Approximately 250,000 U.S. children aged 1-5 years have blood lead levels greater than 10 micrograms of lead per deciliter of blood, the level at which CDC recommends public health actions be initiated. Lead poisoning can affect nearly every system in the body. Because lead poisoning often occurs with no obvious symptoms, it frequently goes unrecognized. CDC’s Childhood Lead Poisoning Prevention Program is committed to the Healthy People goal of eliminating elevated blood lead levels in children by 2010. The program is part of the National Center for Environmental Health's Division of Emergency and Environmental Health Services
Prevention TipsLead poisoning is entirely preventable. The key is stopping children from coming into contact with lead and treating children who have been poisoned by lead.
The goal is to prevent lead exposure to children before they are harmed. There are many ways parents can reduce a child’s exposure to lead. The key is stopping children from coming into contact with lead. Lead hazards in a child’s environment must be identified and controlled or removed safely.
What can be done to prevent exposure to lead?
It is important to determine the construction year of the house or the dwelling where your child may spend a large amount of time (e.g., grandparents or daycare). In housing built before 1978, assume that the paint has lead unless tests show otherwise.
Talk to your state or local health department about testing paint and dust from your home for lead.
Make sure your child does not have access to peeling paint or chewable surfaces painted with lead-based paint.
Pregnant women and children should not be present in housing built before 1978 that is undergoing renovation. They should not participate in activities that disturb old paint or in cleaning up paint debris after work is completed.
Create barriers between living/play areas and lead sources. Until environmental clean-up is completed, parents should clean and isolate all sources of lead. They should close and lock doors to keep children away from chipping or peeling paint on walls. You can also apply temporary barriers such as contact paper or duct tape, to cover holes in walls or to block children’s access to other sources of lead.
Regularly wash children’s hands and toys. Hands and toys can become contaminated from household dust or exterior soil. Both are known lead sources.
Regularly wet-mop floors and wet-wipe window components. Because household dust is a major source of lead, parents should wet-mop floors and wet-wipe horizontal surfaces every 2-3 weeks. Windowsills and wells can contain high levels of leaded dust. They should be kept clean. If feasible, windows should be shut to prevent abrasion of painted surfaces or opened from the top sash.
Prevent children from playing in bare soil; if possible, provide them with sandboxes. Parents should plant grass on areas of bare soil or cover the soil with grass seed, mulch, or wood chips, if possible. Until the bare soil is covered, parents should move play areas away from bare soil and away from the sides of the house. If using a sandbox, parents should also cover the box when not in use to prevent cats from using it as a litter box. That will help protect children from exposure to animal waste.
To further reduce a child’s exposure from non-residential paint sources:
Lead has been found in some traditional (folk) medicines used by East Indian, Indian, Middle Eastern, West Asian, and Hispanic cultures. Traditional medicines can contain herbs, minerals, metals, or animal products. Lead and other heavy metals are put into certain folk medicines on purpose because these metals are thought to be useful in treating some ailments. Sometimes lead accidentally gets into the folk medicine during grinding, coloring, or other methods of preparation.
People selling a remedy may not know whether it contains lead. You cannot tell by looking at or tasting a medicine whether it contains lead. Consuming even small amounts of lead can be harmful. There is no safe blood lead level. Lead poisoning from folk remedies can cause illness and even death.
What to do if you or your child may have taken a medication that contains lead See your health care provider. He or she can perform a blood test to see whether you have been exposed to lead and if so recommend treatment options. Most adults and children with elevated blood lead levels do not have any symptoms. As blood lead levels increase, so does lead’s effects on health.
How to tell if herbal medicines or folk medicines contain lead You only can tell for sure by having the medicine tested in a laboratory. If you have reason to suspect that you may have consumed lead in a folk remedy, see a health care provider for a blood test.
Which folk medicines are known to contain lead Lead has been found in powders and tablets given for arthritis, infertility, upset stomach, menstrual cramps, colic and other illnesses.
Greta and Azarcon (also known as alarcon, coral, luiga, maria luisa, or rueda) are Hispanic traditional remedies taken for an upset stomach (empacho), constipation, diarrhea, vomiting, and used on teething babies. Greta and Azarcon are both fine orange powders that have a lead content as high as 90%.
Ghasard, an Indian folk remedy, has also been found to contain lead. It is a brown powder used as a tonic.
Ba-baw-san is a Chinese herbal remedy that contains lead. It is used to treat colic pain or to pacify young children.
UPDATE: Daw Tway is a digestive aid used in Thailand and Myanmar (Burma). Analysis of Daw Tway samples showed them to contain as much as 970 parts per million (ppm) of lead. The Daw Tway samples also contained high arsenic levels, as great as 7,100 ppm.
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The potential for children to be exposed to lead from candy imported from Mexico has prompted the U.S. Food and Drug Administration (FDA) to issue warnings on the availability of lead-contaminated candy and to develop tighter guidelines for manufacturers, importers, and distributors of imported candy.
Lead has been found in some consumer candies imported from Mexico. Certain candy ingredients such as chili powder and tamarind may be a source of lead exposure. Lead sometimes gets into the candy when processes such as drying, storing, and grinding the ingredients are done improperly. Also, lead has been found in the wrappers of some imported candies. The ink of these plastic or paper wrappers may contain lead that leaches into the candy.
People selling these candies may not know whether the candy contains lead. You cannot tell by looking at or tasting a candy whether it contains lead. Consuming even small amounts of lead can be harmful. There is no safe blood lead level. Lead poisoning from candies can cause illness.
What to do if you believe you or your child may have eaten candies that contain lead
How to tell if your candy contains lead
How to get more information about lead in candy
Children may be exposed to lead—a well known health hazard. Toys that have been made in other countries and then imported into the U.S. or antique toys and collectibles passed down through generations put children at risk for such exposure. To reduce these risks, the U.S. Consumer Product Safety Commission (CPSC) issues recalls of toys that could potentially expose children to lead.
Lead may be used in two aspects of toy manufacturing.
Paint: Lead may be found in the paint on toys. It was banned in house paint, on products marketed to children, and in dishes or cookware in the United States in 1978; however, it is still widely used in other countries and therefore can still be found on imported toys. It may also be found on older toys made in the United States before the ban.
Plastic: The use of lead in plastics has not been banned. It softens the plastic and makes it more flexible so that it can go back to its original shape. It may also be used in plastic toys to stabilize molecules from heat. When the plastic is exposed to substances such as sunlight, air, and detergents the chemical bond between the lead and plastics breaks down and forms a dust.
How your child may be exposed
How to test a toy for lead
What to do if you are concerned about your child’s exposure
How to obtain more information about recalls
A working group of nine federal agencies has been convened to develop a comprehensive strategy to control sources of lead in food and consumer products through interagency collaboration and cooperation.
If swallowed or put in the mouth, lead jewelry is hazardous to children. In 2003, a 4-year-old child swallowed a piece of jewelry bought from a vending machine. The child became ill because the jewelry was made of lead. The potential for children to be exposed to lead from this source caused the U.S. Consumer Product Safety Commission (CPSC) to issue on July 8, 2004, a recall of 150 million pieces of metal toy jewelry sold widely in vending machines.
In 2006, there was a death of a child from acute lead poisoning after ingestion of a heart-shaped metallic charm containing lead. The charm had been attached to a metal bracelet provided as a free gift with the purchase of shoes manufactured by Reebok International Ltd. On March 23, 2006, a voluntary recall of 300,000 heart-shaped charm bracelets was announced by CPSC and Reebok.
What to do if I believe my child has put lead jewelry into his/her mouth
Effects of wearing toy jewelry
How to obtain more information about recalls
The U.S. Consumer Product Safety Commission (CPSC) is charged with protecting the public from unreasonable risks of serious injury or death from more than 15,000 types of consumer products. CPSC announces all recalls on their website.
Only lead recalls are listed here. Click on the links in the menu to the left to see lists of recalled items by product categories. The most recent recalls are listed at the top of each page. Pictures and descriptions are taken directly from the CPSC website. Click on the picture or link to see full descriptions of the recalled items. Many recalls include more than one type of item and have additional pictures available on the CPSC website. These items are marked with double asterisks (**).
How does lead get into my tap water?
Even so, lead still can be found in some metal water taps, interior water pipes, or pipes connecting a house to the main water pipe in the street. Lead found in tap water usually comes from the corrosion of older fixtures or from the solder that connects pipes. When water sits in leaded pipes for several hours, lead can leach into the water supply.
How do I know if my tap water is contaminated with lead?
Does a high lead level in my tap water cause health effects?
Most studies show that exposure to lead-contaminated water alone would not be likely to elevate blood lead levels in most adults, even exposure to water with a lead content close to the Environmental Protection Agency’s (EPA’s) “action level” for lead of 15 parts per billion (ppb). Risk will vary, however, depending upon the individual, the circumstances, and the amount of water consumed. For example, infants who drink formula prepared with lead-contaminated water may be at a higher risk because of the large volume of water they consume relative to their body size.
What can I do to reduce or eliminate lead in my tap water?
You should begin by asking your water authority this question:
1. Does my water have lead in it above EPA’s “action level” of 15 parts per billion (ppb)?
If the answer is no, your water does not contain lead at current levels of concern.
2. Does the service pipe at the street (“header pipe”) have lead in it?
This information is very important. It determines which of the next two actions (A or B) you should follow to protect your household’s health.
A) If the pipe in the street (“header pipe”) does NOT have lead, the lead in your tap water may be coming from fixtures, pipes, or elsewhere inside your home.
Until you eliminate the source, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours:
a. Before using any tap water for drinking or cooking, “flush” your water system by running the kitchen tap (or any other tap you take drinking or cooking water from) on COLD for 1–2 minutes;
b. Then, fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).
B) If the pipe at the street (“header pipe”) DOES contain lead, lead in the tap water may be coming from that pipe or connected pipes (it may also be coming from sources inside your home).
Until the lead source is eliminated, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours. Please note that additional “flushing” is necessary:
a. Before using any tap water for drinking or cooking, run high-volume taps (such as your shower) on COLD for 5 minutes or more;
b. Then, run the kitchen tap on COLD for 1–2 additional minutes;
c. Fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).
3. In all situations, drink or cook only with water that comes out of the tap cold. Water that comes out of the tap warm or hot can contain much higher levels of lead. Boiling this water will NOT reduce the amount of lead in your water.
4. You can also reduce or eliminate your exposure to lead in drinking water by consuming only bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead. See resources below.
5. Children and pregnant women are especially vulnerable to the effects of lead exposure. Therefore, for homes with children or pregnant women and with water lead levels exceeding EPA’s action level of 15 ppb, CDC recommends using bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead for cooking, drinking, and baby formula preparation. Because most bottled water does not contain fluoride, a fluoride supplement may be necessary.
Also, be aware that some bottled waters have not been tested and may not be appropriate for consumption. Contact independent testing organizations that certify bottled water. See resources below.
6. Make sure that repairs to copper pipes do not use lead solder.
Advice for lead safe water practices following plumbing work in housing with lead water lines or lead solder. These practices include:
1. Testing water following plumbing work in older housing, please contact your state lead program for information about water testing in your area;
2. Inspecting the aerator on the end of the faucet and removing any debris such as metal particles and;
3. Flushing water lines before using the water for drinking or cooking.
Home owners may also consider full replacement of lead water lines by removing the private lines running from the water meter into their homes. This precaution has not been adequately studied however because the data available to CDC included too few homes having had full replacement of lead water lines. Contact your water authority for information about replacing water service lines.
If my water has high lead levels, is it safe to take a bath or shower?
This information applies to most situations and to a large majority of the population, but individual circumstances may vary. Some situations, such as cases involving highly corrosive water, may require additional recommendations or more stringent actions. At all times, your local water authority remains your first source for testing and identifying lead contamination in your tap water. Many public water authorities have Web sites that include data on drinking water quality, including results of lead testing. Links to such data can be found at the following EPA Web site.
Please visit the following sites for more information:
Addendum: Following the release of the MMWR, "Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water -- District of Columbia, 2004", some reports have suggested erroneously that the Centers for Disease Control and Prevention has determined that lead in residential tap water at concentrations as high as 300 parts per billion is ‘safe’. CDC would like to reiterate the key message from the 2004 article that because no threshold for adverse health effects in young children has been demonstrated (no safe blood level has been identified), all sources of lead exposure for children should be controlled or eliminated. Lead concentrations in drinking water should be below the U. S. Environmental Protection Agency’s action level of 15 parts per billion.
EPA Ground Water & Drinking Water
International Bottled Water Association
At Risk PopulationsIt has been demonstrated that children who are poor, are members of racial-ethnic minority groups, are recent immigrants, or who have occupationally exposed parents are at higher risk of lead exposure than are other children. Membership in one of these groups does not predict risk in every community, and children in these groups who are not exposed to lead do not have elevated BLLs.
Are you Pregnant?
Prevent Lead Poisoning. Start Now.
Lead Poisoning is caused by breathing or swallowing lead. Lead can pass from a mother to her unborn baby
Too much lead in your body can:
Lead can be found in:
Now is the time to keep your baby safe from lead poisoning. Here’s what you can do:
1. Watch out for lead in your home.
2. Talk to your doctor.
3. Avoid certain jobs or hobbies.
Use caution when eating candies, spices, and other foods that have been brought into the country by travelers, especially if they appear to be noncommercial products.
5. Store food properly.
International Adoption and Prevention of Lead Poisoning
Prospective parents adopting a child from overseas need information to safeguard the health of the child. This site contains information for adopting parents, adoption agencies, and health care providers.
The U.S. Department of State records show that from October 1, 2008, to September 30, 2009, a total of 12,753 internationally adopted children immigrated to the United States. The largest numbers of these children were originally from Ethiopia, mainland China, South Korea, and Russia. The risk for lead exposure is much higher in many countries from which children are adopted than in the United States. Each country sets its own policies on regulations for environmental exposures, and some countries have stronger regulations than others.
Main sources of exposure to lead differ from country to country Children’s exposure to sources of lead varies by country. Even within a country, lead exposure may vary by ethnic group or income level. In the United States, lead-based paint and lead-contaminated dust and soil are the primary sources of high-dose childhood-lead exposure.
Internationally, children can be exposed to lead from:
Publications on country-specific sources of lead can be found here:
Risk of elevated blood-lead levels
Parents or prospective parents of adopted children
Why should I be concerned?
As a group, foreign-born adopted children tend to have higher levels of lead in their blood than children born in the United States. Children can be exposed to lead in different ways in various in countries.
How do I know if my child was exposed to lead? Most children with elevated blood-lead levels do not have any symptoms.
How can I check for lead in my child?
Who can I contact for blood-lead testing or other information about the health of my internationally adopted child?
Some doctors and medical clinics focus on the special issues of children who are born in or adopted from countries around the world. The American Academy of Pediatrics currently lists 90 physicians who specialize in the health care needs of children born outside the United States
International Adoption Agencies
Adoption agencies play an important role in increasing awareness of lead exposure among internationally adopted children. Under current regulations and routine practice, elevated blood-lead levels among foreign-born children may not be detected.
Adopting parents lack information on the hazards of lead exposure that could help them improve their children’s growth, development, and prospects for the future.
It is important that adoption agencies provide lead-exposure fact sheets with health information, including information on accessible testing sites, to prospective parents.
Adoption agencies should also encourage adopting parents and doctors to test foreign-born children for lead exposure when they arrive in the United States. top
Health Care Providers
International Childhood Lead Exposure
Medical Testing before Immigration to United States
Recommendations for Screening and Medical Management of Children with Elevated Blood-Lead Levels
Child Welfare Information Gateway: Intercountry Adoption
American Immigration Center.