1. Lead Poisoning James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Paula Mandel, RN, BSN Public Health Nurse Hamilton County Health Department 317-776-8500 www.co.hamilton.in.is

2. After the presentation you will be able to… recall what lead is list three products that may contain lead explain two ways children would become poisoned with lead identify three signs and symptoms of lead poisoning

3. Exposed Children It is estimated that 14,000 Hoosier children under the age of 7 are lead poisoned In 2005 only 8% of ALL children were tested for blood levels. Of these children 1.27% had confirmed elevated blood lead levels (10mg/dl) Source: ISDH

4. What Is Lead… A bluish white lustrous metal found naturally in the environment Used in consumer products and manufacturing Lead can be found in… ● Lead based paint ● Contaminated soil ● Household dust ● Lead-glazed pottery ● Inexpensive metal jewelry Source: www.webmineral.comwww.webmineral.com

5. Who Is At Risk For Lead Poisoning… Children absorb lead more readily All children are susceptible despite ● Urban or rural residency ● Race or ethnicity ● Income level Children who are from: ● Members of minorities ● Recent refugees ● Medicaid recipients ● Living near or below the poverty level

6. Exposure To Lead… Eating (Ingestion) ● Lead particles & dust on hands transferred to food, drinks and children sucking on their finders ● 20% absorbed in adults (US Department of Health and Human Service) ● 70% absorbed in children and pregnant women (US Department of Health and Human Service) ● Breathing (Inhalation) ● Lead particles in the air

7. Signs and Symptoms… ● Tiredness ● Wrist or foot drop ● Sleep problems ● Weakness ● Dizziness ● Clumsiness ● Irritability ● Joint and muscle pain ● Nervousness ● Vomiting ● Headaches ● Loss of Appetite ● Difficulty concentrating ● Stomach aches ● Depression ● Constipation ● Forgetfulness ● Metal taste in mouth ● Hyperactivity ● Numbness At Low Levels NO observable signs and symptoms

8. Body Systems That Lead Effects… Brain and Nervous System Reproductive System Renal System (Kidneys) Circulatory System (Heart, Blood) Skeletal system (Bones and Joints) Muscular System

9. Other Effects… Learning Disabilities Speech and Language Problems Behavior Problems Hearing Damage Pregnancy complication Concentration Problems

10. Lead And The Nervous System… Most affect by lead Damage can be permanent Lead can damage the brain and destroy brain cells Damage can result in depression, irritability, forgetfulness, clumsiness, learning problems High exposures can result in hallucinations, coma and even death

11. Effects of Lead On the Blood… Lead damages red blood cells Prevents cells from carrying oxygen Lowers hemoglobin (carried oxygen)

12. Effects Of Lead On Bone Tissue… Lead from blood is deposited in bones Prevents calcium release into blood Blocks production of new blood cells Bones and teeth store 95% of lead in the body Lead is stored in bone tissue for over 30 years Under stress, lead is released from bone tissue

13. Effects Of Lead On Male Reproductive System… Decreases libido Infertility Damage to sperm Increase spouse’s chance of miscarrying, premature birth and birth defects in children

14. Effects Of Lead On Female Reproductive System… Reduces fertility Affects menstruation and menopause Lead passes through placenta to fetus May cause brain damage to fetus May cause miscarriage or premature birth May be released from bones back to blood

15. Some Known Sources… Lead-based paint and dust from lead based-paint Lead contaminated drinking water Imported cosmetics Vinyl and plastics Jewelry Pewter Fishing weights, ammunition, etc

16. Other Known Sources… Lead contaminated soil Occupational sources: ● Remodeling construction ● Smelters ● Battery factories ● Hobbies Folk and ethnic remedies (Alarzon & Greta) Food and food containers (tamarind candy, pottery, crystal glassware)

17. Toys… Some toys may have lead paint or other parts that have lead in them To see a list of recalled toys visit: Mattel Toys www.mattel.com/safety/us/ www.mattel.com/safety/us/ Or U.S. Consumer Product Safety Commission www.cpsc.gov

18. Jewelry… Jewelry may contain lead or paint used in the product may contain lead

19. Lead In Homes… Lead paint in homes built before 1978 place children at risk for lead poisoning The older the home the higher the risk for lead hazards Of the children poisoned, 80% of the exposed came from housing 90% of the pre-1950 housing where the poisoned children lived had lead based paint hazards CDC recommends having children tested for lead at 6 months and then yearly if your home contains lead paint of if you are exposed to lead at work or use lead in a hobby

20. Where In The Home Is Lead… Window sills and doors Surface with chipped, peeling or deteriorating paint Porches, rail fence Bare soil around perimeter of house or play area Floors where dust can settle

21. At Risk Criteria… Exposed to or living in a house or childcare center built before 1978 With siblings or playmates who have lead poisoned Frequently in contact with people exposed to lead thought work or hobbies Who are recent immigrants In low-income families Enrolled in Hoosier Health Wise Who are members of minorities particularly African Americans Using folk or ethic remedies Exposed to renovation and remodeling activities Children 6 Years Of Age And Younger:

22. Testing For Lead… A Blood test is used to check for lead exposure: ● Blood from a vein (Doctors office) ● Finger stick (Hamilton County Health Department) Results > 10ug/dL require a confirmatory test: ● Must be sent to physician for a blood draw Medical and case management is required Retesting required if lead poisoning confirmed

23. Blood Test Results… 10 ug/dLSlight loss in IQ; hearing and growth problems 20 ug/dLModerate loss in IQ; hyperactivity; poor attention span; difficulty learning; language and speech problems; slower reflexes 40 ug/dLPoor bone and muscle development; clumsiness; lack of coordination; early anemia; decreased red blood cells; tiredness; drowsiness 50 ug/dLStomach aches and cramps; anemia; destruction of red blood cells; brain damage 100 ug/dLSwelling of brain, seizures; coma; death Normal Range 0-9 ug/dL

24. Treatment… Remove the lead source If the lead source can not be removed, seal the lead product rather than remove it Chelation Therapy: ● Medication that binds with lead so lead is excreted in the urine

25. Other Treatments… Nutrition Therapy: ● Diets high in iron and calcium ● Examples of foods high in iron are: *Cheese, fish, meat, eggs, beans, spinach, raisins ● Examples of foods high in calcium are: * Milk, cheese, ice cream, yogurt, bread, fish, meat, broccoli, fruit, nuts

26. FREE Lead Testing… Hamilton County Health Department 317-776-8500 www.co.hamilton.in.us By Appointment

27. More Information… Centers For Disease Control www.cdc.gov Consumer Product Safety Commission www.cpsc.gov EPA www.epa.gov Indiana State Department of Health www.in.gov/isdh