Childhood lead poisoning

Introduction
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By Michael Vincent S Mendoza MD

Childhood lead poisoning is also known as or subsumes Lead encephalopathy and Plumbism. -ed.

Childhood lead poisoning is a growing concern, particularly because new findings have shown that low level, typical-population lead exposures are associated with the development of cognitive and behavioral deficits. Although the United States Centers for Disease Control and Prevention set the lead level greater than10 µg/dl as the minimum value for intervention, lead effects observed below this limit imply that lead is toxic even in very low levels. The mechanisms of action of lead depend on the time of exposure and the degree of CNS maturation. Early-life lead exposure may lead to disease susceptibility throughout the life course. In this clinical article, Dr. Kathleen Bonifacio of Woodside, New York and Dr. Bhagwan Moorjani of Hope Neurologic Center in Orange, California discuss lead as an environmental risk factor, its effects on health, and its management. They also explain new investigations with implications on modifying lead threshold level that requires intervention as well as continuing actions to decrease lead exposures.

Key Points

  • Cognitive and behavioral deficits have been linked with population-typical lead exposures.
  • Lead influences fetal epigenetic programming that may alter phenotype and consequential disease susceptibility.
  • Maternal bone lead is a marker for adverse fetal outcome.
  • Calcium supplementation during pregnancy and lactation is associated with reduced lead levels.