CDC Strengthens Lead Poisoning Prevention in Children With New Standards

The Centers for Disease Control and Prevention (CDC) recently lowered its threshold for lead poisoning in children, after a study found that over half of U.S. children had detectable levels of lead in their blood.

The CDC reduced the blood lead reference value from 5 milligrams per deciliter of blood​​ to 3.5. With the new standard, twice as many children ages 1 to 5 could be considered to have high blood lead levels, which pose significant risks to all the major organs and the brain.

Jill Cioffi, MD, a board-certified pediatrician at Stony Brook Children’s Hospital, said the CDC’s update reflects better technology and testing capabilities that allow doctors to identify lower levels of lead now than before.

“No measurable blood lead level is considered safe,” Cioffi told Verywell. “As our test capabilities get better, we can lower the standard to which you say, ‘Oh that's not okay.’”

In 1991, the CDC’s blood lead reference value was 10 mg per deciliter, but that changed in 2012 to 5 mg. Some researchers have long advocated for the figure to be lowered.

Along with better testing, researchers have learned that lead exposure can accumulate over time. Being consistently exposed to low levels of lead could cause worse health outcomes than being exposed to higher levels of lead less frequently, Cioffi explained. If testing and research becomes even more precise, she wonders if the CDC may decide to lower the standard further, she said.

How Does Lead Exposure Affect Health?

Lead exposure can put someone at risk for high blood pressure, heart disease, kidney disease, or fertility problems. It can also affect children’s brain development, leading to lower IQ or behavioral changes like reduced attention span.

“Any lead ingested goes throughout the bloodstream,” Cioffi said. “It affects pretty much all the major organs."

While some of these problems can be remedied or treated, when it comes to neural damage, the impact of severe lead exposure cannot be reversed, she added.

“If you have any sort of neurological damage—deviation in IQ or cognitive function—no one would ever say that that's reversible,” Cioffi said. “You would try, but you definitely don't want to get exposed to such a high level, because it is hard to say that any of these are going to reverse.”

Lead can enter the body through ingestion, or through inhalation if it is being burned, according to the World Health Organization (WHO).

Children are commonly exposed to lead through ingestion, since they are prone to putting things into their mouths, Cioffi said. If the kids are playing outside in lead-contaminated soil, they could be vulnerable to exposure during or after playtime—particularly if followed by a snack or meal.

“It's more that children play in the soil, or they play with toys, and then they put their hands in their mouth, and it's on their skin and then put into their mouth,” Cioffi said. “They tend to bite on them or have more oral exposure than an adult would have.”

Lead can be more dangerous to children than adults due to a child’s smaller body size and more absorbable skin, Cioffi added. 

“When you're under six years old, you're considered incredibly vulnerable, just because your surface area is smaller, “ she said. “You're drinking the same water as your family, you're still getting—for your body weight—much more of it.”

A fetus inside a pregnant person can be among the most vulnerable to lead exposure, she added.

How Are Children Exposed to Lead?

Lead is a metal that can be found in the air, soil, water, and structural components of buildings and homes, according to the Environmental Protection Agency (EPA).Historical use of leaded gasoline, lead paint, and other lead-laced products such as some batteries, plumbing units, pipes, and cosmetics can also be sources of lead exposure.

Buildings constructed before 1978 are likely to contain lead-based paint, as that was the year that the U.S. government banned consumer use of the product. Sometimes, lead-based paint is buried under new (or multiple newer) layers of paint. While this may offer a thin veil of protection, the paint can still be a hazard if chipping occurs.

In comparison to the ‘70s, children today are less likely to be exposed to lead paint, although there is still a risk, according to Leah M. Alexander, MD, a New Jersey-based pediatrician and consultant for parenting website Mom Loves Best.

About 20 years ago, Alexander participated in lead clinics where children came in to detox from severe lead exposure—with blood lead levels in the 20s or 30s. These children were admitted to a hospital for about a week and given treatments such as iron through an IV to mitigate some of the toxic effects of the lead, she said. 

Fortunately, in the past several years, she hasn’t seen numbers higher than 15 and the cases were resolved without significant intervention, she added.

“Originally, I would see cases of kids that would get exposure from lead paint from old houses or if any construction was being done in their neighborhood,” Alexander told Verywell. “More recently, there's less of that lead paint construction site issue. People tend to live in newer homes, with municipal efforts to reduce the lead containing materials.”

Instead, she started noticing lead exposure through things like imported toys, infrastructure of municipal buildings, water supplies, and even shooting ranges.

“People like to go to shooting ranges and practice shooting guns—and bullets have lead,” Alexander said. “I've had cases of kids with high levels that the parents didn't realize that and their kids ended up getting exposed.”

Schools can also be a source of lead exposure. Major cities like New York and Philadelphia have found lead problems in public school systems, where children and teachers have been exposed through sources like lead paint and contaminated drinking water.

This tends to be a municipal supply or infrastructure issue, where pipes have not been updated, Alexander said. If a water supply is contaminated, it may get into water fountains or kitchens where food is being prepared, she added.

How Can You Keep Kids Away From Lead?

Keeping children safe from lead exposure requires using some basic precautions on a consistent basis, Cioffi suggested.

“Now that we’re in the midst of the COVID-19 pandemic, many of us wash our hands,” she said. “But really, frequent hand washing can be very important.”

Cleaning household sinks, including the wire traps inside faucets, can also make a big difference in fighting lead exposure, she added. Additionally, it is safer to consume water that comes out of the tap cold than hot, as hot water may contain higher levels of lead.

While low levels of lead have been dangerous long before the recent CDC update, Cioffi said the change may have a positive impact on preventative medicine by increasing health providers' ability to remedy lead exposure before it becomes too severe.

But in order for prevention to take place, people need to first be aware of the problem. Proactively thinking about lead exposure may also reduce a child’s risk, Alexander added.

“People are worried about so many things these days—COVID and their kids going to daycare [and] school—that the lead issue ends up being on the back burner compared to all the other things,” she said.