CHILDHOOD LEAD POISONING PREVENTION BRANCH

Lead Poisoning Overview

Most lead-poisoned children present with no obvious symptoms. If present, symptoms typically are nonspecific complaints, such as stomachache, irritability, headache, fatigue, or loss of appetite. Blood lead level (BLL) testing is the best way to diagnose lead poisoning.

Clinical Signs & Symptoms

No safe blood lead level in children has been identified.

Blood Lead Level	Possible Health Effects
less than 10 mcg/dL	Decreased IQ, neurodevelopmental impairment, no blood lead level known to be without a deleterious effect
10–44 mcg/dL	Behavior problems (hyperactivity, irritability), overt physical symptoms rare
45–69 mcg/dL	Lethargy/fatigue, anemia, abdominal symptoms (pain, constipation, nausea/vomiting)
70–100 mcg/dL	Nephropathy, colic, encephalopathy, seizures
> 100 mcg/dL	Central nervous system (CNS) crisis (cerebral edema, ischemia, seizure, coma, possible death)

Risk Factors

Age: under 6 years (peak risk: ages 1–2 years)

More time spent on floor
Increased hand-to-mouth behavior
High gastrointestinal absorption of lead
Rapid central nervous system development
Impacts critical periods of brain development

Children Enrolled in or Eligible for Services from a Publicly Funded Program for Low-Income Children

Medi-Cal
Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
Child Health and Disability Prevention Program (CHDP)
Head Start

Lives or spends significant amounts of time in pre-1978 housing or buildings

Paint in poor condition
Undergoing renovation
Exposure to lead-contaminated dust or soil
Lives near source of lead air emissions

Highways
Industrial
A general aviation airport used by small aircraft

Exposure to lead-contaminated water source

Contact with Lead-Contaminated Consumer Products

Including some:

Jewelry
Toys
Vinyl/Plastics
Art and Hobby Supplies
Types of dishware (traditional, imported, handmade, older, or damaged)
Other consumer products

Consumption or Use of Lead-Contaminated Food, Remedies, or Cosmetics

Including some:

Foods such as chapulines, candy, spices
Remedies and supplements
Traditional cosmetics and religious / ceremonial powders

Other

Family or household member who works with lead
Recent immigration/foreign adoptee from region with high environmental lead contamination, or spends time outside of the U.S.
Family or household member with hobby exposure (e.g., stained glass, welding, ceramics, firearms, fishing)
Sibling with elevated blood lead level
Mother with history of lead exposure/lead poisoning
Pica (ingestion of non-food items such as paint chips, dirt, plaster, clay, pottery)

Toxicology

Toxicological Profile for Lead, Agency for Toxic Substances and Disease Registry (ATSDR), Centers for Disease Control and Prevention (CDC)

Sources of Lead Exposure

Lead-based paint (pre-1978)
Lead-contaminated soil
Lead-contaminated dust from paint or soil
Take-home/hobby exposure
Food
Imported home remedies and imported cosmetics
Imported or handmade pottery and tableware with leaded glaze
Consumer products
CDC, Lead Exposure Sources Overview

Lead-based paint (pre-1978)

It may have been used both inside and outside of a home or on objects such as furniture. Children may eat paint chips or chew on the surfaces of windows, woodwork, walls, doors, or railings.

Further information on housing and abatement

California Department of Public Health (CDPH), Childhood Lead Poisoning Prevention Branch (CLPPB), Lead Hazard Reduction Section (LHRS)
US Environmental Protection Agency (EPA), Protect Your Family from Sources of Lead - Older Homes and Buildings
Department of Housing and Urban Development (HUD), Office of Lead Hazard Control and Healthy Homes (OLHCHH)

Lead-contaminated soil

Lead may be in the soil where children play, especially near busy roadways or factories. The lead from gasoline used for many years has settled onto soil and is difficult to remove. Lead in soil may also be from other sources of air emissions and deteriorated lead-based paint on homes. This soil may also be tracked inside on shoes and clothing.

EPA, Protect Your Family from Sources of Lead - Soil, Yards and Playgrounds

Lead-contaminated dust from paint or soil

Lead clings to windowsills, floors, doorways and children's toys, and is dangerous to young children who crawl and often put their hands and other objects in their mouths.

EPA, Protect Your Family from Sources of Lead - Dust

Take-home exposure

Children can be exposed to the lead in dust brought home on clothing, equipment, or in the car or truck driven from work, as well as lead in dust that comes from hobbies that use lead.

CDPH / OLPPP - Common Jobs, Hobbies and Other Sources of Lead (PDF)
CLPPB/OLPPP - Don't Take Lead Home From Your Job! (PDF)

Further information on lead exposure related to work, hobbies or other activities

OLPPP
OLPPP - Medical Management of Lead-Exposed Adults
CDC - Lead in Jobs, Hobbies, or Other Activities
CDC - Morbidity and Mortality Weekly Report (MMWR), Occupational and Take-Home Lead Poisoning Associated with Restoring Chemically-Stripped Furniture

Food

Candy

Some candies, especially those that contain chili, have been found to contain lead. Lead has also been found in wrappers and ceramic candy containers.

CDPH, Food and Drug Branch (FDB) - Lead in Candy Test Results
US Food and Drug Administration (FDA) - Guidance for Industry: Lead in Candy Likely To Be Consumed Frequently by Small Children
CDC, MMWR - Lead Poisoning Associated with Imported Candy and Powdered Food Coloring -- California and Michigan
CDC, MMWR - Childhood Lead Poisoning Associated with Tamarind Candy and Folk Remedies
CDPH Warns Consumers Not to Eat la Zagala Branch Fruit Pulp Tamarin Flavor Candy

Food and Spices

Lead has been found in some food including chapulines (grasshoppers), sweet cured plums, spices, and food in cans with lead solder (these cans have wide seams, and are not used in the U.S.)