General Lead InformationClick here to listen to a 2007 WCQS Evening Rounds interview (30 minutes). Participants include Linda Block, Dr. Olson Huff, and Dr. Susan Mims interviewed by David Hurand. (Warning: The recording was started a few seconds into the interview.)
Lead poisoning is one of the most common public health problems for children. According to the Centers for Disease Control and Prevention (CDC), lead poisoning also remains the foremost preventable disease of childhood. The primary cause of childhood lead poisoning is the ingestion of deteriorated lead-based paint and lead-contaminated dust and soil inside and outside the home. Lead-contaminated drinking water is another possible source, which research has shown can add up to about 20% of the total lead exposure. Children can ingest lead directly by eating "sweet tasting" paint chips or by ingesting lead contaminated house dust and soil during normal hand to mouth exploratory activities. Lead is also found in many unexpected places. Click here to learn other places where lead might hide. Blood lead levels are measured in micrograms per deciliter. Blood lead levels are currently classified as: 5-9 g/dl early detection 10-19 g/dl elevated, state action level 20 and above g/dl poisoned As science advances, we are likely to see the question about acceptable blood lead levels again become a cause for concern. A 2003 study in the New England Journal of Medicine has found that blood lead levels as low as 10 µg/dL (micrograms per deciliter) cause a 7 point reduction in a child's IQ compared to children with blood lead levels of 1 µg/dL. A 2005 study confirmed that low lead levels result in a drop in IQ and that a proportionally greater decrease is seen at lead levels <7.5 µg/dl. "The estimated IQ point decrements associated with an increase in blood lead from 2.4 to 10 µg/dL, 10 to 20 µg/dL, and 20 to 30 µg/dL were 3.9 (95% CI, 2.4-5.3), 1.9 (95% CI, 1.2-2.6), and 1.1 (95% CI, 0.7-1.5), respectively. For a given increase in blood lead, the lead-associated intellectual decrement for children with a maximal blood lead level < 7.5 µg/dL was significantly greater than that observed for those with a maximal blood lead level equal to or greater than 7.5 µg/dL (p = 0.015). We conclude that environmental lead exposure in children who have maximal blood lead levels < 7.5 µg/dL is associated with intellectual deficits." Lead is a toxic metal and a probable carcinogen. There is no safe amount of lead in the human or animal body. The Center for Disease Control states that lead poisoning is still the number one environmental disease for children in the United States , even though lead poisoning is completely preventable. For adults, lead most often enters our bodies through the inhalation of lead dust or fumes during renovation projects, our jobs, or hobbies. For children, their natural hand-to-mouth behavior and pica behavior (eating substances that are not normally eaten like soil or paint chips) makes them especially vulnerable to lead ingestion. Children most often ingest lead, lead dust, or paint chips that they encounter on floors, window sills and troughs, in soil, and in products that contain lead. Once in our bodies, lead is mostly stored in bones (70% for children to 90% for adults) and the remainder is stored in blood and kidneys. Some is excreted through the gastrointestinal tract (poop) or kidneys (pee). The half-life for lead in blood and kidneys is ~1 month however in bones it is ~25 years. Lead stored in bones may be released back into our blood stream during pregnancy, times of stress or illness, if a bone is broken, and in old age when our bones begin to break down. Lead has been shown to contribute to stillbirths, premature births, and low birth weights for babies. Many conditions that we now attribute to aging, such as high blood pressure, cataracts, dementia, and impaired kidney function have been linked to elevated lead concentrations. Between 1999-2002, the highest concentrations of lead in blood were found in children aged 1-5 years and in adults over 60. The three systems most affected by lead in our bodies are the nervous system made up of the central nervous system (brain and spinal cord) and peripheral nervous system (nerve fibers), the cardiovascular system (heart, blood, and vessels) including the blood forming system, and the kidneys. Return to TopThe most widely-used method of determining lead concentrations in our bodies is a blood analysis. Blood can be taken from a finger or vein. All children should be screened for lead at ages 1 and 2 and each year up to age 6 if any risk factors exist, such as living in a home built before 1950 or in a pre-1978 home that has undergone recent renovations. Lead screenings are free at the local health departments in Buncombe and Henderson counties for children 6 and under and for pregnant moms at risk, no appointment necessary. Currently only ~30% of children are being screened at ages 1 and 2 in Buncombe and Henderson counties. Hair analysis may give be a better indicator of long-term exposure for adults. Unfortunately, tools for measuring lead in bone are not on the market yet. Levels of lead in blood are measured in micrograms per deciliter (ug/dl). Although the level of concern is 10 ug/dl, much scientific evidence shows that low levels of lead, <10 ug/dl, can affect a child's IQ and behavior. Return to TopAcute poisoning happens due to a high intake of lead over a short amount of time such as someone sanding large surfaces of lead-based paint without a respirator. Symptoms may be abdominal pain (often severe) and constipation or diarrhea. Because it affects the nervous system, other symptoms may include irritability, fatigue, weakness, muscle pain, headache, or confusion. In severe cases lead causes swelling of the brain which produces symptoms such as vomiting, restlessness, tremors, and progressive drowsiness. Because lead affects the formation of red blood cells, anemia is another symptom. Health effects in severe cases include renal failure, convulsions, coma, or death. Return to TopChronic poisoning is accumulated small to medium exposures over time. Symptoms may not be present and if they are present, may seem unnoteworthy since they include common complaints such as irritability, stomach ache, headache, decreased appetite, diarrhea or constipation. Long-term health effects include impaired blood formation, nervous system damage, high blood pressure, reproductive system damage including low sex drive and fertility problems, kidney dysfunction, hearing loss, and damage to a developing fetus. Behavioral effects, due to affects on the nervous system, may include: Learning disabilities like Attention Deficit Disorder (ADD) Memory loss Decreased IQ and poor performance in school Difficulty understanding directions Reduced eye-hand coordination Hyperactivity Aggression Delinquency or anti-social behavior Return to Top1. Children under 6 years old
2. Fetuses Pregnant woman who are exposed to lead while pregnant can pass lead in the blood through the placenta Pregnant woman who were exposed to lead as a child have lead stored in bones. During pregnancy, lead is released from bones, along with calcium, and is passed to the fetus. Breast milk of lead-exposed women may also contain high levels of lead. Exposure during development of a fetus can result in stillbirths, premature births, low birth weight, and can affect a child's intellectual growth and behavioral and psychological development. 3. Those whose occupations or hobbies expose then to lead When is a home considered "child occupied"? If a child aged 6 or less spends at least 3 hours/day or 6 hours/week (combined from at least two visits/week) or 60 hours/year in a home, the location is considered child occupied. Return to TopLead is a metal which is mined from the earth. It is malleable and corrosion resistant. Historically, lead was added to paint as a pigment, to add durability and corrosion control, and as a drying agent. It also made paint more mold and mildew resistant. Although a federal regulation banned lead from residential use in 1978, it still, today, is an ingredient in many products, from industrial and auto body paints to soundproofing and putty to brass and vinyl products (including car keys and miniblinds) to off-road vehicle fuel. That said, dust from lead-based paint is still the main source of lead poisoning for children and adults. Lead paint was expensive and used sparingly. It is most commonly found on exterior surface, on interior and exterior windows, window troughs, and window frames, doors and door frames, and occasionally bathroom and kitchen walls. These were areas exposed to weather or to moisture that benefited from a more durable paint. Return to TopWhich houses are most likely to have lead-based paint? Some of today's house paints still contain small amounts of lead but not enough to meet the definition of lead-based, which is 0.06% lead or more. Lead-based paint was banned from residential use (residential surfaces, toys, and furniture) in 1978. Any house built before 1978 may contain lead-based paint (and some slightly newer homes too, if old paint supplies were used.) That said, those built before 1950 are most likely to contain lead since in the 1950s, titanium dioxide and latex paints became popular and in 1955 the lead industry established a voluntary industrial standard that lowered the amount of lead in paint. Return to TopIs an intact surface painted with lead-based paint a hazard? It depends where this surface is located. In general, if the paint is intact and there is no chipping, peeling, or chalking, it is not a hazard. If it is located such that a child can chew on the surface, like on a window sill, than it can be a hazard. If it is located on a friction or impact surface - a place where two components rub together like on windows or doors, or a place that gets foot traffic like stair treads - than it may be a hazard because lead dust can be produced. Lead particles are extremely small and can easily be spread around a home. Another way an intact surface can become a hazard is if someone cuts through or demolishes the surface. Any activity that disturbs the paint can create a lead dust hazard. Return to TopTo learn where lead-based paint exists in a home, hire a certified lead inspector. That person will conduct a surface-by-surface investigation of every component in every room and submit a final report. To learn about lead hazards and possible actions to reduce those hazards, hire a Risk Assessor. This person will test only those surfaces deemed to be a potential hazard and will include suggestions for repair and maintenance in the final report. If you live in Buncombe or Henderson county and own or rent a pre-1978 house where children aged 6 or less reside or where a pregnant woman resides, UNCA 's Lead Poisoning Prevention Program (LPPP) offers a free limited inspection for lead in paint, soil, water, and dust. In return, the parent must agree to have children tested for lead (free at the Health Department.) Call LPPP at 828-771-5821 for an appointment. Removing lead-based paint is very costly and work intensive. Paint removal is considered an abatement technique since it is considered a permanent solution but there are effective, inexpensive measures, termed interim controls , which can reduce hazards. Abatement must be done by a certified abatement contractor. The only exception to this rule is when a person owns and lives in the home to be abated. If only the immediate family is in the home and there are no children with elevated blood-lead levels, then the work can be done by the owner, although training is highly recommended. Abatement measures are considered permanent; however permanent is defined as 20 years.
Interim controls are generally inexpensive solutions to lead hazards but require routine maintenance. Paint stabilization - i.e. repair any chipping surfaces and the underlying cause of the damage (often water damage) and repaint. Friction and impact surface treatments - i.e. cover window trough with flashing Dust removal - i.e. wet mop, HEPA vacuum Soil barrier - i.e. temporary fencing, thorny bushes, vegetation, sod Return to TopWhat are some no-nos in working with lead-based paint? Uncontrolled hydroblasting Burning lead-based paint Abrasion without a HEPA filter Dry scraping or sanding (except 2" around electrical outlets) Heat guns over 1100 F Methylene chloride for stripper Return to TopThe new EPA Lead-Based Paint Renovation, Repair and Painting rule, April 2008, will require individuals and firms conducting lead-based paint activities for pay in housing and child-occupied facilities built before 1978 to be certified and follow certain work practice standards. Training programs must be accredited. The North Carolina Lead-Based Paint Hazard Management Program (LHMP) is administered by Health Hazards Control . They provide lead information and certify firms and individuals conducting lead-based paint management activities. Health Hazards Control accredits training courses, issues permits for lead-based paint abatement projects, inspects lead-based paint abatement projects, and responds to citizens' complaints. For more information on the management of lead-based paint hazards in North Carolina , contact Health Hazards Control at (919) 707-5950 . Return to TopSoil can become contaminated with lead through past or present exposure to chipping lead-based paint, leaded gasoline (especially near roadways or old filling stations), car batteries, pesticides, or fall out from factory emissions. Lead contaminated soil is most often found around the roof drip line and near roadways. Lead-contaminated soil is harmful if ingested by children, brought into a home on shoes or pet fur, or blown into open windows. Vegetable gardens should not be grown in contaminated soil (i.e. next to a house with chipping lead-based paint) since plants can take up lead. What to do about lead in soil
What to do about lead dust
Lead pipes have been used for plumbing throughout time. Historically, the Romans built their extensive aqueduct systems with lead pipes and the fall of their empire is often attributed to lead poisoning from the resulting water contamination. Interestingly, the word plumber is derived from the Latin word for lead, plumbum. Houses built before 1986 may have lead pipes, galvanized pipes (which contain lead), or copper pipes soldered with lead. All of these are a source of lead contamination in drinking water. In 1986, the US banned lead from use in new drinking-water-supply pipes and from flux and solder used to join these pipes. (The N.C. Building Code Council banned lead solder in 1985.) Lead-safe pipes are not lead-free - by definition they can contain up to 8% lead. Lead-free solder can contain up to 0.2% lead. Brass or bronze plumbing fixtures or well pumps are potential source of lead. Chrome-plated faucets, for example, are generally made of brass, which contains 3 to 8 percent lead. Contamination can occur when water comes in contact with these fixtures. Water that is highly acidic or highly basic is considered corrosive and can dissolve lead from pipes, solder, and fixtures more easily. Hard water, with lots of minerals, can offer some protection as it may cause mineral buildup on the inside of pipes thus reducing the contact of water with the lead. Most of the lead in drinking water in North Carolina comes from the lead in the plumbing in the house, not from the local treatment plant or well. Because of this, rather than limit the amount of lead which may legally be present in municipally-supplied water, each municipal system must now target high risk households (based on materials used in the delivery system and other factors) and analyze tap water samples from these households for lead. If the lead level exceeds the 15 ppb action level in 10 percent or more of the taps sampled, then these three steps must be initiated by the supplier:
Finally, if the above steps do not reduce the lead level at the tap to the 15 ppb action level, then the municipal system must replace lead delivery system components which contribute more than 15 ppb to tap water lead levels. http://www.bae.ncsu.edu/programs/extension/publicat/wqwm/he395.html What to do about lead in drinking water
http://www.bae.ncsu.edu/programs/extension/publicat/wqwm/he395.html Laws Return to TopThe state of NC passed the Residential Agreement Act which states that a property owner or real estate manager must "maintain rental property in a fit and habitable condition." This language remains undefined. Return to TopNC Preventive Maintenance Program (PMP) In 1997 North Carolina adopted the Childhood Lead Exposure Control Act which established a voluntary Preventive Maintenance Program to insure safer housing for renters. In return for keeping a lead-safe home, landlords receive liability protection and a state-issued certificate of compliance. Requirements: 1. On an annual basis, visually inspect the condition of pre-1978 residential rental property, and if needed:
2. For pre-1950's single-family and duplex units, also repair and repaint exterior deteriorated surfaces and correct the cause of deterioration. Areas of bare soil within three feet of the building foundation must also be covered with grass or mulch. 3. Provide occupants with the following information:
4. Encourage you property maintenance staff to attend a lead-safe maintenance class. 5. Verify compliance with the preventive maintenance standard each year by having a certified inspector conduct an inspection and submit a written report to the NC Department of Environment and Natural Resources. To receive a certificate of compliance, the property owner or managing agent must provide the following: 1. A signed statement from the occupants (if any), saying they received information about lead paint hazards. 2. A written report of the inspection conducted by a certified lead inspector or risk assessor; and 3. The laboratory analysis of lead dust samples. http://www.deh.enr.state.nc.us/ehs/Children_Health/Lead/NC_PMP/What_is_PMP.pdf Planning guide available at: http://www.deh.enr.state.nc.us/ehs/Children_Health/PMP_Planning_Guide-NEW04.pdf For more information, contact: North Carolina Department of Environmental and Natural Resources, Division of Environmental Health Children's Environmental Health Branch 1632 Mail Service Center , Raleigh , NC 27699-1632 Telephone: (888) 774-0071 ; Fax: (919) 715-4739 Return to TopFederal Residential Lead-based Paint Hazard Reduction Act Title X of the Residential Lead-based Paint Hazard Reduction Act of 1992 includes requirements for disclosure of known lead-based paint or lead-based paint hazards in housing. This act became fully effective in 1996.
Exemptions include:
Federal Pre-renovation and Education rule A 1999 EPA regulation requires that: Prior to the start of their project, residential property owners/managers, general or special contractors (painters, plumbers, carpenters, electricians), or anyone working for compensation distribute the EPA pamphlet Protect Your Family From Lead In Your Home to owners and occupants of most housing built prior to 1978 in a language they can understand and obtain a signature confirming receipt. If delivered by mail, it must be sent 7 days prior to the start date and a certificate of mailing from the post office can serve as proof. Keep records for 3 years. Before renovating common areas (e.g., hallways, stair wells) in multi-family housing, renovators must inform building residents about the nature and extent of the planned work and make the pamphlet available in a central location. This should be documented and records kept for 3 years after the completion of the project. Renovation means sanding, scraping, and other surface preparation activities that disrupt an area greater than 2 square feet of paint per component and which generate dust or fumes. The rule applies to most private housing, public housing, federally owned housing, and housing receiving Federal assistance. Renovation does not include routine maintenance or repair, emergency renovation operations (specifically defined in the rule), work performed on housing for the elderly (unless children live there) or on zero-bedroom units (efficiencies, lofts, and dormitories), and renovation activities that take place in housing that has already been determined by a certified inspector to be lead free. You can contact the EPA at 1-800-424-LEAD or 404-562-8989 . http://www.epa.gov/lead/leadrenf.htm Return to Top |
Lead is a dangerous and pervasive poison that damages virtually every system in the body. Lead is not naturally in our bodies, and no safety threshold has been established for lead. Anyone at any age-even pets-can become poisoned by lead. Because lead is harmful to the developing brain and nervous system, exposure to lead is especially dangerous to fetuses and young children. Lead in a young child's system hinders neurological development and can lower intelligence levels. Children are particularly at risk for lead poisoning because: