Lead Poisoning in Children

On June 13, 2007, the U.S. Consumer Product Safety Commission in conjunction with RC2 Corporation announced a voluntary recall of various Thomas & FriendsTM Wooden Railway Toys. The reason for the recall as listed on the U.S. Consumer Product Safety Commission site was that the paint on these toys contained lead. These toys were manufactured in China. The recall specifically involves the wooden vehicles, buildings and other train set components.

Studies have proven that lead causes a range of serious health effects, especially for children. Children are more vulnerable to the effects of lead because of their developing brains and nervous systems. Further, when compared to adults who have had identical exposure to lead, children under the age of six have been found to absorb even greater amounts. Death by lead poisoning is rare; however, dangerous levels in children can cause serious health effects.

Brain damage occurs even with low levels of lead in the blood system. Lead levels are categorized into Classes I through V. Class V is the most severe and constitutes a medical emergency. Classes are defined in the following way:

Class I: less than 10 micrograms per deciliter
Class II-A: 10-14 micrograms per deciliter
Class II-B: 15-19 mcg/dL
Class III: 20-44 mcg/dL
Class IV: 45-69 mcg/dL
Class V: 70 or greater mcg/dL

Children who are found to have blood levels higher than 60mg/dL often complain of headaches, abdominal problems, clumsiness, agitation and/or decreased activity. When brain damage does occur due to lead exposure, it is not reversible. Other health problems noted in children are:

• Nervous system and kidney damage
• Learning disabilities
• Speech, language and behavior problems
• Poor muscle coordination
• Decreased muscle and bone growth
• Hearing damage

Treatment depends on the amount of lead that has been found in the blood. Classes I through III can be treated by just removing the lead source. If this is determined to be the treatment course, retesting should occur one month after the removal of the exposure to evaluate if that was a successful plan. For those classes above III, a chelating agent may be prescribed. Chelating agents are used because it binds with the lead and is then excreted in the urine. For those who have lead levels higher than 45 mcg/dL, treatment may require the administration of ethylenediaminetetraacetic acid (EDTA). EDTA is administered intravenously in combination with dimercaprol.

The American Academy of Pediatrics has recommended that physicians screen for potential lead exposure, and in those children who do fit the criteria, obtain blood levels. They also support the government plan included in Healthy People 2010 to eliminate lead poisoning by 2010. They also recommend regulations that control and minimize the entry of lead into the environment.

References:
American Academy of Pediatrics Committee of Environmental Health. Lead Exposure in Children: Prevention Dectection and Management. Pediatrics 2005 Oct 116(40: 1036-1046.

U.S. Consumer Product Safety Commission. RC2 Corp. Recalls Various Thomas & FriendsTM Wooden Railway Toys Due to Lead Poisoning Hazard. June 13, 2007 Release # 07-212. Retrieved July 2007 from http://www.cpsc.gov/prerel /prhtml07/07212.html

Mayo Clinic Lead Poisoning. Retrieved July 2007 from http://www.mayoclinic.com/health/lead-poisoning/FL00068/DSECTION=2

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