Lead-Poisoning Case Studies

Lead, a naturally occurring metal and can be used in almost everything. It can cause serious health issues if it is exposed for a long time, particularly in children as they are more susceptible to absorbing and retaining lead in their bodies. Each year, in the United States 310,000 of 1- to 5-year age group are found to have unsafe levels of lead in their blood, which can cause a wide range of symptoms. (1)

(Campbell, 2016). Two giants in childhood lead poisoning research and advocacy, Dr. Philip Landrigan and Dr. David Bellinger, summarize the adverse effects of lead very completely, yet succinctly: “Lead is a devastating poison. It damages children’s brains, erodes intelligence, diminishes creativity and the ability to weigh consequences and make good decisions, impairs language skills, shortens attention span, and predisposes to hyperactive and aggressive behavior. Lead exposure in early childhood is linked to later increased risk for dyslexia and school failure.”(p. 3).

Lead poisoning has been a concern for many years. In fact, because of the affects of lead poisoning, there has been an extensive decline in its use. "Many people believe lead poisoning is no longer a threat, yet millions of homes contain lead based paint" (Heck, J., 2005, para. 1). Exposure to lead at any level is unhealthy, especially in infants, children, and pregnant women and continues to be an ongoing dilemma in this country. I read two articles concerning lead poisoning; the first article is from FineTuning, a popular press and the second article is from Pediatrics, a peer-review journal. In this paper, I will clearly summarize each article by comparing the content of both articles. In addition, I will summarize the attention to

Everyone is susceptible to the dangers of lead contamination; but children are especially at risk. High levels of lead in children can lead to brain and kidney damage and damage to red blood cells. Low levels of lead can also cause problems that are less life-threatening but can be just as devastating, like low IQ, hearing and language impairment, reduced attention span and poor school performance. In adults, exposure to lead can lead to an increased risk for high blood pressure. Pregnant women and their fetuses are extremely vulnerable to lead. In women, lead increases the risk of infertility and miscarriages; in fetuses, lead can cause low birth weight, premature birth and impaired mental and physical development.

The major sources of lead here were gasoline, paint chips and water from old plumbing. After lead was removed from gasoline and paint, blood lead levels (BLL) in children decreased on average from 16 mcg/dL to less than 3 mcg/dL. Residual lead persists in the environment, however. A toxic level is currently defined as 5 mcg/dL. In U.S. children age 1-5, the prevalence of BLLs >10 mcg/dL decreased from 88% to 4.4% between 1976 and 1994 and further dropped to 0.8% by 2010. Yet there are still almost half a million children in the U.S. with levels >5

According to the Mayo clinic, lead poisoning is most susceptible to children under the age of six. Early estimates indicate that as many as 8,000 children could have been given the drinking water. High levels of lead according to the Clinic’s report “can severely affect mental and physical development… [and] lead poisoning can be fatal.”

The improved screening and treatment of lead poisoning decreased the severity of symptoms usually seen. However, the level of lead in the blood does not establish what symptoms are seen, since lead in blood only establishes current exposure. Recently, studies have shown that a long exposure to low amounts of lead may have severe neurobehavioral effects that are not diagnosed until the child enters school (Singhal et. al., 1980).

The Agency for Toxic Substances and Disease Registry says that lead exposure in children may cause comas, seizures, and death. Because a child’s brain is still developing, the damage of lead exposure is more severe. Not only does lead affect the way the brain physically develops, but lasting neurological and behavioral damage includes lower IQ scores, higher risk of attention deficit disorders and hearing impairments, decreases in impulse control, and potentially violent behavior. Mona Hanna-Attisha, a pediatrician who runs the pediatric medical residency program at Flint’s Hurley Medical Center, studied blood lead level tests and found that the percentage of children with elevated blood lead levels had gone from 2.4 percent to 4.9 percent citywide (Barry-Jester). Hanna-Attisha’s findings showed a rise to sixteen percent in neighborhoods where lead levels were known to be elevated in the water. She points out, "Lead only last in body a short time … and when you screen them, it's no longer elevated. So we've missed children's peak lead levels and that's why everyone says it

There are multiple reasons to expect that a person's lead exposure as a child could affect

Imagine you're drinking a cup of water and every single drop is poison. This could be happening to you. 50% of the United States have lead in their drinking water. This is because of lead based pipes. Lead based pipes have been leaching lead into water which connects to drinking water. It can also be because of the state's water utilities that might have lead in their water. ( EPA's safe drinking water information system database reports, three, 2016 by Isabella DC, USA Today) says Lead can cause brain damage, cancer, seizures, hearing loss, learning disabilities, and more!

Potential lead contamination from drinking water presents a significant health risk. Recent examples of this lead contamination include Flint, Michigan, a city that experienced a large increase in the number of people, especially children, who exhibited symptoms of lead poisoning. A March 9, 2016 article in the Washington Post reported data from the Environmental Protection Agency that indicated approximately 350 schools and day-care centers across the US failed lead tests approximately 470 times between 2012 and 2015. Seven years ago, according to the Post, a study concluded that hundreds of young children in Washington, DC, had potentially damaging amounts of lead in their blood due to contamination in the city’s tap water. The toxin can cause permanent developmental and behavioral issues.

As a family nurse practitioner (FNP) one of the Healthy People 2020 objectives that I want to address in my clinic is “how to eliminate blood lead levels in children ages 1-5 years” (Edelman, Kudzma & Mandle, 2014, p. 432). Exposure to lead can lead to serious adverse effects. While completing my clinical rotations at different family practice facilities, I have never heard a patient and their child being educated on the signs and symptoms of lead exposure. I believe this is a topic that must be addressed to parents during every annual well child visit. Education is the most effective way I as an FNP can ensure this Healthy People 2020 objective gets met.

This specific portion of the population is exposed to multiple contaminants. Low-income communities face increased exposure to heavy metals, especially lead . Especially those of low SES who are of a minority is more likely to be exposed to lead. Lead exposure in this population is almost double that of more affluent white neighbourhoods. Not only is lead exposure more frequent, the levels of lead seen in children in low-income houses have been known to exceed safe limits. This is often a concern for children as lead exposure can increase the risk for many health complications later in life. Furthermore, nutrition can also play a role in one's exposure to lead. Poor nutrition can be affiliated with higher risks of lead toxicity. Children with poor nutrition, suffer from more side effects and complications of lead exposure. It can then be concluded that impoverished communities face greater risks of lead exposure and toxic lead levels. This correlation illustrates that those of low-income houses are a high-risk population for lead exposure in comparison to communities of higher income levels.

The factors that should be included to determine the magnitude of risk to human health from lead within a population would be to consider the effect of lead dose exposer within children and adults and the exposer of lead to a population living in low socioeconomic areas. Lead is exposed through food (canned), water, air, soil, dust, petrol, paint etc. High exposer of lead could damage almost all organ systems which include; Central Nervous System, anaemia, kidney damage and could lead to death. Low levels of lead exposer could indicate health problems such as decreased haemoglobin, vitamin D, central nervous system and growth (Tong, Schirnding & Prapamontol, 2000). Research shows that high blood lead levels is associated with environmental

Despite the documented reduction in the general population’s exposure to lead , research continues to demonstrate significant increases in risk of adverse outcomes in both children {Wigle, 2005 #96;Lanphear, 2005 #18} and adults {Guallar, 2006 #32;Lustberg, 2002 #59;Navas-Acien, 2004 #60} at low blood lead levels. In addition, millions of people carry elevated body burdens of lead, from past exposures, that may induce present and future health effects {Nash, 2003 #99;Nash, 2004 #100}. Given continued uses of lead by human societies (primarily for batteries and lead smelters ), the persistence of past uses (such as house paint, automotive fuels, and plumbing), further understanding of the negative health impact of lead remains a public