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Lead Poisoning and Kids

Lead Poisoning: What It Is, How to Test, What to Do
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Is Your Child at Risk of Lead Poisoning? continued...

A recent U.S. Preventive Services (USPS) Task Force panel noted in a 2006 report that children's blood-lead levels usually peak at about age 2 and go down after that.

Rosen says all children's blood lead levels should be tested at age 12 months and again at age 24 months -- with additional testing every six months if the child is at high risk of lead exposure.

"If a child has never been tested for lead, it should be done regardless of the child's age," Rosen says. "The prime question for a pediatrician to ask is what is the status of the apartment or home where the child lives: Is there peeling paint? Is it an old building, or new construction?"

The USPS panel reached a different conclusion. It found no evidence that universal lead-exposure screening leads to better clinical outcomes than targeted screening of at-risk children.

What to Do for Children With Lead Poisoning

Unfortunately, once a child has absorbed a dangerous amount of lead, there's no quick way to make the lead go away.

Children with dangerously high blood lead levels -- 45 micrograms/dL or more -- can be treated by chelation (pronounced key-LAY-shun). Chelation involves giving a child one of two drugs that quickly remove lead from the blood.

Chelation can save the life of a child with acute lead poisoning. But it does not remove all lead from the body. Most ingested lead is stored in the bones and leaches back into the bloodstream -- and brain -- over time.

"Chelation stops lead poisoning from being life-threatening," Rosen says. "Has damage already been done to the brain? Yes. Chelation does not reverse the adverse effects of lead on the brain. What it does do is save lives. Chelation is of no value -- and may actually harm -- children with lead levels under 45 micrograms/dL."

The USPS panel notes that repeated chelation may temporarily lower blood lead levels, but these reductions are not sustained. The panel found no evidence that these temporary reductions improve health or behavioral outcomes.

What does work? Rosen says the first thing to do is to have the child's pediatrician work with local health authorities to find and remove the source of lead poisoning.

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