Facts and Risks of Lead Paint and Toys

Host: We have a common problem today. We keep hearing the news that toys are loaded with paint from lead and everybody is up in arms; we can't use toys, have the word metal, there is a new thing in the newspaper from another company. How is a pediatrician aware of this problem, approaches the problem, when a parent says, what should I do, should my kid play with toys? Can he have lead poison? How would you approach that as a pediatrician? Vito Sessa: Well, lead poisoning is still with us today, its been around for ages. Lead is a ubiquitous element that's everywhere. It doesn't get metabolized, and so it gets excreted from the body, but it never really leaves the environment. Host: Where you get kid coming now with levels of 200-300, what we are starting to see kids with levels that's a little bit elevated, a little troublesome, but not really high, is that true? Vito Sessa: That is true. But we also know that these lower numbers can be significant in terms of growth and development. Host: What figure would you be comfortable with to say that, kid, you don't have a problem at all? Vito Sessa: Well, right now, under five is what the city, and what the American Academy of Pediatrics is comfortable with. Kids four to five or over. Host: The kids at six, seven, eight, and nine, it doesn't mean the kid is going to have major problems, but it means you have got to watch this kid, it means the kids was exposed? Vito Sessa: It means the kid was definitely exposed. We are all exposed, but -- Host: More than we like it to be? Vito Sessa: More than we like it to be, and we think that there are mild effects of even levels of five and above. So those kids were being followed every month -- Host: But they are not 100% sure, but ten and above, there is a lot of study say, there really is some concern. Vito Sessa: Absolutely. Host: The problem that evolves is coming into the house and shutting things out, is that true? Vito Sessa: That is very true. Host: And unfortunately I used to get ones, and less than threes all the time, I started to get fours and fives. Vito Sessa: Absolutely. Host: We don't know it's toys, we are more aware when we are checking it out. Also, if you go to a lab; is she taking a blood test from the finger or from the central part? Vito Sessa: It should be from the central part, that's a more accurate evaluation. Host: I was told that this is correct, that there is a little dust on the finger, maybe around, it could give you an inaccuracy? Vito Sessa: Absolutely. The finger test can be inaccurate both ways. You can get a contamination or get a false positive because of the lead dust from the skin. If the blood comes out too quickly or if the finger is compressed too much, you will get less blood and you will get a slightly lower blood value. So the finger stick can give you a false value either way. Host: So the question is, how should we approach this problem in primary care practice today, is it a logical approach? When would you check the first time if any kid has lead? Vito Sessa: Well, we check children for lead mandatory by the city, at one and two years; every child needs to be checked regarding environmental screen. Host: That could vary from state to state, but New York City, its the first year and second, you absolutely have to test? Vito Sessa: Right. Host: But what happens if we say two to five, what you do at that point? Vito Sessa: Those tests are recommended as well, as frequent as every six months, there should be a risk assessment. So if children are at risk, and they are at risk if they were foreign born, if they are living in housing that was built before 1950, if there was any construction done in their apartment or house, even in buildings built as late as 1978. If there is anyone living in the household, especially a parent and anyone who works in an industry with lead exposure. If there is any foreign material in the house, for instance, foreign cosmetics, although this morning I heard that they now have found lead in lipstick made in America by Maybelline I think is the name. Host: Maybe it wasn't really made in America. Vito Sessa: Maybe it wasn't made in America. Certainly, cosmetics made elsewhere, foods made elsewhere, herbal medicines made elsewhere, have been known to be contaminated with lead, and of course we know about the toys. Host: Having been made here doesn't guarantee its perfect, but we know there is a better chance it has been checked a little more carefully, is that true? Vito Sessa: Yes is the answer to that, but there is still lead all around us. There is lead around roads, in highways, probably leftover from when we had lead in gasoline. That lead that was in exhaust turned into dust. As I said, lead doesn't go away by itself, all you can do is contain it, get it, pick it up, put it somewhere, where it won't hurt anybody, but if its in a dust form, it's hard to do that. Host: It's silent and you don't even know it.