Lead Poisoning Among Children Outside the United States

What's the Problem?

Lead, a naturally occurring element, can be toxic when taken into the body through breathing, eating, or drinking. Lead is most dangerous to children, especially to those younger than six years. Lead poisoning can affect virtually every body system; it can damage a child's central nervous system, kidneys, and reproductive system. At high levels, lead can cause coma, convulsions, and death. Even low levels of lead in young children's blood can be harmful and can result in decreased intelligence, impaired neurobehavioral development, decreased stature and growth, and impaired hearing. Because childhood lead poisoning often has no distinctive clinical symptoms, it may not be recognized.

Childhood lead poisoning among populations outside the United States varies by source and by country. Even within countries, lead exposure may also vary by ethnic group or income level. Although exposures from deteriorated lead-based paint and from lead-contaminated dust and soil remain significant sources of lead poisoning in the United States, in other countries important sources include leaded gasoline exhaust; industrial emissions; cottage industries (e.g., battery breaking and recycling plants); traditional medicines; and some cosmetics, ceramic ware, and drinking water.

Who's at Risk?

Children under the age of six years are at the greatest risk for lead poisoning since their brains and nervous systems are still undergoing development. Pregnant women are also at particular risk. Because lead easily crosses the placenta, blood levels that do little damage to adults may be very harmful to fetal development.

Can It Be Prevented?

Lead poisoning is entirely preventable. Stopping children from coming into contact with lead is the key to prevention. Lead hazards in a child's environment must be identified and eliminated. Public and private health care professionals, policy-makers, and parents need to be educated about lead poisoning and about ways to prevent it. Lack of knowledge about lead poisoning and its causes often delays parents from taking appropriate safety measures. Lead poisoning is frequently silent: most lead-poisoned children have no symptoms. Children who are at risk for lead poisoning need to be identified, tested, and, if necessary, treated.

The Bottom Line

The predominant sources of lead poisoning among children in countries outside the United States vary. It is important to determine the possible source of lead contamination in an area and to take the appropriate steps to prevent and reduce exposure. Ways to prevent and reduce exposure include:

• Frequently wash a child's hands, pacifiers, and toys because these can become contaminated with lead-containing paint, dust or soil. Children often place their hands and other objects into their mouths.
• Damp-mop floors and damp-wipe surfaces while cleaning your home to reduce exposure to lead from dust, soil and deteriorating paint.
• Parents whose work involves lead-containing products (e.g., automobile battery manufacturing and recycling) should shower and change clothes after finishing work. These simple precautions can decrease people's exposure to lead and prevent carrying lead home on their clothes, skin, or hair.
• Families should stop using traditional medicines that contain lead (e.g., arzacon and greta, which are used for upset stomach or indigestion; pay-loo-ah, which is used for rash or fever).
• Families should discontinue use of certain cosmetics that contain lead (e.g., kohl and alkohl).
• Families should not prepare or store foods and beverages in lowfire ceramic ware that is contaminated with a lead glaze (e.g., cooking utensils, bowls, pots, and pitchers).
• Families who live in older housing, especially those that have young children who live or visit with them, should contact their local health officials to have their homes and soil tested for lead.
• Use only cold water from the tap for drinking, cooking, and for making baby formula. Hot water is more likely to contain higher levels of lead. Lead in household water may come from the older plumbing in your house or from the direct water supply depending on the regulations of a specific country.

Case Example

A mother brings her two-year-old daughter to the local health clinic. The child is experiencing lethargy and abdominal pain. As the health care provider takes the child's medical history, the mother mentions that she regularly has been giving her daughter –greta" (a traditional Mexican remedy used as a laxative). Suspecting that the child could have lead poisoning, the health care provider tests the child for lead. The results show an elevated blood lead level. The health care provider counsels the family about lead poisoning and its prevention (e.g., stopping the use of traditional remedies and the use of lead-glazed ceramic ware) and immediately notifies the local health officials. Health officials visit the child's home and confirm that the use of –greta" was the sole source of the child's elevated blood lead level. The mother discontinues the use of –greta" and other traditional health remedies used in her home.