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Low levels of lead poisoning may affect child’s reading level

May 14, 2013

books,boys,childhood,children,educate,education,Fotolia,kids,learn,learning,libraries,males,people,Photographs,readings,reads,schools,studies,studingWhile even minor levels of lead poisoning have been shown to affect a child’s health and IQ. A recently published study linked an effect of lead poisoning to a child’s ability to read. EmaxHealth reports,

This new study is the first time researchers have examined a relationship between exposure to lead and reading readiness in young children. It is not the first time, however, lead exposure has been shown to cause significant healthand behavior problems in youngsters, as is described below.

The new finding, reported by Pat McLaine, DPH, of the University of Maryland, and colleagues notes that even though the “level of concern” for lead in children, issued by the Centers for Disease Control and Prevention about a quarter of a century ago, is 10 micrograms per deciliter (10 ug/dL), the kindergarteners in their study who had blood lead levels between 5 and 9 ug/dL did not perform well on reading readiness.

Thus it was no surprise that children with lead levels of 10 ug/dL or higher performed even worse on reading readiness tests. The 3,406 children in the study had been tested for lead levels an average of three times before they entered kindergarten.

The study participants were largely low income and consisted of nearly 60 percent Hispanics. Here are some of the findings:

  • Average blood lead levels were 4.2 ug/dL overall
  • 20 percent of the children had at least one reading of 10 ug/dL or higher
  • More than two-thirds of the children had at least one reading of 5 ug/dL or higher
  • Blacks and children whose first language was not English or Spanish had the highest levels of lead
  • Researchers saw a clear relationship between exposure to lead early in life and level of kindergarten reading readiness, even after they made adjustments for language spoken, socioeconomic status, and other factors

The authors concluded that their findings “suggest the need to evaluate current screening approaches for early reading intervention and to determine whether adding a history of elevated [blood lead levels] could improve targeting of children who are at risk of school failure.”

Whole Foods, Trader Joe’s may be selling lead-tainted candies

May 3, 2013

California has filed a lawsuit against Trader Joe’s and Whole Foods over the sale of lead-tainted candies that are improperly labeled.

At Whole Foods, the suit named the market’s “bulk ginger” and The Ginger People Baker’s Cut Crystallized Ginger Chips as not complying with the law. The suit did not identify which company manufactured each specific product sold at each store.

You can read more about this lawsuit here.

Lead in children’s lipgloss

April 15, 2013

One child’s parents found a surprising source of their daughters lead poisoning:

Lead poisoning is most common in kids under age six, and can have serious health consequences from learning disabilities to death.

Kids are typically exposed to high lead levels if they live in an older home with lead based paint, or suck on toys with lead paint. But one eastern Iowa family’s learning lead lurks in other places, too.

Brooklyn Schneiderman just turned six. She’s a happy little girl. But just a few months ago, Brooklyn had a health scare when a routine screening showed her lead levels at nearly double the acceptable amount.

At first, her parents couldn’t figure out what was causing it.

“They reminded us to look at what her favorite toy was, or what she played with the most,” said Brooklyn’s mother, Jennifer Schneiderman. “So that was easy then. It was lip gloss. She’d sit in front of her mirror for long periods of time and apply lip gloss.”

The sparkly, pink glosses look like a perfect play item. But when Jennifer Schneiderman suspected the glosses might be spiking Brooklyn’s lead levels, she a took a closer look only to find many of them had labels with words like “caution” and “keep out of children’s reach.”

It baffled her, since the products are clearly marketed to little girls.

The glosses were of several different brands, mostly made in China.

“They have princesses on them,” Schneiderman said. “So I don’t know what adults would be interested in these products.”

After taking away Brooklyn’s lip gloss, and nothing else, her lead levels dropped to barely traceable.

Luckily, Brooklyn didn’t have any health problems, and Dr. Kelly Schmidt knows it’s because the lead spike was caught early.

But he says this case is a reminder for families to keep a close eye on everything that’s in their homes that could lead to lead exposure.

“With children, it’s the dust in the home, the dust from the paint chips, the soil that could be out in your yard,” said Dr. Schmidt, Cedar Falls Primary Care. “It could be a problem with toys, like Brooklyn getting into some lip gloss that head lead in it when her parents got to looking. It’s just little things you don’t think about.”

Jennifer Schneiderman now reads labels of all the products she buys, and hopes Brooklyn’s story will encourage other parents to do the same.

“We don’t want any other little princesses hurt by their lip gloss,” Schneiderman said.

Lead poisoning is most common in children, but can happen in adults. Removing the source of lead, sometimes through costly home lead abatement, usually helps bring the body’s lead levels into the acceptable range.

If not, kelation therapy medicines can also be used.

To help with home lead screening, the Black Hawk County Health Department does conduct door-to-door home visits in target areas of the community. 

The city of Waterloo even offers programs to help families deal with lead paint problems. It’s available to homeowners with children under age 6, living in a house built before 1978.

Eligible families can get financial assistance to correct problems. To learn more, call (319) 291-4429.

You can also learn more about lead poisoning from the Iowa Department of Public Health at this link:http://www.idph.state.ia.us/eh/lead_poisoning_prevention.asp

Eat rice? It may contain lead

April 11, 2013

Some imported brands have rice have been found to have elevated levels of lead. From Time.com:

Asian food,bowls,chopsticks,food,photographs,plates,rices,saucersAn analysis of imported brands found surprising levels of the metal.

Reporting at the annual meeting of the American Chemical Society, a group of researchers lead by Tsanangurayi Tongesayi, an associate professor of chemistry at Monmouth University in New Jersey announced the results of their analysis of rice from Asia, Europe and South America. The imports, which currently make up about 7% of rice consumed in America, contained higher than acceptable levels of lead.

The levels ranged from six milligrams/kilogram to 12 milligrams/kilogram; factoring in average consumption, that added up to estimated lead exposure levels 30 to 60 times greater than the Food and Drug Administration’s (FDA) provisional total tolerable intake (PTTI) levels for children and 20-40 times greater than the standard exposure levels for adults.

(MORE: Arsenic and Old Rice: Should We Worry About a Toxic Chemical in a Popular Food?)

The agency’s PTTI represent the maximum level of contaminant exposure before potentially toxic or adverse health effects might occur. “Now, according to the FDA, for chemical toxicants to cause a health effect, they have to be ten times the PTTI. Our calculated exposure levels were two to 12 times higher than ten times the PTTI. Meaning, they can cause adverse health effects,” says Tongesayi.

Because Asian populations in the U.S. tend to consume the most rice, the researchers also calculated exposure levels for these groups, and estimated that  Asian infants and children in the U.S. could be exposed to lead at 60 to 120 times higher than the FDA’s PTTI. And young children under six years old can be especially vulnerable to lead poisoning, which can impair mental and physical development and, if the exposure is sustained, can be fatal.

“The thing is that is rice becoming a staple food for a larger percentage of the population,” says Tongesayi. He says their calculations are also conservative, since they were basing consumption on the daily recommended servings. It’s likely that many people consume more than what’s recommend in a given day– or week.

Rice from Taiwan and China contained the highest levels of lead, although rice from Italy, India, Thailand, Bhutan and the Czech Republic also contained levels higher than the PTTI. The researchers are continu8ing their sampling with rice from Pakistan and Brazil as well as other countries. With the increase in imports, Tongesayi says rice from these countries are not only appearing in ethnic and specialty restaurants and stores, but also in mass market grocery store and supermarket chains.

(MORE: Study: Does Eating White Rice Raise Your Risk of Diabetes?)

While lead exposure can negatively affect cognitive development and performance in kids, adults with high lead exposure can also experience problems with blood pressure, heart disease and calcium deficiency. Tongesayi’s team believes the rice became contaminated during growing and harvesting. “Processing can potentially add some contaminants, but from what we studied, it seems that the contamination is coming from contaminated soils and contaminated irrigation waters,” he says.

The findings come after concerns about arsenic contamination in rice as well, but, say the researchers, shouldn’t discourage people from eating rice. Instead, Tongesayi and his colleagues hope their work increases consumer awareness about food safety and prompts more stringent oversight of imported products. “We just hope that our results will  inform public policy and will be used to create stricter regulations on lead in rice, or be used to come up with eating advisories like [those] with mercury in fish,” he says. “It is a bit difficult because people can’t stop eating it, and that is not what we are trying to say, but we want people to be aware that some of the foods they are eating are tainted with these toxic chemicals. You can eat less on a given day.”

Tongesayi only studied imported rice so the findings aren’t applicable to rice grown in the U.S. While the U.S. is a major exporter of rice, imports of rice and rice flour have increased by over 200% since 1999, raising concerns about the safety of the products. Noah Bartolucci, a spokesperson for the FDA, said to BBC News that the agency “plans to review the new research on lead levels in imported rice released today”.  Any adverse effects from contaminants will need to be weighed against the grains’ nutritional benefits. Yet, such results should alert regulatory agencies to be vigilant as global markets continue to expand and imports increase.

Lead in Baby Food?!

April 9, 2013

Big name baby food makers including Gerber, Beech-Nut Nutrition, and Del Monte foods among others, are being sued by an environmental group over the failure to report low levels of lead in baby food products. USAToday.com reports,

Lawyers for the food companies say the U.S. Food and Drug babies,baby foods,children,food,kids,people,photographs,spoonsAdministration tested products targeted in the lawsuit, and decided levels were below the standards that require a warning.

But both sides in the case agree that baby foods containing carrots, peaches, pears and sweet potatoes have some lead. Also covered by the suit are grape juice and fruit cocktail.

Lead exposure can damage a child’s developing brain and lead to a lower IQ. Overall, lead poisoning in the U.S. has declined significantly after it was removed from paints and gasoline formulas.

Still, more than 500,000 U.S. children are believed to have lead poisoning, according to the Centers for Disease Control and Prevention.

Old paint, contaminated drinking water and soil tainted by old leaded gasoline are primary sources of lead exposure to children in the U.S., the CDC reported.

Some specialists describe children as having lead poisoning only when high levels are present, but others use the term more broadly to describe any child with levels that can affect intelligence or cause other harm.

FDA tests on products named in the lawsuit found lead levels “below FDA’s current tolerable intake levels for lead.”

The companies argue the lead in fruit and vegetables used in the products is naturally occurring, which if the trial judge finds is true could exempt the companies from having to warn consumers.

“Despite the trace amounts of lead in the products at issue, the federal government has determined that Americans need to eat more — not less — of these nutritious foods,” the companies’ attorney, Michele Corash, wrote in court documents.

“FDA recently reiterated its conclusion that the trace levels of lead in the products at issue in this case do not pose unacceptable health risks.”

The companies say Prop. 65 does not require a warning label if the concentrations of the lead fall below so-called “safe harbor” levels, or concentrations below the amount required for a warning under the state law.

Jim Wheaton, an attorney for ELF, said California law nonetheless requires food makers to warn consumers about a possible risk of certain toxins, including lead. He noted that California’s Proposition 65 requires warning labels on foods that contain a toxin at 1/1000th of the levels considered dangerous to human health.

The plaintiffs also argue that no level of lead is safe, especially for newborns and pregnant women. “Even when studying the low level of exposure that is typical in the dietary context, scientists have not been able to identify a level of exposure that is without any health risks,” the plaintiffs’ wrote in court documents.

They hope public pressure or the judge will compel the companies to take steps to remove the lead from their foods, knowing that a label warning parents of lead in their baby’s food would be devastating for business.

“Everyone assumes that a company selling foods for children will never offer a product for sale that carries a warning label,” Wheaton said. “They will take the steps their competitors apparently already are taking to offer product with no lead or so low no warning is required.”

Christine Kuhinka, director of corporate communications for Gerber Products Company, which is owned by Nestle Nutrition U.S., said the company does not comment on pending litigation.

“We will, however, vigorously defend the allegations in this litigation,” Kuhinka said in an email.

1 in 38 young children have lead poisoning

April 5, 2013

After the Centers for Disease Control and Prevention (CDC) lowered the blood lead level threshold from 10micrograms/dl to 5, childhood lead poisoning numbers have increased. USA Today reports,

An estimated 535,000 young children in the United States have harmful levels of lead in their bodies, putting them at risk of lost intelligence, attention disorders and other life-long health problems, according to a new estimate released Thursday by federal health officials.

The new number shows lead poisoning affects 1 in 38 children ages 1 to 5, according to the report by the Centers for Disease Control and Prevention.

“To the extent that Americans think this is a problem of the past, clearly this is evidence there is still a problem,” said Rebecca Morley, executive director of the National Center for Healthy Housing, a non-profit lead-poisoning-prevention advocacy group.

Morley noted that Congress has eliminated most of the CDC’s funding for federal lead-poisoning-prevention programs nationwide, which is reducing or eliminating services to help identify exposure sources for poisoned children and take steps to prevent the poisoning of others.

Last May, for the first time since 1991, the CDC revised its standard for lead in a child’s blood, cutting by half the amount that should trigger public health actions. The change was based on a growing body of scientific evidence showing even low-level exposures to lead can cause significant harm to children. The new report says an estimated 2.6% of young children are estimated to have a blood-lead level of at least 5, the new CDC standard.

“No safe blood lead level … in children has been identified,” the CDC report notes.

As lead has been removed from gasoline and paint, the CDC notes that substantial progress has been made reducing the number of U.S. children with elevated levels of lead in their bodies. In the 1976-80 period, the CDC estimates, 88% of children had blood-lead levels of at least 10, the CDC’s previous action level for lead poisoning.

Children today continue to be exposed to lead from a variety of sources. Experts say lead-contaminated house dust and soil are among the most important sources, with children ingesting lead particles when they put dust-covered hands and toys in their mouths. Many older homes contain lead-based paint, which deteriorates into a fine dust. Soil can be contaminated from paint, but also with fallout from historical factory emissions and vehicles that once burned leaded gasoline.

USA TODAY’s “Ghost Factories” investigation found dangerous levels of lead contamination in neighborhoods across the country.

The CDC report notes that its latest review of lead poisoning data continues to find disparities based on race and income in the amount of lead in children’s bodies. The report said, “These disparities can be traced to differences in housing quality, environmental conditions, nutrition, and other factors designed to control or eliminate lead exposure.”

Lead poisoning is a problem that won’t go away…

March 25, 2013

Even though the toxic element lead was banned from household paint, toys, and gasoline more than 30 years ago, lead poisoning is still prevalent today. Check out this article from pharmacytimes.com that explores this ever present problem.

Lead—non-biodegradable, soft, malleable, and heat and corrosion resistant—is environmentally omnipresent. Its known properties made it an ideal metal for the automobile, paint, smelting, ceramics, plastics, and toy industries at one time.1,2Unfortunately, lead is toxic to humans. Humans neither need lead nor derive benefits from it. Although lead toxicity has been a global concern since the industrial revolution in the late 1800s, civilization has been unable to prevent or control it satisfactorily. Overall incidence of lead poisoning among American children has fallen from 4.4% in the early 1990s to 1.4% in 2004.3 In 2002, around 10 of every 100,000 of adults had lead toxicity.4,5 

Venous blood lead levels (BLLs) of 10 mcg/dL and 25 mcg/dL have been considered toxic in children and adults respectively.4-7 Since any level of lead can cause toxicity, the CDC announced a new, lower reference value for children in June 2012: 5 mcg/dL. Infants and children absorb a higher fraction of lead than adults do when exposed, increasing their vulnerability.8 Approximately 450,000 American children have BLLs >5 mcg/dL.9 It is still a problem.

Diagnosis and Clinical Presentation 
Lead exposure can start with prenatal maternal-fetal transmission.10 Outside the womb, children may inhale (or eat) lead dust, often present in street debris, soil, and most frequently, aged house paint.11-14 Lead-based paint was phased out in the 1970s, lowering but not eliminating risk of exposure by this means.14 Old pipes sometimes leach lead into drinking water.12,13 Lead hazards are disproportionately found in low-income housing.15 Adults rarely develop lead poisoning, but risk is increased in workers in industries that use or manufacture lead-based products.16,17

Health care providers use many tests to identify lead poisoning. In addition to the BLL, a blood smear may show basophilic stippling ribosomal clusters.18,19 Increased urinary aminolevulinic acid concentrations are also reliable indicators.20 Plain film radiographs can reveal visible lead lines in patients’ long bones.10,12,17,19,21 Astute clinicians sometimes diagnose lead poisoning after seeing a blue line along patients’ gums (Burton’s line) that forms when lead reacts with sulfur ions released by oral bacteria.22

Lead affects every organ system, causing an unpredictable variety of symptoms.18,21-23 The nervous system is most sensitive (centrally in children, peripherally in adults),24-26 but lead affects hematopoietic, hepatic, and renal systems, producing serious disorders. Acute lead poisoning’s classic symptoms include colic, encephalopathy, anemia, neuropathy, and Fanconi syndrome (abnormal glucose, phosphates, and amino acid excretion).8,27Sometimes, classic signs and symptoms are absent, confusing the clinical picture.

Chronic lead exposure is slowly progressive, creating cognitive and neurobehavioral abnormalities that irreversibly reduce IQ even if BLLs are well below the old CDC standard.15 Rising BLLs correlate with diminished achievement on intelligence tests.6,28 Lower BLLs (from 3 mcg/dL to 8 mcg/dL) can cause mild IQ decreases or attention-deficit hyperactivity disorder. Higher levels (over 40 mcg/dL) may completely stop neurobehavioral development and cause toxic encephalopathy.6,18,28 Adults can also develop cognitive and neurobehavioral consequences after an acute exposure or low-level, exposure for months to years.29,30 Table 1 describes other neurologic symptoms.

In other systems, lead wreaks havoc. Anemia is a common problem—lead inhibits hemoglobin synthesis pathways and shortens erythrocyte life-span, which manifests as fatigue.18,19Hypertension may occur after acute or chronic exposure; ischemic coronary heart disease, cerebrovascular accidents, and peripheral vascular disease also can occur.31-33 Acute nephropathy with hypertension, gout, and proximal tubule dysfunction are also common.18 If it becomes chronic, end-stage renal disease are possible.18,20,34

Gastrointestinal symptoms (discomfort, constipation, or vomiting) may be vague and nonspecific at low exposures. Higher BLLs cause recurrent, severe abdominal pain called lead colic.19,20

Lead poisoning manifests in the ocular system as cataracts.35 Decreased libido, infertility, abnormal spermatogenesis or impotence,17,18 and musculoskeletal and endocrine complaints are possible.12,16

Strategy 
Since many lead toxicities are irreversible, the best strategy is prevention, individual intervention, and public health coordination.36-38 The main preventive measure is screening children at high risk. When prevention fails, clinicians use BLL to manage lead toxicity in children (Table 2).

Chelators increase urinary lead excretion and extract lead from blood and tissue, including the brain.36-38 If effective, they alleviate acute encephalopathy, vomiting, abdominal pain, anemia, and renal insufficiency. They cannot reverse neurologic complications.39-41

  • Dimercaprol cannot be used in patients with hepatic insufficiency or peanut allergies. Caution is needed in children with renal impairment, hypertension, or G6PD deficiency. Adverse effects (AEs) include nausea and vomiting (N/V), headache, tachycardia, and leukopenia. Concurrent iron therapy will increase N/V, and must be stopped.37,38
  • Calcium disodium versenate is considered second line because it may increase CNS lead concentration and subsequently elevate intracranial pressure, but can be given intravenously (IV) or intramuscularly (IM). IV administration creates constant chelation and is less painful than IM. AEs include local injection site reactions, fever, hypercalcemia, renal insufficiency, and excretion of other essential minerals.36-38
  • Succimer is an oral water-soluble dimercaprol analogue associated with fewer AEs than parenteral chelators. AEs include rash, neutropenia, elevated transaminases, and gastrointestinal upset. Patients may object to succimer’s sulfur odor, and opening the capsules and sprinkling the beads onto food or dissolving in juice can help.36-38
  • The oral copper chelator D-penicillamine also chelates lead in children with low-level toxicity; this is an off-label use. AEs include nausea and vomiting, transient neutropenia and thrombocytopenia, rash, abdominal pain, and abnormal liver function. If drug-induced rash develops, therapy may need to be stopped. 36-38,42Chelation’s efficacy in adults with lead toxicity is unclear.17 Treatment starts with identifying the exposure source, removing it, then using chelation in patients with a BLL greater than 80 mcg/dL; between 60 and 80 mcg/dL with symptoms; or between 40 and 60 mcg/dL if symptoms continue after the exposure source is removed.43

Why Won’t It Go Away?
Lead poisoning is more likely in low income areas, and in children who suffer from poor nutrition.44 Lead is everywhere, and almost impossible to remove entirely from the body once it enters. There is no safe blood level and fixing this problem is very costly. This is why public health strategy is essential: it targets areas where lead poisoning is likely, and encourages preventive strategies like sequestering industries dealing with lead apart from inhabited areas and banning the use of lead when appropriate replacements are available.