growing evidence that even low levels of lead can cause permanent cognitive,
academic and behavioral difficulties in children, the AAP urges national
commitment to eliminating its sources before exposure occurs.
ELK GROVE VILLAGE, IL – Even at
half the levels previously considered safe, growing evidence shows a child’s
exposure to lead can cause irreversible cognitive and behavioral problems. In
updated recommendations published online Monday, June 20, the American Academy
of Pediatrics (AAP) urges policy makers and the medical community to take new
action to protect children from this critical health threat.
The AAP calls for stricter
regulations, expanded federal resources and joint action by government
officials and pediatricians in the policy statement, “Prevention of Childhood Lead Toxicity
,” published in July 2016 Pediatrics. Identifying and
eliminating sources before exposure occurs is the only reliable way to protect
kids from lead poisoning.
“We now know that there is no
safe level of blood lead concentration for children, and the best ‘treatment’
for lead poisoning is to prevent any exposure before it happens,” said Dr.
Jennifer Lowry, MD, FAACT, FAAP, chair of the AAP Council on Environmental
Health and an author of the policy statement. "Most existing lead
standards fail to protect children. They provide only an illusion of safety.
Instead we need to expand the funding and technical guidance for local and
state governments to remove lead hazards from children's homes, and we need
federal standards that will truly protect children."
The AAP calls for new federal
standards defining and testing for lead hazards in house dust, water and soil.
It also urges legal requirements that lead be removed from contaminated housing
and child care facilities and to ensure water fountains in schools do not
exceed water lead concentrations of more than 1 part per billion.
Until recently, children were
identified as having a blood lead “level of concern” if test results showed a
concentration of 10 or more micrograms per deciliter. But extensive evidence
now indicates problems begin at levels less than half that amount, including
lower IQ scores and academic performance, inattention, impulsivity, aggression and
Preventing young children from
ever coming into contact with the metal would have substantial population-wide
benefits -- saving more than 20 million total IQ points among U.S. children and
billions of dollars in annual costs associated with lead exposure. For
every $1 invested to reduce lead hazards in housing units, for example, society
would benefit by an estimated $17 to $221–-a cost-benefit ratio comparable with
that for childhood vaccines.
"Eliminating lead from
anywhere children can be exposed to it should be a national priority,"
said AAP President Benard Dreyer, MD, FAAP. “The drinking water crisis in Flint
was just one indication of how our country’s aging infrastructure is
jeopardizing children’s health, especially in areas already dealing with toxic
effects of poverty,” he said. An estimated 37 million homes in the United
States still contain lead-based paint, for example.
Despite dramatic drops in
children’s blood lead concentrations after the U.S. eliminated lead from gasoline,
paints and other consumer products, children are still exposed to lead in their
homes and communities. Children's risk of lead exposure increases as soon as
they begin crawling and teething. Children who live in older homes that are
poorly maintained, or being renovated, are at particular risk. So are those who
live near airports and factories, where lead-contaminated exhaust has settled
into the soil, or where pollution from rivers and lakes have leached lead from
aging pipes into the tap water. Some toys, dishware, vinyl miniblinds, imported
aluminum cans, hobby materials and other consumer products also contain lead.
Adults who work in certain settings such as firearms ranges, where lead dust is
prevalent from the use of lead bullets, also can expose children to lead on
The AAP recommends pediatricians
and other primary care providers conduct targeted screening of children for
elevated blood lead concentrations if they are between 12 and 24 months of age
and live in areas where 25 percent or more of housing was built before
1960. They should monitor children who have blood lead concentrations of
more than 5 micrograms per deciliter and routinely recommend individual
assessments of older housing, particularly if it is not well-maintained or has
undergone renovation or repair within the past six months that may have
generated lead-contaminated dust.
The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org