Lead Hazards for Pregnant Women and Children: Part 1

Abstract

Poor, urban, and immigrant populations are at far greater risk for lead exposure than are other groups in the United States. Children with even slightly elevated blood lead levels are at increased risk for significant neurobehavioral problems that can extend through adolescence. Research has shown that elevated blood lead levels in pregnant women, even those well below 10 micrograms per deciliter-the Centers for Disease Control and Prevention's "level of concern"-can cause miscarriage, premature birth, low birth weight, and subsequent developmental delays in their children. Despite these well-established dangers, routine prenatal lead screening and lead education is not a standard of care. Part 1 of this two-part article presents a short case example of a pregnant mother with lead poisoning and describes the epidemiology of lead exposure in the United States, the main sources of lead exposure, and the effects of lead on the pregnant mother and the developing fetus and child. Prevention is crucial. Treatment options such as chelation must be used selectively and will not reverse damage once it's occurred. Part 2 will describe recommendations for screening, education, nutrition, reducing environmental exposures, and treatment.

Blood Lead Levels in Children Aged 0–6 Years Old in Hunan Province, China from 2009–2013

“…Children, especially younger children, are at greatest risk for elevated BLLs. Some studies have demonstrated that children appear to have approximately four to five times higher lead absorption than adults [ 10 ], and the detoxification capability of lead in adults was three times higher than in children [ 11 ].…”

Unintentional and Sequential Lead Exposure from a Ceramic Mug and Maca (Lepidium meyenii)

“…Lead is a naturally occurring element in the environment but has no known biological role within the human body. Uncommon sources of inadvertent human lead exposure include imported foods, Ayurvedic medications, household items, and toys [1,2].…”

“…Lead oxide glaze, known as Bgreta,^is commonly used in the manufacture of ceramic cooking vessels in Hispanic communities; use of imported lead-glazed ceramic dishes has been recognized as a risk factor for lead toxicity in Hispanic populations [6]. Over time, lead may leach out of pottery glazes; acidity and heat may increase the risk of this occurrence [1,6]. In our case, the acidity of the lemon and the heat of the water used from the patient's instant hot water tap likely increased the rate of glaze breakdown and leaching from the ceramic mug, leading to lead exposure.…”

“…Since the 1970s, improvements in health policies and increased public health education have reduced the incidence of lead poisoning in the USA [1]. Even so, elevated blood lead levels continue to be reported in all age groups.…”

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“…A pregnant woman's elevated blood lead level can lead to miscarriage, prematurity, low birth weight, and problems with development during childhood 11 . Lead induces disturbances in the development of different types of WBCs during postnatal development and lead to an abrupt neutrophilic degeneration, immature cells, abnormal neutrophils, reactive and plasmacytoid lymphocytes 12 .…”