RESEARCH








Prevention Measures

LEAD POISONING GUIDE FOR FAMILIES

Contents

Lead and your family’s health

Who is at risk

Pregnant and breastfeeding women

Young children are at greater risk

Workers in lead industries

Home renovators

People living near lead industries or main roads

People whose hobbies use lead

Sources and exposures

The danger of lead paint

Lead-contaminated dust

Lead in the workplace

Other sources of lead

Exposure - how lead gets into people

Health Effects and Symptoms

‘Mystery’ symptoms - what to look for

Behavioral and social problems

Symptoms of exposure to different lead levels

Testing for lead

What you can do

Reduce or remove exposure to lead

Stop lead hazards from happening

Eating well

Don’t do-it-yourself

Reduce your exposure at work

Ask yourself

Lead and your family’s health

Lead is a metal which, because it is cheap and useful, is found in many products and in many places in the environment.

Lead entering our bodies may cause serious long-term health problems, especially for young children. So it’s important that you know about lead poisoning and how it is caused, -- especially if you are a parent, or plan to be one.

You can take many simple actions that will protect you and your family from lead.

Who is at risk?

While lead can affect anybody, some people in the community are more at risk than others. This can be due to:

• your age

• your health (particularly if you are pregnant or have a poor diet)

• your job or hobbies

• your home (its age and condition)

• where you live (such as near lead industries)

Why each of these groups is at greater risk is discussed below. Some people may be exposed to lead in more ways than one. For example, a person may work in a lead industry, such as battery breaking or making jewelry, and also may live in a home that contains lead paint.

Pregnant and breastfeeding women

Pregnant and breastfeeding women can pass lead on to their babies. Care must be taken to avoid or reduce exposure to lead during pregnancy and breastfeeding. All people store lead in their body, - mainly in the bones. As women’s bodies change during pregnancy, previously stored lead can be released from the bones and affect the health of the developing fetus. This can be serious if the woman has high lead levels and is not eating enough calcium, iron or zinc. There is some evidence that lead can increase the risk of pre-term delivery, low birth weight, miscarriage and stillbirth.

Young children are at greater risk

The toxic effects of lead are particularly damaging to the fetus and children under four.

This is because:

  • their developing brain and nervous systems are more vulnerable
  • children absorb a much higher proportion of lead than adults if it is swallowed,

up to 50 per cent compared to 10 per cent in adults

  • normal behaviors in young children (e.g. hand-to-mouth activity, crawling, chewing

on objects) make them more likely to find and swallow lead if their surroundings

are contaminated.

  • Children who constantly eat non-food substances (e.g. dirt) are at even greater risk.

Workers in lead industries

People with jobs where lead is used are at most risk as they can be exposed to high levels of lead over a long period of time. They can breathe in or accidentally eat lead-contaminated food, water etc. Smokers can breathe in lead dust that has settled on their cigarettes. If you work in a lead industry, you may bring lead dust home on your clothes or tools, or in your car, and contaminate your house and family.

Work hazards

Occupations most at risk include:

• automotive body or radiator repairers

• battery breakers, recyclers or manufacturers

• brass or copper foundry workers

• bridge, tunnel and tower workers

• building, construction and demolition workers (including painters, plumbers and pipe

fitters)

• cable manufacturing and splicing

• ceramic and jewellery workers

• lead mining, smelting and processing

• paint, pigments and shellac factory workers

• petrol refinery/service station workers

• scrap metal merchants

Home renovators

Many painted houses and buildings contain lead paint. White and bright yellows, oranges and red paint often contain lead. Some types of house paints currently manufactured in India have been found to contain over 20% lead. Some types of industrial or special use paints (road marking, marine, automotive, sign painting etc) may contain even higher lead levels than those used in homes - check the label. If you’re renovating a home which was painted with bright coloured paint and which may contain lead, adults, children or pets can easily breathe in or swallow lead dust and particles if precautions are not taken.

People living near lead industries or main roads

People who live near industries which produce or use lead can be exposed to more lead than others may, since lead dust and other emissions in the air may have fallen in their homes and gardens. People living or working near heavy traffic locations may be at higher risk, as exhaust from leaded petrol can contaminate the environment. Inhaling fumes from leaded petrol causes increases in blood lead level across the whole population. However, reducing the use of leaded petrol and reducing amounts of lead in the petrol will result in a decline in such risks, especially to people who live near main urban thoroughfares.

Sources and exposures

Lead is widely used and found in many common consumer products and many places in the environment. Lead from such sources can enter and contaminate your home and surroundings. Dust can be tracked into homes and yards from the street. It can contaminate soft furnishings like carpets, blankets, soft chairs, and a baby’s soft toys. It can build up over the years in the soil in your garden or in the dust in your ceiling. It can also remain as paint, coating your doors, windowsills, children’s furniture such as cots or children’s toys.

The danger of lead paint

Many cases of acute lead poisoning in children admitted to children’s hospitals in recent years have been attributed to home renovation activities that disturb lead paint. Lead becomes a danger when activities deal with existing lead paint or dust in the house, or create new lead dust hazards. Unsafe renovations where old lead paint is removed or prepared for painting are the most common cause of lead poisoning. Open-flame torches create dangerous fumes. Dry sanding without water creates lead dust. Fumes and dust can be breathed in, accidentally eaten, and they can contaminate the house, its contents and the surrounding area. You can do renovations safely if you take simple precautions and use the right equipment.

Lead-contaminated dust

Many older homes and buildings have lead dust in their ceiling cavities, cavities in walls and under the floor. This dust has built up over many years from many sources such as:

• industrial pollution from power stations, incinerators, car repair sites, mines and smelters

• exhaust emissions from the use of leaded petrol

• unsafe renovations and demolitions

• pollution from wood burning or coal-burning.

Demolition of walls, floors or ceilings can disturb lead paint and dust. Any work that disturbs dust may be hazardous. Once the dust is released into living spaces it can contaminate soft furnishings, carpets, soil, food and water and is very difficult to remove.

There are many simple precautions you can take to reduce the hazard from lead dust.

Lead in the workplace

As mentioned earlier, breathing in lead particles or fumes is a particular hazard for workers in many industries which use lead or lead-based products. Adults may ingest lead through eating, smoking, chewing betel or nail-biting on lead contaminated hands, particularly after work which involve melting or casting lead, or work such as burning, scraping or sanding lead paint or lead objects which involve disturbance or creation of lead dusts or lead fumes. Parents working in these industries can accidentally ‘take home’ lead dust on their work clothes, hair, skin and vehicles and pass it on to their children.

Other sources of lead

Petrol

Continuing use of lead in petrol exposes the entire community to lead through car emissions in the air. However, reducing the use of leaded petrol and reducing amounts of lead in the petrol will result in a decline in lead in the air we breathe, especially to people who live near main urban thoroughfares. Lead also can enter the body when leaded petrol comes into contact with the skin.

Food

Food may be contaminated in these ways:

  • Soil, pesticide or zinc fertiliser containing lead may be taken up into a root plant or deposited on leafy plants. Lead emissions from cars or industry may be deposited on plants grown in home or market gardens near main roads.

  • Foods or beverages, particularly acidic foods such as pineapples, pickles and tomatoes, may be packed in cans with lead-solder side seams or processed by equipment containing lead soldering. Foods or beverages may be stored, cooked, reheated or served in lead-glazed ceramics or porcelain, cookpots ‘tinned’ with a lead-tin mixture, brass cooking or serving vessels, or leaded crystal or glass. Spices and food colouring may also be contaminated with lead from petrol emissions, lead pigments or painted storage containers.

Water

Lead in drinking water may not be a common source of lead in India. The major source is the corrosion of leaded plumbing materials in the water supply and household plumbing. Contamination can arise from lead connectors, lead and PVC piping, lead-soldered joins in copper and brass faucets and other fittings containing lead.

Water from lead-soldered water tanks or run-off systems from roofing with lead-based paint also pose a risk, especially in areas near mining and smelting sites where dust and emissions could add to the problem.

Consumer products containing lead

Some consumer products can contain lead:

• old toys, soldiers and model cars

• some imported painted jewelry, buttons etc

• certain Ayurvedic and Indian system medicines and remedies

• some cosmetics, including kohl, surma, henna, hair dyes and treatments

Exposure - how lead gets into people

Lead gets into our bodies when we breathe in air which has lead fumes or dust in it, or if we eat food or drink water which contains lead. If breathed in or eaten often enough, small amounts of lead can build up in the body and cause health problems for you and your family. Normal behaviors in young children (e.g. hand-to-mouth activity, crawling, chewing on objects) makes them more likely to find and swallow lead if their surroundings are contaminated, particularly with lead dust or lead contaminated soil. Older children may deliberately swallow soil, paint flakes or other objects or suck fingers or toys which have come into contact with contaminated soil and dust. They can suck or chew windowsills, skirting boards and doorjambs coated in lead paint or dust.

Adults can swallow lead through eating, smoking or nail biting with lead contaminated hands, particularly following work activities that might leave lead dust on their hands or work areas. If you smoke, don’t smoke or carry cigarettes in the work area, as they can be contaminated with lead dust that you can breathe in when smoking. If your hands might be contaminated with lead dust, wash hands before smoking to stop lead entering your mouth.

Health effects and symptoms

Exposure to lead can have a broad range of health effects depending on the amount of lead and the length of exposure. Generally, the greater the exposure, the greater the impact on health, though children will be more affected at lower levels of exposure than adults.

‘Mystery’ symptoms - what to look for

The symptoms of lead poisoning may not be present, or may be mistaken for some other health or behaviour problem. They may be something of a mystery. The signs of high lead levels are similar in children and adults, but children show symptoms at lower levels than adults do. If your child does display some of these symptoms, answer the questions on section ‘Ask Yourself’, check out your home or work environment for lead hazards and ask your doctor.

Behavioral and social problems

Excessive lead in children aged up to four years may cause learning disabilities, slowed growth, poor hearing and behavioural problems like hyperactivity and aggressiveness.

High levels of lead in children over four, teenagers and adults have been linked to poor

performance at school and work, lower IQ, reading and vocabulary difficulties, problems with coordination and increased absenteeism.

Testing for lead

It is often difficult to see that symptoms of ill health are due to lead. Tell your doctor about any possible exposure to lead which you or your family may have experienced. Answer the questions in section ‘Ask Yourself’. If you think there is a risk to you or your family, have a blood test - it is the best way to check for lead poisoning. The test shows how much lead is in the blood. If you suspect, have a blood test of your children if they:

• are aged up to four years and live in areas where lead could be present

• have brothers or sisters with high blood lead levels or if you work with lead

• have pica (habitual eating of non-food items e.g. dirt)

• are aged up to four years and live near an active lead mine, smelter, battery recycling

plant or other industry likely to release lead

• live near heavy road traffic areas

• have developmental delays.

As an adult, you should also have a blood test if you have any of the symptoms above, especially if you work in industries or have hobbies which use lead. Ask your doctor or health care professional about blood tests for lead.

The dangers of lead

Exposure to lead is linked to:

Pregnant women

and unborn children

• pre-term delivery

• low birth weight

• miscarriage and stillbirth.

Children

• damage to the brain and nervous system in children up to age 4

• impaired growth and IQ

• poor hearing

• learning difficulties

• hyperactivity and aggressiveness

• social and behavioral problems.

Adults

• loss of libido, infertility

• aggressiveness and higher blood pressure

• loss of appetite, constipation

• anemia

• in severe cases, paralysis, fits, swelling of the brain, seizures, coma and death.

Symptoms of exposure to different lead levels

The table below shows the symptoms caused by ‘moderate’, ‘severe’ and ‘medical emergency’ levels of lead in the blood.

What you can do

The best solution to reducing lead hazards is to avoid being exposed in the first place.

If you are already being exposed then you must reduce your exposure. Find sources of hazards in the home and at work and eliminate them. Reducing hazards reduces exposure and risk.

Reduce or remove exposure to lead

This means stopping your or your children’s contact with lead; here are some suggestions:

  1. Reduce or remove exposure to lead. This means preventing children or adults from having access to sources of lead or hazard situations. For example, move work involving lead out of dwellings and away from food preparation and living areas, replace older cooking pots where lead/tin solder may have been used on recent repairs, move children or pregnant women away from sources of exposure to lead, and discourage children from sucking dirty fingers or toys.
  2. Reduce or remove the hazard. This means addressing existing contamination and removing the hazard itself; for example, washing food preparation surfaces before cooking or making meals, cooking spices and covering cookware to prevent dust accumulation, replacing or covering contaminated soil with organic materials or other covering.
  3. Prevent the creation of lead hazards. Don’t bring lead hazard activities such as battery breaking or jewelry work into living areas at home.

When renovating or disturbing lead paint

• Move out pregnant women and children.

• Don’t use blowtorches or sanders on lead paint.

• Contain lead paint dust and debris within work areas.

• Protect yourself with safety masks or coveralls.

Old lead paint

• Test paint in your house or assume it is present.

• Check your house for peeling or deteriorating paint.

• Protect yourself and your family when disturbing lead paint.

• Prepare the work area and use the right equipment.

• Dispose of waste and clean up safely.

Stop lead hazards from happening

If you’re renovating an older home, a test for the presence of old lead paint will help you prevent hazards. If you’re not sure or not planning to test it, then assume the paint has lead in it and take the necessary precautions.

Children and pregnant women should be out of the home when lead removal is carried out, or when unsafe renovations which may disturb lead paint are going on.

Other things you can do include:

• remove or seal off soft furnishings before renovation or paint removal work and seal off

work areas with plastic and taping to prevent contamination with paint flakes and dust

• ensure workers clean the work area daily during renovations and thoroughly clean your

home and dispose of debris before children or pregnant women return

• prevent the use of blowtorches, arc welders or high temperature heat guns which burn

paint and create lead fumes.

• avoid using blasting or power equipment if possible. Power sanders create large amounts

of dust which can contaminate the house and yard. If this equipment is to be used, the

surface should be wet during the work and dust contained within the work area.

Eating well

Lead is absorbed more easily if your diet lacks essential minerals such as iron, calcium and zinc. To reduce the amount of lead the body absorbs if it is inhaled or swallowed, make sure your family - especially young children and pregnant women - has a diet low in fat and rich in:

• calcium (milk, cheese, yogurt, nuts - especially almonds)

• iron (eggs, lean red meat and poultry, liver, fish, cereal, beans, peas, lentils, dark green

leafy vegetables)

• zinc (wheat bran, yeast products, red meat and liver, oysters and crab).

Too much fat also aids lead absorption (but there is no evidence that a low fat diet minimizes absorption). Frequent nutritious meals are important for children. Food in the stomach decreases the absorption of lead from non-food sources.

Reduce your exposure at work

Employers should provide workers with a lead safe workplace and employees need to be aware of the hazard. If you work in a lead industry:

• wash hands, face and hair, and change clothes before you finish work

• if you smoke, don’t carry cigarettes or smoke in the work area, as you can breathe in

lead dust in the cigarette smoke; wash hands before smoking, to stop lead on your hands

entering your mouth

• wash work clothes separately from all other clothes and rinse the washing machine

afterwards

• contact an occupational health specialist if you’re concerned.

Fix up your yard

• Keep young children away from bare soil where lead work such as battery breaking or

jewelry repair has taken place.

• Remove, turn over or mulch contaminated soil to prevent exposure.

• Cover bare areas of soil that may be contaminated with lead.

• Move children’s play areas to uncontaminated parts of the yard.

• Test the soil.

Ask yourself…

If you think you or your family may have a health problem caused by lead,

ask yourself the following questions.

About your neighborhood

1. Do you live near an active lead mine, smelter, battery recycling

plant or other industry likely to release lead?

2. Is your home on land which was previously used for industrial

purposes that may have involved lead?

3. Is your home near a major road or traffic intersection?

4. Are car parks or garages located close to entrances or windows

in your home?

5. Have older structures nearby - such as bridges, water tanks

or towers - been renovated recently?

About your family and friends

6. Does your child regularly visit a house with peeling or chipping

paint (schools or homes of baby-sitters or relatives.)

7. Does your child have pica, or chew or eat non-food items, or suck

his/her thumb excessively?

8. Do you or family members have a job or hobby which involves

exposure to lead?

9. Do you have pets (especially furry ones)?

About your house

10. When was your home built or painted? Is lead paint likely to have been used?

11. Have unsafe renovations been carried out recently?

12. Has landfill been used in the grounds of the home?

13. Does your home have bare areas of soil or sandpits where lead work may have taken

place?

14. Have unsafe renovations taken place in your home without a thorough clean-up being

carried out?

If you answer Yes to any of these questions ask your doctor if a blood lead test is necessary for you or your children.

Want more information?

Ask your doctor or health care professional if you want to know more about illness from lead.

This has been adapted from ‘A guide for healthcare providers’, a publication of the Lead Reference Center, New South Wales Environment Protection Authority, Australia.

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