For many parents, lead poisoning might sound like a problem of the past, but the truth is that it still poses a risk today and is even sometimes found in surprising sources. The good news, however, is that there are concrete steps that parents can take to keep their families safe. The most important first step is to educate yourself on what lead is, where it comes from and how to prevent lead exposure.

What is lead, and how does lead poisoning affect one’s health?
Lead is a toxic metal found naturally in the environment that can disrupt the normal functioning of vital organs, including the kidneys, muscles and brain. Unlike many other harmful substances that the body can process and eliminate more quickly, lead accumulates in the body over time and is removed very slowly once it enters the system.

While anyone can be harmed by lead, children under the age of six are most vulnerable to negative health effects after lead exposure, which can lead to damage in the brain and nervous system, as well as issues with hearing, speech, learning and attention that may have lasting effects over time. Not only are young children still growing and developing, but they are also more prone to getting lead into their systems because of their curious nature.

“Children are always crawling around on their hands and knees, getting into things and putting their hands and other objects in their mouths,” said Janine Kerr, childhood lead poisoning prevention program health educator at the Virginia Department of Health.

She continued, “There’s just a huge amount of growth and development happening for kids, and lead specifically interferes with growth and development, so that’s why those young kids are so vulnerable. Also, the bodies of children absorb lead at a faster rate than the bodies of adults. If an adult and a child are exposed to the same amount of lead, the child’s body is going to absorb more of that lead, and it’s going to absorb it faster, making them particularly vulnerable to all of those negative health impacts.”

Why is lead still a concern, and where is it found?
When most people think of lead exposure, they think of lead-based paint, which is the most common source of lead. However, there are also other, less obvious sources of lead that might surprise parents. These include cookware, ceramics, spices, cosmetics or traditional medicines that are brought from other countries and sometimes used in refugee or newcomer populations, toys that are imported and even antique jewelry that’s been passed down through generations.

“A mother might have on an antique necklace or bracelet, and as she’s holding her teething baby, the child might put the jewelry in their mouth and accidentally ingest any lead present in it,” said Kerr. 

Beyond objects, lead can also be found in the environment, in contaminated soil.

Kerr noted, “Contaminated soil is usually common around high-traffic areas, or around areas where the exterior of a home was painted with lead-based paint. As that home continues to age, and that paint starts to deteriorate, sometimes small pieces can chip and flake off and fall into the soil. Kids who are playing outside may put this lead-contaminated dirt or their hands in their mouths after they’ve been playing and can accidentally ingest lead that way.”

When it comes to homes where lead-based paint was once used, deterioration over time is the biggest problem. Major U.S. policy changes banned lead-based paint in 1978 and lead service lines in 1986, but for communities with older homes, like the many historic buildings found in Fredericksburg and the surrounding region, aging infrastructure is a major concern.

“People oftentimes think that lead poisoning was an issue of their parents’ generation,” explained Kerr, “but as homes continue to age, any that were painted with lead-based paint before that ban went into effect become an even bigger lead hazard.” 

Over time, lead-based paint that was once intact can start to chip, peel and turn into fine dust, which is easily inhaled or ingested, especially by young children. This is especially common around high friction areas like windowsills and door frames. And, older service lines can leach lead into water as well.

This is especially common around high friction areas like windowsills and door frames. And, older service lines can leach lead into water as well.

How do you know if a child has lead poisoning?
One of the most challenging aspects of lead exposure is how difficult it can be to detect. “The trickiest thing about lead poisoning is that, for the most part, most kids don’t show any outward sign or symptom that they’re sick,” Kerr explained. 

Unlike common childhood illnesses, there’s often no obvious sign that something is wrong. In most cases, children with elevated lead levels appear perfectly healthy, which is why testing plays such a critical role. 

Occasionally, if exposed to a very high amount of lead, children may show signs of an upset stomach, headaches, dizziness or a difficult time focusing, but more often than not, they won’t have any symptoms. 

“A blood lead test is the only sure way to know if a child has been exposed to lead,” Kerr said. 

Without testing, exposure can go unnoticed, sometimes for years.

When should a child be tested? 

In Virginia, testing recommendations are based on risk factors. Children exposed to lead often show few or no symptoms of sickness, so blood testing is critical for early identification. 

Kerr explained, “Virginia does targeted testing, so we have a set of eight risk criteria, and if a child falls under any of those eight categories, then they need to get a blood lead test at ages one and two.” 

She added, “If anyone else living in the house has had evidence of lead exposure, then the kids who are also living there should get a test.” 

Even if a child misses early testing windows, it’s not too late. Testing can be done any time risk factors are present.

How is lead poisoning treated? 

If a child does test with elevated lead levels, the most important next step is identifying the source of the exposure so it can be eliminated. 

Kerr explained, “Parents can expect to receive education on lead poisoning prevention, either from the provider or their local health department, and to schedule follow-up testing, as it’s very important to monitor that lead level to make sure that it’s decreasing over time.”

If the child’s lead level is high enough, someone from the Virginia Department of Health will also typically contact the family to walk them through what the potential lead exposure was. In some cases, they may even send someone to do a walkthrough of the family’s home to visually inspect it to try and identify the hazard.

Kerr continued, “Another tricky thing about lead exposure is that there isn’t a medicine or a magic treatment that will just perfectly remove the lead. Sometimes, children with extremely high lead levels can undergo a treatment called chelation, but it’s very hard on the body, so for the majority of cases, it’s about identifying the exposure source and then removing it from the child’s environment. Once that exposure source is removed, that blood lead level should start to go down.” 

Children exposed to lead can go on to lead a healthy, normal life, but early identification of exposure is key. Kerr emphasized that parents should focus on identifying the lead source and eliminating it to prevent any future exposures.

What to know if lead-based paint was used in your home
Understanding where lead exposure occurs is one of the most powerful tools parents have.

For starters, even everyday actions like opening and closing windows covered with lead-based paint can create lead dust. Renovation and repair projects are another common act that can disturb old paint and pose a hazard. Something as simple as hanging a painting can even disrupt dust containing lead.

If you live in an older home, the most important thing to do is to bring in a lead-safe certified contractor.

“If your home was built before 1978, you should not remodel or renovate it yourself. You should hire a lead-safe certified contractor. This is a certification that the U.S. Environmental Protection Agency (EPA) provides to contractors to make sure that these contractors know how to renovate these older homes properly in a way that won’t contaminate other rooms or present any kind of health hazard to the family,” said Kerr.

Certain commercially-sold lead test kits can be a faster and less expensive first step to determining if there is lead in your home. However, many of these kits are inconsistent and inaccurate. Consumers should only utilize EPA-certified lead testing kits and always follow up with a professional regardless of the result.

The EPA has an online tool so that families can easily find a lead-safe certified contractor near them. For families who need assistance covering the cost of remediating lead hazards in their home, The Virginia Department of Housing and Community Development has a program that provides remediation and abatement at no cost to families who meet the income requirements. Remediation is the process of identifying, controlling and removing lead hazards, most commonly lead-based paint, from a home.

Preventative actions that can reduce lead exposure

While lead exposure can feel overwhelming, many of the most effective prevention strategies are simple and manageable. 

These include frequent handwashing, cleaning toys routinely and maintaining a nutrient-dense diet (one that is especially rich in iron, calcium and vitamin C to lessen lead absorption). 

If a child has been playing outside in bare soil around the home, or if the family has a parent who has a job or hobby (construction, demolition, firearms, etc.) where they come into contact with lead, then changing clothes immediately and leaving shoes outside is also an effective strategy. 

Using the “wet-wet method” of cleaning with wet mops and wet washcloths, which reduce the likelihood of dust flying into the air, is also extremely useful. Families can apply the wet-wet method when cleaning around window sills, door frames or tabletops. 

And, for those with older service lines, flushing the water for 60 seconds before using it can get rid of stagnant water that has been sitting in the pipes for a longer period of time. Using only cold water from the tap when cooking will also help, as heat corrodes pipes faster. 

“It all sounds like little things,” Kerr said, “but all added up, they can actually make a really big difference.”

The most important first step

With so many factors involved, it’s easy to feel unsure where to begin, but according to Kerr, the starting point is simple. “The biggest thing is to go through that set of risk criteria and figure out if your child is at risk,” she said. 

From there, testing, education and prevention strategies can follow. 

“The faster you identify the source, the faster it can be removed from a child’s environment,” said Kerr. “Knowledge is power. If families have all the tools to be able to talk to their provider about testing and implement some of these prevention strategies, they’ll be able to reduce the risk of exposure in the home.”