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While a child's chronic exposure to relatively low lead levels may result in learning or behavioral problems, Wykoff says that "higher levels of exposure can be associated with anemia and changes in kidney function, as well as significant changes in the nervous system that may, at extreme exposures, include seizures, coma and death."

In adults, lead poisoning can contribute to high blood pressure and damage to the reproductive organs. Severe lead poisoning can cause subtle loss of recently acquired skills, listlessness, bizarre behavior, incoordination, vomiting, altered consciousness, and — as with children — seizures, coma and death. Poisoning without severe brain effects can cause lethargy, appetite loss, sporadic vomiting, abdominal pain, and constipation.

By the time symptoms appear, damage is often already irreversible.

"The most important thing for families to do," says Baltimore's Davoli, "is to learn what steps they can take to prevent lead poisoning. We don't want to get to treatment. And they should take their children to the doctor regularly for checkups and, if the children are at risk, get blood lead tests done."

Critical to prevention is focusing on the important lead sources. FDA's Rosenthal says, "Dealing with sources of lead means recognizing them in your family's environment, knowing which ones contribute significant exposures, and eliminating or avoiding those exposures."

Top Contaminator: Lead Paint

America's No. 1 source of lead exposure in children is deteriorating lead paint in older housing. Because young children frequently put their thumbs and fingers and objects they handle in their mouths, they are easily poisoned from chronic ingestion of lead paint chips and house dust or soil that may have lead particles in it.

The Consumer Product Safety Commission (CPSC) banned house paint having more than 0.06 percent lead in 1978. But housing built before then, particularly before 1950, may contain lead paint. The Environmental Protection Agency and Department of Housing and Urban Development require owners of pre-1978 housing to give prospective buyers or renters federally approved information on the risk. Buyers must have 10 days to inspect for lead-based paint before being obligated by a contract.

Improper housing renovation increases exposure. The riskiest practices are sanding, scraping or removing lead paint with a heat gun, which taint the air with lead paint dust. CPSC warns: There is no completely safe method for do-it-yourself removal of lead paint. Only experts should remove lead paint.

For more information about lead paint, see "Protect Your Family from Lead Poisoning."

Occupational Hazards

Clark Carrington, Ph.D., of FDA's dairy foods and beverages contaminants branch, names workplace exposure as the next major potential source of lead. Besides their own exposures, workers may bring lead dust home on clothes, hands or hair, exposing children in the household.

Occupations that may expose workers to lead include painting, smelters, firearms instruction, automotive repair, brass or copper foundries, and bridge, tunnel and elevated highway construction.

To help protect workers from such exposure, the Occupational Safety and Health Administration calls for removal of workers from the workplace if their blood lead levels reach 50 mcg/dL. EPA limits lead emissions from certain industries.

Keeping Drinking Water Safe

Certain drinking water systems can also pose a lead risk.

Under EPA rules, if lead exceeds 15 parts per billion (ppb) in more than 10 percent of public water taps sampled, the system must undergo a series of corrosion control treatments. The main culprits are corroded lead plumbing, lead solder on copper plumbing, and brass faucets. Lead is highest in water left in pipes for a long time — for example, when the faucet isn't used overnight.

FDA's quality standard for bottled water requires that lead not be present at 5 ppb, the lowest concentration that generally available methods for water analysis can reliably measure. If bottled water contains lead above this level, it is subject to regulatory action, including removal from the marketplace.

Lead in Ceramicware

Some ceramicware has lead in the glaze and may introduce small amounts of lead in the diet, which the body can tolerate, says Carrington. "The major problem with ceramicware is the rare poorly made piece with very high levels of leaching lead."

Bolger adds that even with these pieces, risk varies. "A plate coming in brief contact with food is not an issue," he says, "but storage of food in such a bowl or pitcher is a risk." It's especially wise to avoid storing acidic foods like juice and vinegar in ceramicware, as acids promote lead leaching.

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www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.