Nsedu Obot Witherspoon, MPH
Executive Director
Children’s Environmental Health Network

In the early twentieth century, physicians became aware that lead-based paint was a cause of lead poisoning. In the 1920s and 1930s, high rates of lead poisoning were observed in children by various hospitals and at least one large health department.¹ By the latter half of the 20^th century, it was known that lead poisoning affected many children – particularly those who were poor, belonged to minority racial or ethnic groups, and who lived in older housing. Towards the end of the 1970s, the mean blood lead level in children was nearly 15 mcg/dL. Because of concerns about these blood lead levels, lead was removed from gasoline, paint, solder, and other commercial products. This has resulted in a marked decline in mean blood lead levels (currently around one mcg/dL), but this does not mean that the problem of lead poisoning in children is solved.

Children absorb more lead than adults do, and their brains and nervous systems are particularly at risk. In addition, pregnant women are also at high risk for exposure to lead through their home or occupational settings.

Science tells us that there is no safe level of lead in the blood; i.e., there is no blood lead level below which we are certain that harm will not occur. The CDC has set five mcg/dL as the “reference level” for blood lead testing. A blood lead level of five mcg/dLor greater means that that child is being exposed to more lead than his or her peers. Blood lead levels less than five mcg/dL can impair cognitive development.² Today, at least four million households have children living in them that are being exposed to high levels of lead.³ Annually, approximately half a million children ages one to five are found to have blood lead levels above five micrograms per deciliter (µg/dL).

While many aspects of children’s exposure to environmental toxicants can get complicated and may require more tests to determine scientific validity, this is not the case for lead. The peer-reviewed literature unequivocally shows that lead poisoning results in behavior and learning problems, lower IQ, hyperactivity, slowed growth, hearing problems, and anemia.⁴ Children are exposed to lead in paint, dust, soil, air, food, and drinking water.

Because there is no treatment for damage done by lead, primary prevention (avoiding exposure to lead in the first place) is the best and only way to protect children from lead poisoning once and for all.

To help us collectively move toward no childhood lead exposure, below are some collaborative efforts that I want to highlight for your knowledge and reference. Fortunately, a growing number of collaborative efforts are under way to help us collectively move toward our ultimate goal: no childhood lead exposure. To reach that goal, the focus of childhood lead-poisoning policy must shift from case identification and management to primary prevention⁵ by providing environmentally safe housing, child care, and schools for all children.

The Lead Service Line Replacement Collaborative (LSLR) began as a result of the Flint, Mich., water crisis. It is a unique partnership of public health, community, water and policy leaders working to accelerate the voluntary replacement of all lead service water lines in the United States.

At Project TENDR (Targeting Environmental NeuroDevelopmental Risks), scientists, health professionals, and children’s and environmental health advocates work together on addressing the dangers of six key neurotoxicants. Lead is one of the key hazards that it has focused on, resulting in congressional hearings, public commentary letters and meetings with leadership in Congress.

My organization, the Children’s Environmental Health Network (CEHN), is a nonprofit that provides resources and technical assistance on public health best practices for protecting children from lead poisoning and an array of other environmental health hazards. CEHN  manages the Eco-Healthy Child Care (EHCC) program, which  supports child care professionals in creating child care settings that are as environmentally healthy and safe as possible. Lead is one of the primary focus areas for the EHCC trainings, checklists encouraging best practices and program resources.

The Pediatric Environmental Health Specialty Units (PEHSUs) are a connected system of specialists throughout North America who respond to questions from public health professionals, clinicians, policymakers, and the public about the impacts of environmental factors on the health of children and reproductive-age adults. The PEHSUs are organized by regions, and lead is one of the many topics for which their public health- trained staff can provide assistance to anyone.

This recent Public Health Institute study published in Pediatrics focuses on the dangerously low diagnoses rates for children with elevated blood lead levels.

1. Rabin, R. Warnings unheeded: a story of child lead poisoning. Department of Labor and Industries, Newton, MA 02165
2. U.S. Centers for Disease Control and Prevention, Childhood Lead Poisoning and Prevention Program. Accessed May 14, 2017 – https://www.cdc.gov/nceh/lead/about/program.htm
3. American Academy of Pediatrics Committee on Environmental Health, Lead Exposure in Children: Prevention, Detection, and Management, Pediatrics. October 2005, Vol 116/issue 4.
4. U.S. Centers for Disease Control and Prevention, Childhood Lead Poisoning and Prevention Program. Accessed May 14, 2017 – https://www.cdc.gov/nceh/lead/about/program.htm
5. American Academy of Pediatrics Committee on Environmental Health, Lead Exposure in Children: Prevention, Detection, and Management, Pediatrics. October 2005, Vol 116/issue 4.