Used in many materials and products, lead is a heavy metal that is dangerous to human health. Since lead is a natural element, it does not break down in the environment. Once lead has been dispersed and redeposited into the environment, it will remain there to poison generations of children unless it is controlled or removed. Even very limited exposures to lead are hazardous to children.
Since lead hazards are more prevalent in older and substandard housing, lead poisoning is a concrete expression of the affordable housing crisis; it’s more common among poor children, children of color, and those living in older housing. Responsible property management, enforceable housing quality standards that are both practical and cost effective, and increased resources are needed to protect high-risk communities and preserve the nation’s affordable housing stock.
Exposure to lead in housing poses a significant health risk to young children. When absorbed into the body, it is highly toxic to many organs and systems and seriously hinders the body’s neurological development. Lead is most harmful to children under age six because it is easily absorbed into their growing bodies and interferes with the developing brain and other organs and systems. Pregnant women and women of childbearing age are also at increased risk, because lead ingested by the mother can cross the placenta and affect the unborn fetus.
Lead poisoning causes irreversible health effects, and there is no cure for lead poisoning. At very low levels of exposure in children, lead causes reduced IQ and attention span, hyperactivity, impaired growth, reading and learning disabilities, hearing loss, insomnia, and a range of other health, intellectual, and behavioral problems. At low levels, lead poisoning may not present identifiable symptoms, and a blood test is the only way to know if a child is poisoned. The Centers for Disease Control and Prevention (CDC) defines a blood lead level of 5 µg/dl as its reference value, indicating that steps should be taken to reduce ongoing lead exposure, though research has shown that even lower levels of exposure can cause health problems.
At very high levels of exposure, which are now rare in the U.S., lead poisoning can cause mental retardation, coma, convulsions, and even death. Except for severely poisoned children, there is no medical treatment for this disease. While drug therapy can reduce high levels of lead in the body, it does not reverse the harm caused to developing organs and systems.
As lead poisoning rates have declined nationally, the disparities of this disease have increased. In some communities, the rate of exposure is about five times the national average, which is estimated at 1.6% of children ages one through five. In the U.S., children from poor families are more likely to be poisoned than those from higher-income families. African-American children are also at increased risk when compared with both Hispanic and white children.
Sources of Lead
Dust and Paint
The major remaining cause of lead poisoning is lead-based paint in housing, especially housing built before 1950, when lead paint was commonly used. Most children with elevated lead levels are poisoned in their own homes by peeling lead-based paint and the lead dust it generates. Lead dust settles quickly, is difficult to clean up, and is invisible to the naked eye. Young children usually are poisoned through normal hand-to-mouth activity, as lead dust settles on their toys and the floor. Children may also be seriously poisoned by eating lead-based paint chips, but this is relatively rare.
Two situations account for the vast majority of poisoning in children. Most commonly, children are poisoned by lead dust from deteriorated paint in poorly maintained older housing. A lesser number of cases—though often more serious—are caused by repainting and remodeling projects that disrupt old painted surfaces without proper safeguards to control, contain, and clean up lead dust. In both scenarios, small amounts of lead dust can create substantial health risks. For example, imagine the amount of sugar in a one-gram packet. The same amount of lead particles evenly spread over 100 rooms, each measuring 10 feet by 10 feet, would leave dust levels of 100 µg/ft2, an amount of lead that is more than twice the federal standard (40 µg/ft2) for a hazardous level of lead on floors.
Housing age is an important predictor of risk, because the lead content of paint varied substantially over the past century. During the first half of the 20th century, the lead content of paint was marketed as a measure of its quality—the more lead the better. Prior to about 1940, leaded paints typically contained high amounts of lead, ranging from 10% to as much as 50%. Lead was added to make paint durable, so lead paint was frequently used in high-traffic and high-moisture areas, including but not limited to kitchens and bathrooms, exterior siding and trim, window and door trim, stairs, and porches. In the early 1950s, the paint industry began reducing lead content, although many paints still contained harmful amounts of lead. Federal regulations limited lead content in 1972 and effectively banned lead in residential paints in 1978.
While lead paint is a widespread problem, the mere presence of lead-based paint in a home is not a hazard, as about 40% of all U.S. housing contains some leaded paint, and the vast majority of children live safely in these homes and apartments.
The U.S. Geological Survey (USGS) estimates the mean naturally occurring lead in soil concentration to be 16 parts per million (ppm). Additional lead in soil can come from many sources, including:
- Exterior lead-based paint that is peeling or flaking
- Dust or paint chips resulting from repainting or renovation projects
- Demolition of buildings with lead-based paint
- Exterior sandblasting
- Deposition from emissions of vehicles that used leaded gasoline (i.e., when leaded gasoline was used in the past, it released lead particles into the air, which have since settled in soil)
In yards where soil is contaminated with lead, children can become exposed to harmful levels of the heavy metal when they get their hands dirty and place their fingers or a dirty or dusty toy in their mouths during normal play activity. Lead-contaminated soil and dust can also be tracked into homes on shoes or by pets or can be blown in through open windows and doors. Vegetables grown in lead-contaminated soil may absorb lead and poison both children and adults.
The U.S. Environmental Protection Agency (EPA) defines a soil lead hazard as 400 parts per million (ppm) in play areas and a 1,200 ppm average for bare soil in the rest of the yard.
Drinking water may become contaminated with lead from pipes or solder when water corrodes them. EPA estimates that drinking water accounts for 10% to 20% of human exposure to lead. Infants may be put at increased risk from lead in drinking water when contaminated tap water is used to make baby formula. EPA recommends that action be taken if more than 10% of tap water samples exceed the action level of 15 parts per billion.
Less common sources include workplace exposures to lead where workers may receive doses well above those experienced by the general population. Exposed workers may carry lead particles home on their clothing, shoes, or hair, putting family members at risk. Those who work in construction, demolition, painting, with batteries, in radiator repair shops, lead factories, or with a hobby or activity that involves lead (such as fishing, hunting, or target practice) are often exposed to lead.
Rare sources of exposure include food and drink stored in leaded crystal, lead-soldered cans, or lead-glazed ceramicware; home remedies and cosmetics that are popular in some cultures; and some consumer products.
Testing for Lead
As it isn’t possible to see specks of lead in household dust, a lead dust test is the only way to be sure that lead-contaminated dust is not present.
Key steps in testing:
- Call a lead expert or order a home dust kit yourself.
- Collect lead dust wipes on floors and windowsills.
- Send lead test materials to an LPAT-approved laboratory for analysis. Results are usually mailed back within a few days.
- Compare the results to the national standards listed below.
How to arrange for testing:
- Contact your state or county health department. Some agencies provide testing services or maintain lists of services.
- Use a home dust test kit. Call an environmental laboratory for a home test kit. (Detailed protocols for lead dust testing are available below.)
- Contact a certified lead professional. (Contact your state health department.)
- Instant spot test kits can provide useful information but are not as accurate as a test that uses a laboratory.
- HUD standards for lead dust are 40 micrograms of lead per square foot for floors and 250 micrograms of lead per square foot for windowsills.
How much will it cost?
- Lab analysis costs about $5 to $20 per sample, depending on the number of samples and the laboratory you choose.
- Usually, two or three samples per room provide enough information.
- Having someone else come to your home to collect the samples costs more.
Most health department lead poisoning prevention programs postpone action to address lead-based paint hazards until after a child has been identified as lead poisoned. In effect, children are used to detect lead hazards in their homes. Over the past decade, emphasis has shifted to primary prevention to prevent and control lead hazards in housing before a child’s health is harmed.
Primary prevention of lead exposure is key to protecting the health of children and others. Major components of primary prevention are:
- Checking homes for hazards, including testing for lead content in and around homes
- Housing maintenance to prevent hazards from arising
- Remediation of existing hazards — or fixing dangerous problems — to reduce lead exposure
The following are several steps that can help reduce your family’s exposure to lead:
- If you live in an older home or apartment or if you have any reason to worry about lead poisoning, have your child’s blood tested for lead. Make sure it is a blood lead test and that you are told the actual number for your child’s blood lead. The U.S. Centers for Disease Control and Prevention (CDC) defines a blood lead level of 5 µg/dl as a level of concern, indicating that you should take steps to reduce ongoing lead exposure. At higher blood lead levels, more aggressive measures are recommended, such as medical treatment. Young children served by Medicaid are entitled to free lead tests.
- If you purchase or rent a home built before 1978, you should have received information about lead-based paint hazards. As a result of federal requirements that went into effect in 1996, property owners of pre-1978 units must disclose any known hazards and provide a pamphlet to prospective tenants or buyers about lead. Prospective purchasers have the option to have the property tested for lead hazards at their own expense.
- Good maintenance is important to keep lead-based paint intact. (Maine’s Department of Environmental Protection also has a good maintenance guide.)
- Remodel and renovate safely.
- Conduct a simple test for lead dust in your home.
- Consider having your home evaluated for lead hazards by a state- or EPA-certified risk assessor, or send a dust or paint sample to a laboratory. Remember, if your home was built before 1978, chances are that it contains some lead paint—it’s almost certain to be present in pre-1950 homes. Keep in mind that intact lead paint is rarely a hazard.
- Do not remove lead-based paint yourself. This can be extremely hazardous. Only an EPA-certified renovator or abatement specialist should attempt to remove lead-based paint.
- Keep areas where children play as dust-free and clean as possible. Wet-mop floors and wipe window ledges and surfaces such as cribs with a general all-purpose cleaner or a cleaner made specifically for lead and warm water.
- Have children play in sand and grassy areas instead of dirt, which sticks to their fingers and toys.
- Have children wash their hands after playing outside and before meals, naps, and at bedtime.
- Don’t bring lead dust into your home from the workplace or environment. Wipe your feet before entering your home. Remove work clothes and wash them separately from the rest of your family’s clothing.
- Have your water tested for lead. Water may contain lead from pipes, solder, or faucets containing lead.
- Eat a healthy diet that includes iron, calcium, and foods low in fat. Foods rich in iron include eggs, some nuts, and beans. A healthy diet causes the body to absorb less lead.
Federal agencies have developed and implemented some measures, such as those below, that are reducing exposure to lead hazards:
- HUD’s Lead Hazard Control Grants Program enable local and state agencies to contract for lead hazard control in low-income high-risk homes.
- EPA’s and HUD’s Real Estate Notification and Disclosure Rule mandates that property owners reveal information about lead-based paint and hazards to prospective buyers and renters.
- EPA’s Lead-Based Paint Activities Certification and Accreditation Program oversees the development of capacity to perform lead-based paint inspections, risk assessments, and abatement.
- HUD’s Lead Safe Housing Rule governs how lead safety must be addressed in all federally assisted housing.
- EPA Standards on Lead Dust define what is a dangerous level of lead in paint, bare soil, and interior dust.
- EPA’s Renovation, Repair and Painting Rule requires contractors and workers who work in older homes and child-occupied facilities to take simple, low-cost precautions to avoid creating and spreading lead debris and dust.
Federal policies are also in place regarding screening children for lead poisoning, though there are still pending policy issues surrounding this topic.
Alameda County Lead Poisoning Prevention Program
This CLPPP works with local and statewide organizations to educate the public and medical community about lead poisoning; provide case management services; identify, reduce, and remediate lead hazards; and assist local housing departments in lead hazard remediation activities.
AIHA Laboratory Accreditation Programs: Directory of Accredited Laboratories
The American Industrial Hygiene Association Laboratory Accreditation Program’s (AIHA-LAP) database lists every lab they’ve accredited, across a variety of specialties. Select the ELLAP accreditation program to produce a list of labs approved for lead in paint, dust, soil, and air. All ELLAP-accredited labs are also recognized by the National Lead Laboratory Accreditation Program (NLLAP). [url; AIHA-LAP]
Don’t Spread Lead: A Do-It-Yourself Guide to Lead-Safe Painting, Repair, and Home Improvement
Developed by the New England Lead Coordinating Committee, Don’t Spread Lead explains lead-safe work practices to do-it-yourself home remodelers. [pdf; UConn CAHNR, 2009]
Global Lead Network
Provides policy and advocacy tools and resources to develop and implement solutions to international aspects of lead poisoning and pollution, maintains online discussion conferences, and has searchable databases of members, best practices, legislation, and citations.
Lead Safe Illinois
Lead Safe Illinois has free educational tools, interactive tests, housing guidelines, and local statistics for the Chicago, Illinois, area.
Maintaining a Lead Safe Home
Maintaining a Lead Safe Home is a do-it-yourself manual, published in 1997 by Dennis Livingston, for homeowners and property managers, which provides step-by-step instructions and detailed illustrations of affordable solutions to lead-based paint problems. To order copies, contact Community Resources: 28 East Ostend Street, Baltimore, MD 21230; Phone: 410-727-7837 or Fax: 410-706-0295.
National Safety Council – Lead Poisoning
Includes general information, contact links, and alerts about current lead threats
This interactive web-based tool, developed jointly by the Alliance for Healthy Homes and Environmental Defense, presents community-level information about potential lead hazards associated with housing, enables users to determine the relative risk of lead hazards in their state or county, and allows users to rank that state or county’s lead hazards relative to other portions of the country.
State of Maine, Department of Environmental Protection – Essential Maintenance for a Lead-Safe Home
Lead – directory to a wide variety of information on hazards, prevention, statistics, policy resources, and more
National Report on Human Exposure to Environmental Chemicals
Childhood Lead Poisoning Prevention Program (in English) (en Español)
- Lo que todo padre debe saber acerca del envenenamiento por plomo (What every parent should know about lead poisoning)
U.S. Department of Housing and Urban Development
- Office of Healthy Homes and Lead Hazard Control
- The Prevalence of Lead-Based Paint Hazards in U.S. Housing (published in Environmental Health Perspectives, 2002)
- Caution: Lead Paint: Handle with Care
- Lead Paint Can Poison: Learn the Facts
- A Field Guide for Painting, Home Maintenance and Renovation Work
U.S. Environmental Protection Agency
- Lead in Paint, Dust, and Soil – Outreach Materials
- Lead in Drinking Water
- EPA Region 1, New England Lead Coordinating Committee – An Insider’s Guide to Lead-Safe Painting and Home Improvement – also available in Spanish
- Renovatation, Repair, and Painting Rule (2010)
U.S. Occupational Safety and Health Administration – OSHA-approved Blood Lead Laboratories Listed by Location
National Lead Information Center: 1-800-424-LEAD [1-800-424-5323]
The NLIC provides the general public and professionals with information about lead hazards and their prevention. Callers may order an information package or speak to an information specialist.
Safe Drinking Water Hotline: 1-800-426-4791
This hotline provides information on Safe Drinking Water Act regulations, lead and radon in drinking water, filter information and a list of state drinking water offices.
Su Familia (Your Family) Helpline
The National Alliance for Hispanic Health sponsors this toll-free helpline (1-866-SU FAMILIA or 1-866-783-2645) to offer Hispanic consumers free, reliable, and confidential health information in Spanish and English and help navigate callers through the healthcare system. | En español: La National Alliance for Hispanic Health (Alianza Nacional para la Salud de los Hispanos) patrocina esta línea de ayuda gratuita (1-866-SU FAMILIA o 1-866-783-2645) para ofrecer a los consumidores hispanos información de salud gratuita, confiable y confidencial en español e inglés y ayudar a las personas que llaman sistema de cuidado de la salud.
TSCA Assistance Information Service: 202-554-1404
Provides information on Toxic Substances Control Act regulations and on EPA’s asbestos program.