Lead is a soft, dense metal used to make many products. It may be found in ceramic dishes, glassware, old plumbing, fishing weights, bullets, car batteries, and electronics among other things. Years ago, it was added to gasoline and to paint. Because of health problems, lead was banned from paint in 1978 and from gasoline in 1996.

Lead is toxic, or poisonous, to people if it gets inside the body. Lead can damage organs, especially the nervous system, brain, and kidneys. It can interfere with normal brain development, causing reading and learning problems, damage to hearing, restricted growth, behavioral problems, and even permanent neurological damage. At very high levels lead can cause seizures, coma, and even death. Lead toxicity can be particularly dangerous for children. 

Lead can enter the body in many ways. Adults and children can get lead poisoning if they:

• Breathe in lead dust (especially during activities such as renovations, repairs, or painting that disturbs painted surfaces)
• Swallow lead dust that has settled on food, food preparation surfaces, and other places
• Eat paint chips or soil that contains lead
• Use cosmetics or products purchased outside the United States that contain lead

There are a number of things you can do to prevent exposure of lead for yourself and your children.

Your home...

• If you live in a building built before 1978, the paint may contain lead. Often the soil around the building also contains lead. Use lead-safe work practices when performing any renovations or maintenance and keep bare soil covered with mulch or vegetation.
• Damp mop floors and surfaces like windowsills often to remove lead.
• Discourage children from playing in bare soil; frequently wash your child’s hands, toys, and pacifiers.
• The Environmental Protection Agency considers a home at high risk for lead plumbing if it was built before 1940 or contains copper pipe and lead solder built before 1988. 
• Take precautions with:
  • Ceramic pottery or dishes, and pewter or brass containers, handcrafted or produced in cottage industries and not officially imported into the United States
  • Leaded crystal for storing or serving food or beverages
  • Dishes that are chipped or cracked
  • Exposure to others’ who smoke (“second-hand smoke” increases lead levels)

Your occupation and hobbies...

Certain jobs and hobbies may expose you to lead, including activities that involve:

• House painting or renovation
• Furniture refinishing
• Stained glass
• Firearms
• Recycling or making automobile batteries

Adults can bring invisible lead particles into their home if they have a job or a hobby that exposes them to lead. To reduce exposing others in your home, shower immediately upon arriving, or even before returning home.

Certain items that younger children might “mouth”...

Below is a list of items that may contain lead, and could cause lead poisoning if children put them in their mouths (even if they don’t swallow them):

• Toy jewelry
• Fishing weights or lures
• Bullets, buckshot, and musket balls
• Imported or antique toys with painted surfaces
• Vinyl mini-blinds made before 1997 (can produce dust that can be picked up by children)
• Handcrafted or foreign-made ceramic dishes may contain lead that can get into food or drink

Cosmetics and foods...

Avoid the following:

• Folk medicines or remedies, like azarcon, pay-loo-ah, or ayurvedic medicines that were not produced or officially imported into the United States.
• Cosmetics such as kohl, kajal, or surma that are produced outside the US.
• Food, food additives, candies and spices that have been brought into the country by travelers from outside the US, especially if they appear to be noncommercial products of unknown safety.
• Nonfood items, such as clay, soil, pottery, or paint chips, because they may be contaminated with lead.

Things you and your family SHOULD DO to reduce the risk to lead exposure:

• Avoid the use of cigarettes: second-hand smoke increases exposure to others.
• Consume a healthy, balanced, low fat diet with appropriate amounts of calcium, iron and vitamin C. (A healthy diet makes you or your child less likely to absorb lead.)
• Stay alert for recalls of toys or products that may contain harmful amounts of lead. The U.S. Consumer Product Safety Commission (CPSC) keeps a frequently updated list on their website.

The biggest source of childhood lead poisoning is paint in homes built before 1978. As old paint ages, it may chip and peel, or form invisible lead dust. Lead dust can also form when painted surfaces are rubbed together, scraped, or sanded, as in a window frame or while a home is being renovated. Dust settles on places where babies and young children crawl and play. They swallow lead when they touch dust-covered surfaces and put their hands in their mouths. Children may also eat visible chips of paint.

Is my child at risk?

Lead poisoning can affect any child. Lead is especially dangerous to children under the age of 6 because children’s brains and nervous systems are more sensitive to the damaging effects of lead. Children under age 3 are at the greatest risk of exposure because they frequently put their hands and objects in their mouths.

How do I know if my child has lead poisoning?

Children with lead poisoning sometimes have stomach aches or act irritable, but most of the time there are no symptoms at all. Your child’s doctor can do a blood test. That is the only way to be confirm if there has been an exposure to lead. Children less than 6 years old who are at risk for lead poisoning should be tested even if they do not appear sick. The only way to be sure if your child has lead poisoning is through a blood test performed at your doctor’s office.

Should I have my child tested for lead poisoning?

The Code of Virginia (following the Centers for Disease Control and Prevention recommendations) requires testing as follows:

1) All children at 12 months of age

2) All children at 24 months

3) Children age 2-6 years if they meet any of the following criteria:

• Have never been tested for lead before
• Previously had an elevated blood lead level, but did not have a subsequent test demonstrating that it is no longer elevated
• Receive public assistance due to low income status (e.g. Medicaid or WIC Nutrition Services)
• Live in a building or frequently visit a house built before 1960
• Visit a house or apartment built before 1978 that has recently been remodeled
• Have a sibling, housemate, or playmate who has or had an elevated blood lead level
• Live with an adult whose job, hobby, or other activity involves lead exposure
• Live near an active lead smelter, battery recycling plant, or other industry likely to release lead
• Whose parent or guardian requests the child’s blood be tested
• Is a recent refugee or immigrant or is adopted from outside the United States

Additionally, you should have your child tested if you have any concerns about the possibility of lead exposure or lead toxicity. Discuss lead testing with your child’s pediatrician or family doctor.

How is the lead test done? Where can I get my child tested?

Lead is tested through a blood test. The results are reported to the doctor who orders the test. 

You can get your child tested through your child’s pediatrician or family doctor. 

Pregnant women with high lead levels in their bodies before or during pregnancy may expose the fetus to lead. This can be dangerous to a developing baby – it may cause a baby to have low birthweight or congenital anomalies. Lead can also cause pregnant women to have complications during pregnancy such as hypertension (or high blood pressure) or preterm delivery.

Common risk factors for pregnant women include recent immigration; practicing pica; occupational exposure (see “How Do I Prevent Exposure to Lead” above); use of alternative remedies or cosmetics that contain lead; use of traditional lead glazed pottery; and poor nutritional status.

Women who are at risk should be tested for blood lead levels as soon as possible – even before conception. All women who are concerned, even if they do not have the risk factors listed above, should be tested.

Lead exposure during breastfeeding can result in lasting adverse health effects.

See “How Do I Prevent Exposure to Lead” above. And talk to your doctor about having a blood test for lead.

State law requires healthcare providers report elevated blood lead levels to Alexandria Health Department (AHD). AHD provides a number of lead-related public health functions including: 

• Education, guidance and technical assistance to healthcare providers about lead toxicity and testing for lead
• Environmental Health assessments of residences of persons where high lead levels have been detected in their blood
• Public health nursing follow-ups for persons who have high lead levels detected in their blood
• Technical assistance to City and community partners to ensure Alexandrians are protected from potential sources of lead poisoning

• Brief Overview on Lead: (English)   (Spanish)    (Amharic)    (Arabic)
• CDC Blood Lead Levels in Children (June 2016): (English)
• Agency for Toxic Substances and Disease Registry (ATSDR) Lead FAQs:  (English)   (Spanish)   (Arabic)
• Kohl - Kajal - Surma FAQ: (English)   (Spanish)    (Amharic)    (Arabic)
• Letter to Healthcare Providers (June 8, 2016)
• http://www.cdc.gov/nceh/lead/parents.htm
• https://www.epa.gov/lead
• http://www.vdh.virginia.gov/leadsafe/