Dr. Abby Markham (Guest): We screen children between the ages of one and two, although children up to the ages of five or even a little bit older are at risk for lead poisoning. However, we do screen kids that are a little bit younger routinely.
Melanie: How do you get lead poisoning?
Dr. Markham: The main source of lead poisoning in our country today is from paint that is sometimes in our home. Lead was reduced in paint in around the ‘50s and eliminated in 1978. However, lots of homes still have that lead paint. When people remodel their homes or even if the paint is chipping that is the biggest source of lead poisoning for kids. Although you can see lead on old toys; you can see lead on costume jewelry. You can see lead on some bibs and things like that: older items that have been passed down maybe from several years ago.
Melanie: So, gasoline and paint--those kinds of things are no longer made with lead in them. Is there anything that still is?
Dr. Markham: Gasoline today in the U.S. doesn’t emit any more lead exposure. However, there are other countries which they think there is still a trace amount. That can still be a source for kids outside of the United States. But, for right now it’s mainly the paint in homes.
Melanie: How would kids ingest this? If they are swallowing paint? Or, what are they doing to ingest it or do they just have to be in the vicinity of something that contains lead?
Dr. Markham: It’s mostly the lead dust. They can get hold of lead chips that have chipped off of buildings if the building has been painted recently. They can chew on the chips. But, a lot of it is just the dust. Sources of exposure are kids who eat food that has fallen on the floor that may be from an old home where dust is picked up from the paint chipping over time. We suggest that families keep their window sills nice and clean and they keep their floors nice and clean and that we try to keep kids from eating off floors because that is often where they are exposed to it.
Melanie: How would we know if a child has been exposed?
Dr. Markham: That’s a great question. Most kids are asymptomatic meaning they aren’t showing any symptoms. At its very worse a lot of kids can have problems thinking, problems acting. There are cognitive issues and seizures at its very, very worse. Most kids don’t have any symptoms. Sometimes it’s belly pain, nausea, vomiting. It can come and go. It’s very nonspecific, we call these symptoms. That’s why we do screen kids about the age of one or two, depending on your insurance and your risk, we ask you about all of those things. It’s a simple blood test that we screen kids with.
Melanie: So then, what can be done about it? We hear about poisoning, Dr. Markham, we think about calling Poison Control but this is a little bit more ongoing and insidious. What do you do for it?
Dr. Markham: For the most part, we keep an eye on things and most kids have very low levels of lead. At that point, if it’s a very low level, we talk about what the exposure may be. There are lead dust kits that you can get through our government. You can swipe your home to see if the lead is coming through the home. Maybe it’s coming from a toy. We try to identify where that lead is coming from. We talk a lot about your diet. We like kids to be eating lots of calcium and iron because it reduces the absorption of lead. At its very worse, if it is very, very high sometimes we have to hospitalize these kids and there are specific therapies that we can give. However, that is fairly rare at this point in time but the risk of having long-term, neurocognitive affects from even a small amount of lead is quite severe. We do treat it pretty quickly.
Melanie: Give us some of your best advice on home care, things that we can do to prevent it. If we’re walking around, Dr. Markham and we’re trying to clear out the house of some of those hazards, what are we looking for? What do we do?
Dr. Markham: You can check the paint on windows and the floors. If the floors are peeling or flaking at all, you should try and take care of those. You can either tell your landlord about them. If it is your own home, you can often get an EPA certified contractor who knows how to clean up lead. That’s really one of the most important things to do. Keeping things clean is important because a lot of times, it’s just the dust that is in the air that contains the lead from these old homes. Cleaning the floors, the window sills, the table tops at least once a week. It is real important to wash your kid’s hands before eating or before sleeping because that is when the hands often go in the mouths. They have been touching lots of things, including maybe some lead dust around. They suggest that you also wash the toys once a week and keep the toys away from any areas with chipping paint. If you have young kids, always feed your kids at the high chair so that they have a less risk of touching the lead dust. Don’t let your kids eat food that has fallen on the floor, washing pacifiers and bottles if they have fallen on the floor. If you are going to go and repair your home or paint your home, especially if it’s older than 1978, it’s real important to talk to an EPA certified contractor. You can go on the EPA’s website to find out a little bit more about who those people are and what makes them certified. One of the other sources of exposures are people who work with lead in the job. If dad works with lead and he does piping or he works in any sort of mining, it is important to have him change his clothes or shoes right away, or if mom does.
Melanie: So, just in general, poison information, Dr. Markham, give your best advice to the listeners as a pediatrician about poisons and how easily our children can get into them; what we should look for and what we should do about them.
Dr. Markham: About poisons in general?
Melanie: Yes, poisons in general.
Dr. Markham: Anytime you are worried about any type of poisoning in any child, calling Poison Control is very, very important. They can walk you through is it concerning, is it not concerning. If it is concerning, what do you do about it and they are extremely helpful.
Melanie: Poison Control is 1-800-222-1222. That’s 1-800-222-1222 from anywhere in the country and they will direct you to your local poison control. So, in just the last few minutes, Dr. Markham, and with poisons in general, what might people not know? We’ve spoken about lead poisoning, where it’s found and what we can do to hopefully prevent it. But, what about in general? Poisons that we might not be aware of; poisons in our home that we might not be aware of that you want to let the listeners know to be careful of.
Dr. Markham: I think it is always important to keep all detergents locked away and anything in a bottle away from a child. If you can keep everything above the sink instead of below the sink, that’s really helpful. Keeping cosmetics away from kids. In the shower, making sure that things are up high and not down low. If you come across your child and they have ingested anything, even small amounts, calling poison control is definitely your first step. They may say it’s not a concern or they may say exactly the opposite: that you should seek medical care. But they, of course, are the professionals and can help you out with that.
Melanie: Why should people come to Maine Medical Partners for their care?
Dr. Markham: I think we provide the best care. We are really conscientious about keeping kids safe and healthy and we love our kids.
Melanie: That’s such great information. What a great pediatrician I’m sure you are. Thank you for being with us today. You’re listening to MMC Radio. For more information, you can go to MaineMedicalCenter.org. That’s MaineMedicalCenter.org. MMC.org. This is Melanie Cole. Thanks so much for listening.