Lead and Arsenic exposure Susan Buchanan, MD, MPH University of Illinois at Chicago School of Public Health

Lead in Paint and Gasoline 1978 lead paint ban 1976 leaded gas phase-out

Common Sources of Lead Plenary A - Susan Cummins, MD, MPH 3

Common sources of arsenic

Children’s touching and mouthing behaviors touches to surfaces 83/hr hand to mouth area 35/hr hand/object in mouth 21/hr Ko et al, J Expo Sci Environ Epid 2007 Plenary A - Susan Cummins, MD, MPH 5

Lead Exposure  Death 100 Encephalopathy 60 40 Abdominal pain 30 Lead in Blood (g/dL) CDC Reference Level 1960 1978 1985 1991 2012 Health Effect Death Encephalopathy Abdominal pain Anemia Reduced IQ Behavioral problems  100 60 40 30 25 10 5 Deaths are now rare, but still occur. Last known deaths related to exposure: 2000: NH lead paint exposure; 2006, MN – ingestion of charm containing lead. 1960s=60, 1970=40, 1978=30, 1985=25, 1991=10. Levels roughly correlate with clinical symptoms. Should it be lower than 10? (1) no intervention, (2) lab variability, (3) no threshold even exists, and new # would be arbitrary 6

Children 1 to 5 years Blood Lead Level (BLL) 16 14 14.9 12 10 Geometric Mean BLL, g/dL 8 6 NHANES: program to assess health an nutrition: combines interviews and physical exams. >88% of all children had a BLL>10; by IV 1.6% had BLL>10. Geo mean: numbers multiplied to the nth root of product is taken, only applies to positive #s. 4 3.6 2 1.9 1976-1980 1988-1991 1999-2002 NHANES II NHANES III NHANES IV 7

Health Effects of Lead No “safe” blood lead level for neurobehavioral effects Loss of IQ Behavioral problems Poor school performance

Health effects of arsenic Cancer liver, bladder, and lungs Nerve damage Skin rash

Prevention *REMOVE FROM EXPOSURE* Wash hands frequently Wash toys, wet mop Yearly blood lead test