Lead Toxicity in Children: Health Effects, Policies and
Recommendations
Anushree Rathore1, Deepak Singh Choudhary2, Mohammad Abu Bakr Siddique1,
Amit Kumar1
1Department of Oral Pathology and Microbiology, Bhabha College of Dental Sciences, Bhopal,
2Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Bhopal,
ABSTRACT: Lead is a dangerous element that exists naturally in the Earth's crust. Any kind of lead causes a
detrimental response in the human body. It is discharged into the environment during the manufacturing
of batteries, foundries, ammunition, lead paint, water pipes, and other manufactured goods. It can enter
the body through a variety of pathways, including those in the air, water, soil, food, and dust. Concern is
raised since there is no amount of lead that is safe for the human body. The problem persists despite
several prevention measures that the state and the federal governments have put in place. This review
assesses the effects of lead exposure on children as well as suggested solutions to the issue.
KEY WORDS: lead toxicity; fetal neurotoxicity; lead poisoning; lead damages
Address for correspondence : Dr. Anushree Rathore, Reader, Department of Oral Pathology & Microbiology, Bhabha College of
Dental Sciences, Bhabha Campus, Jatkhedi, Bhopal-462026, Madhya Pradesh, E-mail: anushreerahulsingh@gmail.com
Submitted: 12.06.2023, Accepted: 15.06.2023, Published: 26.06.2023
INTRODUCTION:
Lead is a dangerous element that exists naturally in
the Earth's crust.[1]
The environment naturally contains lead.
Traces of lead that are naturally present in the
environment are not harmful. It is only when lead gets
mined and turned into manufactured goods, toxicity
sets in.[2,3] A few examples are petrol, lead based paints
and pigments, solder in food cans, ceramic glazes,
incineration of lead containing waste, electronic
wastes etc. Lead toxicity has recently gained
international attention, mainly because lead's toxicity
potential never declines, and it is persistent in the
environment.[3] As per Centers for Disease Control and
Prevention (CDC), the environment around a child is
lead filled. Children can be exposed to lead from a
variety of sources, including gasoline, solder, water
pipes, consumer goods, artificial grass, confectionery,
traditional medicine, fine jewelry, and toys.[4]
Children in the US have recently been exposed
to lead through a variety of unique means. The various
sources include lead-containing children's jewelry,
Mexican tamarind candy and candy wrappers, food
served on imported ceramic bowls and pitchers,
breathing lead fumes from melting for fishing weights.
Interestingly, there has been a case where the mother
and the child were exposed to lead from the bullet in
the mother's spine because she had been shot fifteen
years earlier. [5]
Lead exposure and child health effects:
1. Intellectual disability: Lead exposure is associated
with intellectual disability. Lead exposure in children
with maximum blood lead levels 7.5 µg/dl is
connected with intellectual impairments, claims a
global pooled investigation by Lanphear et al. They
gathered the information from 1,333 children who
participated in seven international population-based
longitudinal cohort studies, followed from birth or
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People’s Journal of Scientific Research / Volume 16 / Issue 1 / Jan-June 2023 47
How to cite this article: Rathore A, Choudhary DS, Siddique MAB,
Kumar A. Lead Toxicity in Children: Health Effects, Policies and
Recommendations. PJSR. 2023;16(1):47-49.
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Rathore A et al. Lead Toxicity Effects, Policies & Recommendations
infancy until 5-10 years of age in order to examine the
relationship between test intellectual scores and blood
lead concentration for children with maximum blood
lead levels of 10 µg/dl. The full-scale Intelligence
Quotient (IQ) score served as the key outcome
indicator. 103 (8%) children had a maximal blood lead
concentration <7.5 µg/dl and 244 (18%) of the
children had maximum blood lead concentrations
below 10 µg/dl.[6] When the confounders were taken
into account, it was discovered that the blood lead
levels and IQ score had an inverse connection. There
was a notable 6.9 decline in IQ [95% confidence
interval (CI), 4.2-9.4] with an increase in blood lead
levels from 2.4 to 30 µg/dl. A rise in blood lead levels
was linked to a decline in IQ.[6]
2. Fetal Neurotoxicity: There are few other factors
that also expose children to lead. For example, lead in
maternal bones can be linked to fetal neurotoxicity.[7]
As per the study by Gomaa et al, a 2-fold increase in
cord blood lead level (e.g. from 5 to 10 µg/dl) was
associated with a 3.1-point decrement in Major
Depression Inventory (MDI) score.[7]
3. Fetal death and low birth weight: Lead-
contaminated drinking water is linked to fetal
mortality and poor birth weight.[8] Fetal fatalities
reached their maximum point in 2001, when water lead
levels were at their highest, and then began to decline
after 2004 when various public health actions were put
into place, according to an ecological research
conducted during the Washington DC lead crisis.[8]
4. Congenital lead poisoning: Lead can enter an
infant's system through the feto-maternal circulation,
which can result in congenital problems in infants, or it
can enter an infant's system through breast milk.[9] If
the mother has chronic lead toxicity, breastfeeding is
one of the other keyways that babies become
affected.[9]
Existing solutions proposed by public health
agencies:
Several federal laws such as Environmental
Protection Agency (EPA) Lead Renovation, Repair
ahead to establish the required infrastructure to
promote lead poisoning prevention measures, and to
take actions to support Flint, Michigan in its
recovery.10]
As per CDC's Blood lead screening policy, all
children aged nine months to six years should be
screened for lead. However, screening should focus
on children who have particular risk factors, such as
those who live in inadequate housing or come from
low-income households.[10]
At the state level, Surveillance programs are
in place to track the State lead poisoning prevention
status and the database is named as Lead Statutes
database.[10]
RECOMMENDATIONS:
Despite all these measures and policies at
state and federal levels the lead toxicity in children
still prevails. Following measures can be implemen-
ted to solve this problem. Policies by FDA to reduce
the amount of lead in food and household goods,
guidelines to lower airborne lead emissions can be
undertaken.[11] Establishing the surveillance program
to identify and address the sources of lead exposure in
children similar to that of adults. Implementing
policies to provide affordable coverage to ensure that
children with elevated blood lead levels have access to
developmental and neuropsychological evaluations as
well as appropriate, high-quality programs. In
addition, increasing public accessibility to local data
and artificial intelligence can also be used for
surveillance to keep a check in the population.[12]
CONCLUSION:
Much has been learned about the neurode-
velopmental and behavioral effects of lead poisoning
in children in recent years. Lead damages the brain
and central nervous system at high levels of acute
exposure, resulting in unconsciousness, convulsions,
and even death. A child who has acute or chronic
poisoning is usually left with mental impairment and
behavioral problems even if they survive. Lead does
not currently have any known safe concentrations. We
only know that it has detrimental impact on children's
health, notably their mental development, even at
and Painting Program Rule (RRP) requires that extremely low concentrations like 5 µg/dl. Even
certified home renovators be employed to renovate
homes that were built before 1978 to replace lead-
based paints; The Water Infrastructure Improvements
for the Nation (WIIN) Act gave HHS agencies the go-
though several policies are in place to prevent and
monitor lead exposures in children, but more effective
policies need to be implemented such as complete ban
of lead in consumer goods, and a better surveillance
program to track exposures. So that children can live a
48 People’s Journal of Scientific Research / Volume 16 / Issue 1 / Jan-June 2023
Rathore A et al. Lead Toxicity Effects, Policies & Recommendations
People’s Journal of Scientific Research / Volume 16 / Issue 1 / Jan-June 2023
49
healthy life free of lead.
Financial Support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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