In this episode, we discuss lead toxicity and lead screening. We will talk about what lead is, what happens when a child is exposed to lead, what to ask parents about if you’re worried about lead exposure, how to screen for lead toxicity, and what to do if your patient has an elevated lead level. 

Sources of lead exposure 
Ingestion of contaminated food or water
Ingestion or breathing in of lead dust
Other sources: lead-acid batteries, ammunition, lead-based pigments and paints, stained glass, lead crystal glasses, ceramic glazes, jewelry, toys
For families from other cultures, think about ceramic glazes, traditional cosmetics, traditional medicines


Government policies to decrease lead exposure
Unleaded gasoline
Lead-free paint
Lead-free solder in food cans
Lead-free water pipes


Why young children are at risk for lead toxicity
Hand-to-mouth behavior
Increased absorption of lead
Developing nervous system is vulnerable
Calcium or iron deficiency increase absorption of lead


Effects of lead toxicity in children can be seen at levels as low as 3.5 µg/dL
Growth and development delays
Lower IQ
Learning and behavior problems
Hearing and speech problems
School underperformance
At higher levels, you may see
Irritability
Loss of appetite, weight loss, fatigue
Abdominal pain, vomiting, and/or constipation
Anemia
Pica
Seizures, coma, death




Universal lead screening at 1 and 2 years
Screening questionnaires are not very sensitive or specific 
Blood lead test 
Capillary – get results quickly, but can be falsely elevated

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