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Collier Building, RM 4405

3000 Arlington Ave
Toledo, OH 43614
Mail Stop 1026
Student Services: 419.383.5810
Undergrad Advisor: 419.530.2673
Graduate Advisor: 419.383.5841

admitnurse@utoledo.edu

Effects of Lead

LEAD LEVEL (THERE IS NO SAFE LEVEL)

According to the Centers for Disease Control and Prevention (CDC), there is no safe blood lead level (BLL) (2015). Overall, the goal set for Healthy People 2020 to eliminate blood lead levels of 10 µg/dL or higher has not been met (CDC, 2015). In 2010, the CDC deemed the upper limit of blood lead levels to be 5 µg/dL; therefore, anything over 5 µg/dL requires intervention.

When a level between 5-9 µg/dL is found, the lead level should be confirmed with a venous sample test within 1-3 months (if initial stick is from a capillary sample). A referral to the child's primary care provider, local clinic, or the Lucas County Health Department can be made for follow-up testing. Levels of lead should continue to be drawn every 3 months for the first year; after 4 tests, lead levels should be drawn every 6-9 months until the level is below 5 µg/dL. A level of 10-44 µg/dL should be confirmed by venous sample within 1 month (ODH, 2015).                 

EFFECTS OF ELEVATED LEAD

There is compelling evidence that elevated lead levels have significant neurodevelopmental consequences:

  • decreased IQ
  • decreased attention span
  • lower executive functioning
  • poor spatial-visual skills
  • behavioral challenges
  • speech and language delay
  • impaired fine and gross motor skills (CDC, 2015)

Children and pregnant women tend to absorb lead at a higher rate; children absorb around 50% of ingested lead, whereas adults absorb about 10% (Manahan, Brockman, & Woods, 2007). Calcium and iron are competitive antagonists of lead, therefore, a deficiency in either can cause increased absorption of lead. Once lead is absorbed by the body, it deposits in blood, bone, and tissue (Manahan et al., 2007). Lead impacts tertiary brain structure development. Normal development occurs at a timed sequence, therefore, interruption of this can cause permanent disabilities such as the aforementioned neurological developmental consequences (Manahan et al., 2007).

Multiple studies have shown elevated lead levels negatively impact educational performance and testing outcomes even when mildly elevated (CDC, 2015).

Tables 1. Studies on Lead and Educational

 

Outcome Blood Lead Levels

Educational Impact Size of Study Location of Study
      ≤ 3 µg/dL  Decreased end of grade test scores More than 57,000 children North Carolina 
(Miranda et al. 2009)
     4 µg/dL at 3 years of age Increased likelihood learning disabled classification in elementary school Poorer performance on tests More than 57,000 children 
35,000 children
North Carolina 
(Miranda et al. 2009) 1 Connecticut (Miranda et al. 2011)
    5 µg/dL 30% more likely to fail third grade reading and math tests 
More likely to be non-proficient in math, science, and reading
More than 48,000 children 
21,000 children
Chicago (Evens et al. unpublished data) Detroit (Zhang et aJ. 2013)
     5-9 µg/dL Scored 4.5 points lower on reading readiness tests 3,406 children Rhode Island (Mclaine et al. 2013)
   ≥ 10 µg/dL Scored 10.1 points lower on reading readiness tests 3,406 children Rhode Island (Mclaine et al. 2013)
     10 and 19 µg/dL Significantly lower academic performance test scores in 4th grade More than 3,000 children Milwaukee (Amato et al. 2012)
     ≥ 25 µg/dL $0.5 million in excess annual special education and juvenile justice costs 279 children Mahoning County, Ohio (Stefanak et al. 2005)

                                                                                                                                                                 (CDC, 2015)

Last Updated: 7/27/17