrician about lead if your child might be at risk for lead poisoning, especially if the child is aged between six months and three years.

According to the American Academy of Family Physicians, the following criteria should be followed to screen children for lead poisoning.

  • Screening all children at 12 months
  • Screening all children again at 24 months or at least once between 36 to 72 months if not screened previously
  • Universal screening of all people in areas where more than 27% of the houses were built before 1950 or if 12% or more children aged 12 to 36 months have blood lead levels greater than 10 µg/dL

Effects Of Lead Poisoning In Children

According to the World Health Organization, young children are more vulnerable to lead poisoning from any given source as they may absorb four to five times more lead after exposure than an adult would.

Low-level exposure to lead can cause

  • Reduced intelligence quotient (IQ)
  • Reduced attention span
  • Increased antisocial behavior
  • Reduced educational attainment

High-level exposure to lead can affect the brain and the central nervous system and lead to

Lead exposure can also cause the following problems

  • Anemia (low red blood cell count)
  • Hypertension (high blood pressure)
  • Renal impairment (kidney problems)
  • Immunotoxicity (problems with fighting infections)
  • Toxicity to the reproductive organs (infertility)

Treatment For Lead Poisoning In Children

The treatment for lead poisoning begins with identifying and eliminating the source of the exposure to stop the progression of the symptoms. Medicines cannot reverse the effects, but in the case of extremely severe lead poisoning, a process called chelation therapy, which pulls heavy metals from the circulating blood, is performed.

However, chelation therapy may have severe side effects and may also lead to death. Thus, the doctor will advise chelation only if the benefits of chelation outweigh the risks.

Prevention Of Lead Poisoning

The following steps can help you protect your child from lead poisoning.

  1. Lead is more readily absorbed on an empty stomach. Therefore, keeping the child’s tummy full with foods rich in iron, calcium, and vitamin C and low in fat can cause lesser absorption of lead.
  2. Keep the child away from peeling or chipping lead-based paint.
  3. Keep floors and window sills clean to protect the child from lead-contaminated dust and paint chips.
  4. Practice and model good hygiene. Encourage them to wash their hands after play, before meals, and before bedtime. This is necessary for young children who put their hands in the mouth frequently.
  5. If your residence is surrounded by empty space and bare dirt, cover the area with grass, wood chips, or plantings to keep the dust down.
  6. Wash the child’s toys, books, and teethers (pacifiers) regularly.
  7. If you are moving into a rented house, enquire about peeling and chipping of paint with the landlord and be sure to know when the house was built
  8. Check with the pediatrician about when you should have your child tested for lead poisoning.
  9. You may purchase a lead test kit from any hardware store to check if the paint chips or dust in your house contains lead. 

Imported candies and cosmetics, low-quality toy jewelry or decorations, or lead-contaminated water and soil, among other things, can cause lead poisoning in children. It can be asymptomatic or cause behavioral problems, unexplained weight loss, developmental delays, fatigue, or learning disabilities. While removing the source of lead exposure and, in extreme cases, chelation therapy can help, the ideal solution is to prevent leading poisoning. If lead poisoning has been reported in your neighborhood and you have concerns about your child’s risk of lead exposure, take precautions and consult a physician or your local health authority.

Key Pointers

  • Children with low levels of lead poisoning are usually asymptomatic and appear to be in good condition.
  • Lead exposure in children can come through dust, soil, or water, as well as imported goods and consumer products.
  • Lead poisoning can affect a child’s IQ, development, growth, and hearing even at low levels.
  • In highly severe lead poisoning, chelation therapy can be considered, but the process has significant negative effects and even causes death.

References:

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Dr. Jessica Madden

(MD, FAAP, IBCLC)
Jessica Madden is a pediatrician, neonatologist, lactation consultant, and mother of four, who has been taking care of newborns since 2001. She works as a neonatologist in the NICU at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, and founded Primrose Newborn Care, a newborn medicine and “4th trimester” home-visiting and telemedicine practice, in 2018.  Dr. Madden is a Fellow... more

Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. She also holds a certificate in lactation counselling from iNational Health... more