The good news — if slow, insidious, and permanent poisoning can be described as “good news” — is that blood lead levels in American children have steadily declined over the past half century.
The bad news is that the pandemic may have wiped out some of those gains.
During the pandemic, especially in the early days of strict COVID-19 lockdowns, fewer children are seeing their doctor for a healthy child check-up, which means fewer children are getting routine check-ups to monitor their blood lead levels (BLL), according to A 2021 CDC report. Meanwhile, with schools and daycares closed, these children are spending more time at home and are exposed to lead-based paint, water, dust and soil on a daily basis.
“Lead exposure affects the developing brain in early childhood, and the effects are essentially permanent,” said Dr. Andrew Loza, a resident physician at Yale University School of Medicine who examined lead testing in children during the pandemic at a clinic in Connecticut. Rate.
Even low levels of lead exposure can reduce IQ and cognitive performance, cause learning difficulties, reduce a child’s attention span, and cause behavioral problems. For adults, lead exposure is associated with a higher risk of cardiovascular death and kidney damage.
High lead levels also increase the risk of violent and even criminal behavior later in life.Published on Environmental Studies And where population-level peaks of childhood lead exposure have been mapped — usually after 20 years — crime rates are nearly identical.
“Lead Exposure Linked to Behavioral Disorders and Crime,” said Dr. Michael McFarland, 2022 co-author NASA Research shows that half of the U.S. population is exposed to lead in early childhood. “My view is that lead exposure definitely fuels these crime waves.”
How common is this problem? A study in 2021 American Medical Association Pediatrics, based on testing of more than 1 million U.S. children under the age of 6, showed that more than half had detectable lead levels in their blood, and nearly 2% had elevated lead levels. That might not sound steep until you do the math: There are nearly 475,000 children across the country. Loza said there is growing evidence that “there is no safe level of lead.”
The US government banned residential lead paint in 1978 and banned leaded gasoline in most vehicles in 1996. But decades of lead exposure — in dust wafting from painted window frames, in backyard soil where exhaust fumes, through lead-welded pipes in sluice gates — has left a toxic legacy.
McFarland’s PNAS study showed that more than 170,000,000 people — mostly those born between 1951 and 1980 — were exposed to high lead levels in early childhood. That was yesterday’s child. But children growing up today still suffer from lead exposure and its irreversible effects.
“It’s most harmful during the biologically sensitive period, from infancy to around age five,” McFarland said. Once in the body, lead mimics calcium, a dangerous chemical trick that can change the way brain signals travel from one neuron to another. This can trigger a cascade of effects, including emotional confusion, ADHD and general psychological distress, he said.
Lead exposure disproportionately harms children of color. According to a 2020 article, black children are 2.8 times more likely than white children to have a BLL of more than 5 micrograms—a level of exposure that stems from decades of housing discrimination and generational poverty. International Journal of Environmental Research and Public Health.
Children of color are more likely to live in homes with deteriorating lead paint, as well as in dense urban areas, where leaded car exhaust deposits in soil and groundwater. “These same populations are also the ones most affected by COVID — both financially and healthily,” Loza said.
Testing for children’s BLL is far from uniform: Those enrolled in Medicaid must be tested at ages 1 and 2, but requirements vary from state to state for children with private insurance.
At the peak of COVID-19 restrictions, routine BLL testing in children fell 34% in 34 states and territories compared to the same period in 2019, according to a February 2021 report from the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.
This means that nearly 10,000 children with BLL over 5 micrograms may be neglected. Loza, co-author of the 2021 Pandemic Lead Detection Rate Study Journal of Pediatric Health Carerecalled seeing a family with two children: a 4-year-old whose BLL was tested before the pandemic but not followed up, and a younger sibling who had never been tested.
“Parents say taking kids to the doctor is scary; they try to reduce exposure [to COVID-19]. I realize we’re putting some of the burden of preventive medicine on families, weighing COVID exposure versus lead toxicity,” Loza said.
Lead exposure is irreversible, but doctors and advocates say it’s still critical to know when a child’s BLL is elevated so families can eliminate the source of lead and teachers, parents and doctors can look for and respond to any cognitive and behavioral changes.
“This is not rocket science,” said Colleen Macaulay, MPH, co-chair of the Penn State Lead-Free Commitment Project, which aims to eliminate lead-based paint hazards in homes, increase lead testing, and refer affected children Receive early intervention services. “This is a completely preventable health condition.”
What will be the lifetime impact of lead exposure on the COVID generation — children who have also weathered the social, emotional and learning toll of the pandemic?
“Kids with lead in their bodies have trouble learning. They have trouble concentrating,” Macaulay said. “Children who test positive for lead are at higher risk of not graduating from high school. They are at higher risk of being involved in criminal activity.”
As for the future of these children, McFarland said, there are more questions than clarity. “we know [lead exposure] There are effects on intelligence – lower levels, equivalent to a large loss of income. We know it’s associated with mood disorders, ADHD, and other disorders.
“But what are the unknowns? Will cognitive decline have an impact? How will this affect people as they enter old age? [Lead exposure] We suspect this will continue to affect people’s health for decades to come. “
While lead may not be found in car gasoline and new paint, it is still used in propeller plane fuel, he noted. Lead is also lurking in soil, drinking water, some traditional medicines, and consumer products such as toys and collectibles—things more children have been exposed to at home during the pandemic.
Lead has a long and contaminated history. Considered by the ancients to be the “father of all metals”, lead was an ingredient in rouge and mascara, pigments, spermicides, condiments, and pipes that quenched the thirst of Rome and its imperial cities. The Romans knew that acute lead poisoning could lead to insanity and even death, but they were unaware of the contagious effects of low-level exposure.
Every grain of lead that remains in the environment poses a threat to children. But, McFarland says, we can still learn from the mistakes of the ancients — and our own haphazard use of lead in previous decades. “There have been concerns about lead toxicity since the early 1920s,” he said, but it has also been assumed that the substance “is innocent until proven guilty.”
Now, he says, “Maybe we shouldn’t assume [substances] They are benign until proven, but there are some criteria to determine if they are harmful before we release them to the general public. “