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Populations at Higher Risk

Children, people who are pregnant, refugees, and certain workers experience higher risk for lead exposure compared to other populations.

Children under 6 years old are at risk for lead poisoning because their bodies more easily absorb lead compared to adults. Additionally, they tend to put their hands and other objects into their mouth that may be contaminated with lead dust.

Children who live in households at or below the federal poverty level and those who live in housing built before 1978 are at the greatest risk of lead exposure.1 Also, communities of color are at a higher risk of lead exposure because they may not have access to safe, affordable housing or face discrimination when trying to find a safe, healthy place to live.1 This is called housing inequity, and it puts some children, such as non-Hispanic Black persons, at a greater risk of exposure to lead.1

Children may not show signs of lead exposure until they are older. The only way to find out if your child has been exposed is to get a lead test. Lead testing is covered by Medicaid, Nevada Check Up, and most private insurance.

CDC Testing Guidelines:

  • Test children at 12 and 24 months of age or at least once before age 6, if not previously tested.

Providers should also screen children who are symptomatic or potential exposure to lead has been identified, regardless of the child’s age.

Providers for children not eligible for Medicaid or NV Checkup should – at a minimum – conduct a lead risk evaluation using the Childhood Lead Risk Questionnaire (CLRQ) to determine the risk of potential exposure during a healthcare visit if screening is not a viable option.

Consider a blood test, regardless of age, if children have any of the following conditions:

  • Pica, developmental delays, behavior problems, ADHD
  • Unexplained illness such as severe anemia, lethargy, abdominal pain
  • Ingestion of paint chips or object that might contain lead

References:

1Centers for Disease Control and Prevention. (2021, April). Populations at Higher Risk. Childhood Lead Poisoning Prevention. https://www.cdc.gov/nceh/lead/prevention/populations.htm

If a pregnant person has been exposed to lead in the past, the lead stored in their bones can be released back into the blood during pregnancy. This can cause increased blood lead levels, which can negatively affect the pregnant person and developing baby. The effects of lead in pregnant persons include increased risk for miscarriage, gestational hypertension, and preeclampsia. Since lead can cross the placenta, the effects of lead in the developing baby could include preterm birth, low birth weight, congenital disorders, and damage to the brain, kidneys, and nervous system.

CDC Testing Guidelines:

  • The CDC recommends that medical providers conduct blood lead testing as early as possible for pregnant persons or persons trying to get pregnant who have an increased risk for historical lead exposure. Consider testing preconceptionally or at first contact with the patient.
  • Behaviors such as pregnancy-related pica may occur after the initial blood lead test in the first trimester. In such cases, it may be warranted to test multiples time during the course of a pregnancy.

Use the Prenatal Lead Exposure Questionnaire to determine if a lead test is needed.

Lead poisoning disproportionately impacts refugee and other newcomer children resettled in the United States. Overall, refugee children arriving in the United States tend to have higher blood lead levels than U.S.-born children. In some cases, refugees are resettled into older housing in the U.S. with deteriorating lead based-paint that can case lead poisoning.

CDC Testing Guidelines:

  • Perform a blood lead test for children aged 6 months to 16 years within 30 days of entry to the U.S.
  • Within 3-6 months of an initial test, conduct a follow-up test for children aged 6 months to 6 years, regardless of the initial test result.

Consult the CDC Immigrant, Refugee, and Migrant Health webpage for more information.

Certain jobs and hobbies can cause someone to come in contact with lead. These activities have been known to put workers at risk of lead exposure:

  • Making ceramics with leaded glazes and paints
  • Jewelry making and electronics (with lead solder)
  • Making stained glass and glass blowing
  • Print-making
  • Refinishing old furniture
  • Hunting and target shooting
  • Casting ammunition, fishing weights, or lead figurines
  • Enameling copper
  • Casting bronze
  • Welding
  • Glass manufacturing
  • Recycling of metals, electronics, and batteries
  • Distilling liquor

CDC Testing Guidelines:

Test individuals who participate in any of the above-mentioned activities.

 

Updated on:  August 21, 2023

2023-08-21T16:31:53-07:00
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