Lead Poisoning Symptoms

Childrens Lead Risk

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Lead Poisoning Symptoms

by National Institute of Health

The symptoms of lead poisoning are numerous and affect many different body systems. Chronic exposure to even low levels of lead is detrimental to mental development in children, and has been correlated with decreased IQ and behavioral problems.
Other symptoms of lead piosoning may include hyperirritability, aggressive behavior, decreased appetite and energy, poor sleeping, headaches, constipation, and loss of recently acquired developmental skills (in young children). Anemia and abdominal cramping are also common.
Very high levels may cause acute encephalopathy with vomiting, staggering gait, muscle weakness, seizures, or coma. 

Body as a whole
muscle soreness
fatigue
weakness
joint pain
incoordination
tremor
twitching
convulsions

Eyes, ears, nose, and throat visual abnormalities

Gastrointestinal
loss of appetite
weight loss
constipation
nausea and vomiting
abdominal pain

Heart and blood vessels
high blood pressure

Nervous system
agitation
coma
hallucinations
lack of desire to do anything
irritable
uncooperative
headache
sleeping difficulty
confusion

Where is Lead Found?  

Note: This list may not be all inclusive.

Home Treatment   

Before Calling Emergency   

Poison Control, or a local emergency number   

What to expect at the emergency room   

Expectations (prognosis)   

Causes, incidence, and risk factors

Lead occurs naturally in the environment at very low levels. Relatively high level sources of lead occurred in car exhaust prior to 1980 (the lead from exhaust fumes was ultimately deposited onto the ground) as well as in older paints (modern paint does not contain lead). Other sources exist such as pewter pitchers and dinnerware, birdshot, and fishing weights.

In the past, toothpaste tubes were made of lead and condensed milk cans were soldered with lead. This has been corrected. Lead can also be found in drinking water from homes whose pipes were soldered with lead solder. New building codes require lead-free solder.

Infants and children most at risk are those living in pre-1960's housing where paint often contained lead. Small children often ingest paint chips or dust from lead based paint. Soil in cities with high traffic density may contain high levels of lead from car exhaust.

Signs and tests

Laboratory tests may include:
* serum lead levels
* erythrocyte protoporphyrin
* iron level
* complete blood count and coagulation studies
* bone marrow biopsy (stippled erythroblasts)
* X-ray of the long bones and abdomen
Treatment Return to top
For long-term exposure:
* isolation from or disposal of the lead source
* chelation therapy to remove lead from the body
In cases where someone has potentially eaten toxic doses of lead in a short period of time, the following treatments might be done:
* gastric lavage
* bowel irrigation with polyethylene glycol solution

Expectations (prognosis)

The outlook varies depending on the severity of toxicity. People with mildly elevated lead levels often recover without problems. However, even mild lead poisoning in children can cause permanent mental deficits.
People with higher lead levels have an increased risk of long-lasting health impairments and must be followed carefully. Children who have had acute encephalopathy from lead exposure have a much more guarded outlook.

Complications

A possible complication is acute encephalopathy (brain disease).
Calling your health care provider

Call your health care provider or local poison control center if signs of lead poisoning exist. 1-800-222-1222

Preventing Cryptosporidiosis:
A Guide to Water Filters and Bottled Water

Tap Water Filtering: Many, but not all available home water filters remove Cryptosporidium. Some filter designs are more suitable for removal of Cryptosporidium than others. Filters that have the words "reverse osmosis" on the label protect against Cryptosporidium. Many other types of filters that work by micro-straining also work. Look for a filter that will remove particles that are less than or equal to 1 micron in diameter. There are two types of these - "absolute 1 micron" filters and "nominal 1 micron" filters. The absolute 1 micron filter will more consistently remove Cryptosporidium than a nominal filter. Some nominal 1 micron filters will allow 20% to 30% of 1 micron particles to pass through.

NSF-International (NSF) does independent testing of filters to determine if they remove Cryptosporidium. To find out if a particular filter is certified to remove Cryptosporidium, you can look for the NSF trademark plus the words "cyst reduction" or "cyst removal" on the product label information. You can also contact the NSF at 789 N. Dixboro Road, Ann Arbor, MI 48105 USA, toll free1-877-867-3435, fax 313-769-0109, email info@nsf.org, or visit their Web site at www.nsf.org/certified/DWTU/. At their Web site, you can enter the model number of the unit you intend to buy to see if it is on their certified list, or you can look under the section entitled "Reduction claims for drinking water treatment units - Health Effects" and check the box in front of the words "Cyst Reduction." This will display a list of filters tested for their ability to remove Cryptosporidium.

Because NSF testing is expensive and voluntary, some filters that may work against Cryptosporidium have not been NSF-tested. If you chose to use a product not NSF-certified, select those technologies more likely to reduce Cryptosporidium, this includes filters with reverse osmosis and those that have an absolute pore size of 1 micron or smaller.

Package and Label information for purchasing water filters:

Note: Filters collect germs from water, so someone who is not HIV infected or immune impaired should change the filter cartridges. Anyone changing the cartridges should wear gloves and wash hands afterwards. Filters may not remove Cryptosporidium as well as boiling does because even good brands of filters may sometimes have manufacturing flaws that allow small numbers of Cryptosporidium to get in past the filter. Selection of NSF-Certified filters provides additional assurance against such flaws. Also, poor filter maintenance or failure to replace the filter cartridges as recommended by the manufacturer can cause a filter to fail.

If you drink bottled water, read the label and look for this information:

Bottled water labels reading "well water," "artesian well water," "spring water," or "mineral water" do not guarantee that the water does not contain crypto. However, water that comes from protected well or protected spring water sources is less likely to contain crypto than bottled water or tap water from less protected sources, such as rivers and lakes.

Home distillers: You can remove crypto and other germs from your water with a home distiller. If you use one, you need to carefully store your water as recommended for storing purified water.

Other drinks: Soft drinks and other beverages may or may not contain crypto. You need to know how they were prepared to know if they might contain crypto.

If you consume prepared beverages, look for drinks from which crypto has been removed:

Juices made from fresh fruit can also be contaminated with crypto. Several people became ill after drinking apple cider made from apples contaminated with crypto. You may wish to avoid unpasteurized juices or fresh juices if you do not know how they were prepared.

Lead in Drinking Water:
Questions and Answers

How does lead get into my tap water?

How do I know if my tap water is contaminated with lead?

Does a high lead level in my tap water cause health effects?

What can I do to reduce or eliminate lead in my tap water?

If my water has high lead levels, is it safe to take a bath or shower?

How does lead get into my tap water?

Measures taken during the last two decades have greatly reduced exposures to lead in tap water. These measures include actions taken under the requirements of the 1986 and 1996 amendments to the Safe Drinking Water Act www.epa.gov/ and the EPA’s Lead and Copper Rule http://www.epa.gov/. Even so, lead still can be found in some metal water taps, interior water pipes, or pipes connecting a house to the main water pipe in the street. Lead found in tap water usually comes from the corrosion of older fixtures or from the solder that connects pipes. When water sits in leaded pipes for several hours, lead can leach into the water supply.

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How do I know if my tap water is contaminated with lead?

The only way to know whether your tap water contains lead is to have it tested. You cannot see, taste, or smell lead in drinking water. Therefore, you must ask your water provider whether your water has lead in it. For homes served by public water systems, data on lead in tap water may be available on the Internet from your local water authority. If your water provider does not post this information, you should call and find out.

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Does a high lead level in my tap water cause health effects?

High levels of lead in tap water can cause health effects if the lead in the water enters the bloodstream and causes an elevated blood lead level. Most studies show that exposure to lead-contaminated water alone would not be likely to elevate blood lead levels in most adults, even exposure to water with a lead content close to the Environmental Protection Agency’s (EPA’s) “action level” for lead of 15 parts per billion (ppb). Risk will vary, however, depending upon the individual, the circumstances, and the amount of water consumed. For example, infants who drink formula prepared with lead-contaminated water may be at a higher risk because of the large volume of water they consume relative to their body size.

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What can I do to reduce or eliminate lead in my tap water?

If your tap water contains lead at levels exceeding EPA’s action level of 15 ppb, you should take action to minimize your exposure to the lead in the water. You should begin by asking your water authority this question:

1. Does my water have lead in it above EPA’s “action level” of 15 parts per billion (ppb)? If the answer is no, your water does not contain lead at current levels of concern. If the answer is “yes,” also ask the next question: 2. Does the service pipe at the street (“header pipe”) have lead in it?

This information is very important. It determines which of the next two actions (A or B) you should follow to protect your household’s health. A) If the pipe in the street (“header pipe”) does NOT have lead, the lead in your tap water may be coming from fixtures, pipes, or elsewhere inside your home. Until you eliminate the source, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours: a. Before using any tap water for drinking or cooking, “flush” your water system by running the kitchen tap (or any other tap you take drinking or cooking water from) on COLD for 1–2 minutes; b. Then, fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).

B) If the pipe at the street (“header pipe”) DOES contain lead, lead in the tap water may be coming from that pipe or connected pipes (it may also be coming from sources inside your home). Until the lead source is eliminated, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours. Please note that additional “flushing” is necessary:

a. Before using any tap water for drinking or cooking, run high-volume taps (such as your shower) on COLD for 5 minutes or more;

b. Then, run the kitchen tap on COLD for 1–2 additional minutes;

c. Fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).

2. In all situations, drink or cook only with water that comes out of the tap cold. Water that comes out of the tap warm or hot can contain much higher levels of lead. Boiling this water will NOT reduce the amount of lead in your water.

3. You can also reduce or eliminate your exposure to lead in drinking water by consuming only bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead. See resources below.

4. Children and pregnant women are especially vulnerable to the effects of lead exposure. Therefore, for homes with children or pregnant women and with water lead levels exceeding EPA’s action level of 15 ppb, CDC recommends using only bottled water for cooking, drinking, and baby formula preparation. Because most bottled water does not contain fluoride, a fluoride supplement may be necessary. Also, be aware that some bottled waters have not been tested and may not be appropriate for consumption. Contact independent testing organizations that certify bottled water. See resources below.

5. Make sure that repairs to copper pipes do not use lead solder.

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If my water has high lead levels, is it safe to take a bath or shower?

Yes, bathing and showering should be safe for you and your children, even if the water contains lead over EPA’s action level. Human skin does not absorb lead in water.

http://www.epa.gov
/safewater/dwinfo.htm

Water Resources

Please visit the following sites for more information:

General:

EPA Ground Water & Drinking Water
www.epa.gov/safewater
/lead/index.html This site includes comprehensive information on lead in drinking water. Safe Drinking Water Hotline: 1-800-426-4791.

Water Fluoridation:

CDC Oral Health Resources http://www.cdc.gov/OralHealth
/topics/fluoridation.htm This site includes water fluoridation fact sheets, frequently asked questions, and publications.

Bottled Water and Water Filters:

NSF International
http://www.nsfconsumer.org
/water/bottled_water.asp A nonprofit organization that certifies bottled water and water filters. Consumer Affairs Office toll-free hotline: 1-877-867-3435.

International Bottled Water Association
http://www.bottledwater.org The trade association that represents the bottled water industry. Information Hotline: 1-800-WATER-11.

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District of Columbia concerns about elevated levels of lead in drinking water.

According to the most recent information available, elevated levels of lead in District of Columbia drinking water are due to increased water corrosivity, and are aggravated in some homes by the presence of lead service lines. This article contains information on how to have water tested, special precautions that should be taken, and contact information for concerned customers.

Use your browsers "back" button to navigate this "elevated lead in drinking water" menu.

WASA's 2003 Drinking Water Quality Report [pdf, 12 pages, 1.3M, about pdf]

Consumer advisory

Special recommendations for children and pregnant women and nursing mothers

Bottled water and home water treatment devices

How to find out if you have a lead service line and get your drinking water tested for lead

Where to obtain additional information

Certified laboratories

Changes in lead levels during annual switch to free chlorine

Consumer Advisory

Steps you should take today to reduce potential exposure to lead in drinking water:

All consumers:

• Boiling your water will not remove lead!

• Use only cold water for drinking or cooking; hot water contains higher levels of lead. For making hot beverages or cooking, heat cold water on the stove.

• Before using faucet water for drinking or cooking, flush water lines by running the cold water for 60 seconds.

•Periodically, remove and clean the strainer/aerator device on your faucet to remove debris.

If you believe that you have a lead service line:

• The District of Columbia Department of Health (DC DOH) recommends that children under 6 years old and women who are pregnant or breast feeding should not drink unfiltered tap water until the concerns regarding the lead levels in the water have been resolved. DC DOH advises that unfiltered tap water should not be used for preparing infant formula or concentrated juices. Follow all of the flushing instructions below before filtering tap water. Flushing will decrease lead levels in the water from your tap, allowing water filtration units to perform more effectively. In addition, DC DOH recommends that all pregnant women and children under 6 years old have their blood lead level tested. For more information on blood lead level screening, contact DC DOH at (202) 671-0733.

• Draw water for drinking or cooking after another high water use activity such as bathing or washing your clothes so that a total of at least 10 minutes of flushing has occurred. (The large amount of water used will flush significant amounts of water from your home's pipes.)
and Flush your kitchen tap for 60 seconds and then collect drinking water in clean containers and store in the refrigerator.

If you still have concerns about lead poisoning:

• Have your water tested by a certified laboratory or contact DC WASA

Special recommendations for homes with children, pregnant women, and nursing mothers

Children and pregnant women are most at risk of adverse health effects from lead in drinking water. In homes with lead service lines, the District of Columbia Department of Health (DC DOH) recommends that children under 6 years old and women who are pregnant or breast feeding should not drink unfiltered tap water, nor should unfiltered water be used for preparation of infant formula or concentrated juices, until the concerns regarding the lead levels in the water have been resolved. Follow all flushing instructions before filtering tap water. Flushing will decrease lead levels in the water from your tap, allowing water filtration units to perform more effectively. DC DOH also recommends that all pregnant women and children under 6 years old have their blood lead level tested.

DC DOH provides information on how to have children screened for blood lead levels. The DC DOH can be reached by calling (202) 671-0733 or by visiting its Web site . If you have additional concerns about a child's health, contact his or her pediatrician.

Bottled water and home water treatment devices

If you are flushing your water lines but still have concerns about lead, you may want to consider switching to bottled water or purchasing a treatment device. Although EPA does not certify or endorse specific home drinking water treatment devices, you should purchase a treatment device certified by an independent testing organization, such as NSF International.

Choose a "point-of-use" (POU) device that will be used after potentially lead-leaching plumbing components. Point-of-use devices must be installed and operated according to manufacturers' instructions.

Bottled water is regulated by the U.S. Food and Drug Administration (FDA). When purchasing bottled water, look for products certified by NSF International or the International Bottled Water Association. You may also want to consider fluoride supplements because not all bottled water is fluoridated.

How to find out if you have a lead service line and get your drinking water tested for lead

DC WASA is responsible for supplying drinking water to the residents of the District of Columbia. There is not a problem with lead in drinking water as it leaves the treatment plant; the problem arises when the water causes corrosion inside the lead service lines and in homes with lead in their plumbing.

Please visit DC WASA's Web site to find out if you have a lead service line and how to get your water tested. We strongly encourage District of Columbia residents who believe they may have a lead service line to contact DC WASA and offer to be a testing site for the accelerated sampling program. We also urge them to cooperate in the full removal of lead service lines that test high for lead.

The DC WASA lead services hotline can be reached by calling (202) 787-2732 or by sending an e-mail to WQP2003@dcwasa.com.

Where to obtain additional information

EPA's Safe Drinking Water Hotline:
(800) 426-4791

DC WASA Lead Services Hotline:
(202) 787-2732
email WQP2003@dcwasa.com

District of Columbia Department of Health (DC DOH)

Blood Lead Screening Hotline (202) 671-0733

Lead in the District of Columbia

Lead Information Update

Laboratories Certified in Maryland and Virginia for the Analysis of Lead in Drinking Water

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