Get The Lead Out

Today’s news of Mattel’s huge recall of lead painted toys comes right on the heels of a scientific study demonstrating that no level of lead in our children is OK. Is this really 2007?

lead

Multiple sources today reported the recall by Mattel of 1.5 million children’s toys due to concerns of lead paint contamination. This marks the second recall in months due to lead paint on toys made in China – the RC2/”Thomas the Tank Engine” fiasco being the first. Lots of editorials out there about how we need to better police imports in the global market of the 21st century. What about the fact that China, a billion dollar toy industry giant, still uses lead paint?!? Is this the 1900’s all over again? We’ve been fighting for the past hundred years to get lead out of our environment – our paint, our gasoline – as the paint industry continues to deny it knew about the health effects years ago. Sound familiar, tobacco fans? For more on this sad story, read Dr. Howard Markel’s remarkable editorial in a recent issue of JAMA.

Ironically, only yesterday the prestigious journal Environmental Health Perspectives published an article (“The Relationship between Early Childhood Blood Lead Levels and Performance on End-of-Grade Tests,” Miranda ML et al) demonstrating the additive adverse effects of even small concentrations of lead on children’s cognitive development. Historically, “acceptable” blood lead levels in children have been lowered as science catches up to the common sense reality that any amount of lead is potentially neurotoxic. The current “acceptable” standard is less than 10 micrograms per deciliter; anything less is not actionable according to all conventional guidelines. Under these guidelines, chelation therapy – the use of prescription pharmaceuticals to bind lead to increase its excretion – is not advised until the blood lead levels reaches 45 mcg/dl. Yet we know that children with levels possibly as low as 2 mcg/dl may suffer neurological damage. Does anyone else detect a problem here? Let’s put it simply: NO AMOUNT OF LEAD IS OK. What to do about it is another story. Which brings me to the most powerful conclusion I can provide. The following story was sent to me today by a concerned mother and experienced pediatrician.

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I wonder what I, personally, am supposed to do with this information? I understand what I, professionally, am to do with it. That is caution parents about the potential harm from even low levels of lead and encourage aggressive testing for lead even among “educated professionals who choose to live in rehabbed inner city housing and insist that their child does not need lead testing!” Yes, I have had this discussion more than once.

Personally, however, I have a son who just graduated from 6 years of college, with some difficulty, after having been an amazing student in a small private high school. He is a very sociable person, with excellent people skills. In pre-school he was diagnosed to have ADHD and treated for some time until it became clear that the treatment was much worse than the disease. Why am I telling you all of this? Because, when I was working days, nights and weekends as a pediatric resident, this then toddler was discovered next to an old door in our apartment with visible signs of flaking paint. Because of the age of this house and the uncertain age of the paint on the door, I tested my son’s blood for lead in something of a panic. This was 1984. The level of 7 ug/dl was met with dismissive assurances by my seniors that there was absolutely no clinical significance to this finding.

At that time, I wondered how ANY LEVEL of lead could be considered harmless. There was no support for pursuing this. I was clearly being hysterical. My mind raced, fruitlessly, after all this level was only a snapshot. What had his lead level been last month or three months ago.

Still, I ask you. What am I to do now? There is no landlord to sue (He’s long dead – a very nice old German gentleman). Do I need more mother’s guilt? Should I suggest that my son have chelation (many years after the fact)? Should I tell him that, by the way, he was a victim of lead poisoning as a child, we simply didn’t know it? Or do I ignore this finding and tell myself that it’s all water under the bridge and he’s doing as well as can be expected and I couldn’t have done anything differently anyway?

This young man has learning, behavior and motivational issues that may be related to lead exposure at an early age. What I would like to know is how does this (new research) information help him? I look forward to seeing someone tackle the next logical step and tell us what to do with this information beyond sharing it for preventive purposes. What do we tell the moms now, whom we told before, there was no reason to be concerned?

Comments

  1. From today’s Reuters:
    “A 2005 report in a Beijing newspaper cited estimates that 60 percent of Chinese-made toys used paint with lead above internationally accepted limits.”
    These poor children.
    http://sciam.com/article.cfm?alias=for-chinese-children-lead&chanID=sa003&modsrc=reuters

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