Lead Poisoning Prevention Program

The Rockland County Department of Health's Childhood Lead Poisoning Prevention Program (CLPPP) began in 1994 and is overseen by the Lead Program Coordinator.  It employs the efforts and services of four different divisions of the Health Department to effectively prevent and treat lead poisoning in children up to age 18.

Lead is a naturally occurring element that is found in many places. Lead is toxic to the human body. Lead poisoning is the #1 environmental health concern for children in the U.S.


Facts About Childhood Lead Poisoning:


Who Can Get Lead Poisoning?

Anyone can get lead poisoning, but children between the ages of six months and six years of age are at the highest risk because they often put their hands and toys in their mouth.  Hand-to-mouth behavior is the most common way children ingest lead.  Children and adults can also inhale lead particles that may be found in the air.

What are the health effects of lead poisoning in children?
Lead interferes with the brain's development and function.  It also can cause serious damage to the kidneys, liver and red blood cells.  Children are in more danger than adults because their bodies are still developing.

Lead poisoning can cause:

  • Slowed development
  • Learning or behavior problems
  • Lower IQ
  • Hearing loss
  • Restlessness

What are the symptoms of lead poisoning?
The only way to tell if someone is lead poisoned is by doing a blood test.  New York State Department of Health requires that all children ages 1 and 2 receive a blood test and that parents of children up to the age of six be asked a series of Risk Assessment Questions to find out if they have a risk of being exposed to lead in their environment.  Recent research finds that there is no safe level of lead in the blood.  Children often do not look or feel sick when blood lead levels are in the lower range of lead poisoning.

At high levels, symptoms include:

  • Headaches
  • Stomach aches
  • Nausea
  • Tiredness
  • Irritability

A child with these symptoms may appear to have the flu or a virus. 
The only way to tell if a child is poisoned is by doing a blood lead test.

What is the most common source of lead exposure?
The most common source of lead is cracking, peeling, chipping or otherwise deteriorating lead-based paint and dust particles.  Lead-based paint on windows, doors and other areas where surfaces rub against each other create dust and may cause lead particles to be released into the environment.

Are there other sources of lead exposure?
Other potential Sources of Lead include soil, water, occupations/hobbies, imported ceramics or foods, and some traditional/folk remedies and Ethnic Spices, herbs, etc.

Imported children's furniture, toys, jewelry (made in countries outside of the U.S.) may also contain lead.
See Product Recalls on the following website: http://www.health.state.ny.us/environmental/lead/recalls/

How do I pay for my child's lead screenings (the word screening in this document means a blood lead level test)?
Insurance plans and HMOs cover lead tests. The health department provides screening for children not covered by health plans.

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Prevention:


Hand Washing

  • Deteriorating lead-based paint often produces dust that settles on windowsills, floors, toys or other surface areas that children touch. Since children tend to put their hands and toys in their mouth and often eat with their hands ("finger foods"), swallowing or inhaling lead dust is the most common exposure route.
  • Wash your child's hands and face after play, before meals, and before bed.
  • Wash toys, stuffed animals, pacifiers and bottles with soap and water often.
  • Mop floors often, and use damp paper towels to clean window wells and sills.

What can I do to keep my children safe from lead?

  • Keep children away from peeling or chipped paint.
  • Before making repairs in a home built before 1978, call your local health department to learn how to work safely and keep dust levels down.
  • Children and pregnant women should stay away from repairs that disturb old paint, such as sanding and scraping. They should stay away until the area is cleaned using wet cleaning methods and a HEPA vacuum (not dry sweeping).

Nutrition

  • Children with empty stomachs absorb more lead than children with full stomachs, so providing your child with four to six small, nutritional meals during the day can also help protect against lead poisoning. There are several nutrients that can help reduce the absorption of lead.

Iron

  • Children who are iron-deficient (anemic) tend to absorb more lead because their bodies absorb the lead to make up for the lack of iron.  Consuming foods rich in iron can significantly reduce the amount of lead stored in a child's body.

Some example of foods rich in iron are:

Breads & Cereals Cereals which provide 45% or more US Recommended Daily Allowance of Iron (read the label - all WIC cereals are high in iron), Whole Wheat Bread, Enriched Breads, Enriched Noodles, Macaroni, Spaghetti, Enriched Rice
Fruits & Vegetables Potatoes, Bananas, Watermelon, Sweet Potatoes, Dried Fruit, Raisins, (Caution - may cause choking in small children) Broccoli, Winter Squash, Prunes, Prune Juice, Spinach, Greens (collard greens, mustard greens)
Protein-rich Foods Lean Meats (Chicken, Turkey, Beef, Pork, Liver), Fish (Tuna, Salmon), Peanut Butter, Dried Peas and Beans, Nuts and Seeds, Tofu


Vitamin C

  • Vitamin C helps the body absorb iron.

Some examples of foods rich in vitamin C are:

Fruits & vegetables Grapefruit, Grapefruit Juice, Tomatoes, Tomato Juice, Oranges, Orange Juice, Greens, Sweet Potatoes, Green Peppers, Muskmelon, Cantaloupe, Potatoes, Spinach, Broccoli, Cabbage, Pineapple, Cole Slaw, Raspberries, Cauliflower, Strawberries, Watermelon, WIC Juices


Calcium

  • Foods rich in calcium will also reduce the amount of lead absorbed by a child's body.  Having enough calcium to support growth and other developmental functions will prevent lead from settling in bones.

Some examples of foods rich in calcium are:

Dairy products Milk, Cheese, Yogurt, Cottage Cheese, Milk Shakes
Green Leafy Vegetables Spinach, Collards


Low-Fat Foods

  • Foods high in fat increase the amount of lead absorbed by the body.  Children need some fat, such as the fat found in milk, cheese, or yogurt, but other added fats such as fat from fast foods, fried foods, or "junk" food may increase the amount of lead absorbed by the body.  Parents should try to limit the amount of added fat that a child consumes. 

Some foods to limit include:

Any Fried or Greasy Food

Bacon, Biscuits, Bologna, Chocolate Bars or Candies, Cookies, Corn Chips, Doughnuts, French Fries, Hot Dogs, Sausages, Sausage links, Sausage Patties, Potato Chips

 

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Temporary Measures to Reduce Lead Hazards

Repairing and/or maintaining painted surfaces (primarily windows, exteriors, and trim) will also reduce lead exposure:

  • Cover chipped paint and holes with contact paper, duct tape, or cardboard.
  • Clean up lead chips and lead dust with a wet mop or a wet cloth.
  • Clean your floors and inside windowsills with soap. Then rinse areas well and throw dishrags and/or towels away.

The only way to permanently remove lead hazards is to replace painted surfaces in a lead-safe manner.

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Lead-Safe Home Remodeling / Repair

In Rockland County over 80% of the homes were built prior to the ban on lead-based paint in 1978.  Therefore, many of the homes may contain lead-based paint.  If home renovations or repairs are not done using lead-safe methods, they can increase the risk of lead exposure in the home.  There are many ways to reduce the hazards of lead-based paint and it is very important that you pick the safest method for your particular project.

Some people prefer to hire a contractor certified by the Environmental Protection Agency (EPA) that is trained to safely remove lead-based paint.  Other people prefer to do the work themselves.  Either way, a person hiring a contractor or a person doing the work themselves should become familiar with the measures necessary to safely complete renovations and repairs that involve lead-based paint.

Valuable resources about lead-safe methods of home improvement are available by clicking on the links below:

Important lead hazard information for families, childcare providers and schools
http://www.epa.gov/lead/pubs/renovaterightbrochure.pdf

Steps to Renovation, Repair and Painting
http://www.epa.gov/lead/pubs/steps.pdf

Lead Paint Safety: A field guide for painting, home maintenance, and renovation work
http://www.epa.gov/lead/pubs/leadsafetybk.pdf

New York State Department of Health
http://www.health.state.ny.us/forms/order_forms/lead.pdf
http://www.health.state.ny.us/environmental/lead/index.htm
http://www.health.state.ny.us/nysdoh/environ/reducing_environ_exposures.htm

What Home Owners Need to Know About Removing Lead-Based Paint
http://www.health.state.ny.us/nysdoh/lead/leadbroc.htm

You can also call the Department of Health (845) 364-2501 for information and suggestions on lead-safe methods of home improvement.

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Environmental Lead Investigations

The Bureau of Housing and the Bureau of Special Services of the Rockland County Department of Health will conduct environmental lead investigations for children whose blood lead levels are equal to or greater than 15 µg/dL in an effort to identify the source of lead exposure.  A Housing Inspector/Lead Assessor investigates a child's home and/or other places where the child spends time.  Environmental investigations may consist of visual assessment of risk areas, surface paint evaluation, water sampling, and/or other case-specific actions.

Based on the results of the environmental lead investigation, the Housing Inspector/Lead Assessor will provide the owner or landlord with recommendations on how to address lead hazards in the home.

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New York State Department of Health Screening Guidelines

(Statutory Authority:  Public Health Law, Section 206 and Title X of Article 13; Subpart 67-1)

At each routine well-child visit, health care providers will assess children 6 months to 72 months of age for risk of lead exposure and screen or refer for screening those children found to be at risk.

During well-child visits at age 1 & 2, health care providers will screen children or refer them for screening for elevated blood lead levels.

Children age 36 to 72 months of age with a history of blood lead levels of 15 µg/dL or greater should receive follow-up blood lead testing annually.

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Proof of Lead Screening Required at Daycare or Pre-School

(Statutory Authority:  Public Health Law, Section 206 and Title X of Article 13; Subpart 67-1)

Prior to or within 3 months of initial enrollment, each child care provider licensed, certified, or approved by any State or local agency shall obtain a copy of a certificate of lead screening for any child at least 1 year of age but under 6 years of age, and retain such document until one year after the child is no longer enrolled.

When no documentation of lead screening exists, the child shall not be excluded from attending preschool or childcare; however, the child care provider, principal, teacher, owner, or person in charge shall provide the parent or guardian of the child with information on lead poisoning and lead poisoning prevention and refer the parent or guardian to the child's primary health care provider or local health unit to obtain a blood lead test.

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What Does Your Child's Blood Lead Level (BLL) Mean?

The blood lead test tells you how much lead is in your child's blood. Lead can harm a child's growth, behavior and ability to learn.  The lower the test result, the better.
Most lead poisoning occurs when children lick, swallow, or breathe in dust from old lead paint. 

Most homes built before 1978 have old lead paint, often under newer paint. If paint peels, cracks, or is worn down, the chips and dust from the old lead paint can spread onto floors, windowsills and all around your home. Lead paint dust can then get onto children's hands and toys, and into their mouths.

Most children have had some contact with lead in old paint, soil, plumbing, or another source. This is why New York State requires doctors to test all children with a blood lead test at age 1 and again at age 2. For children up to age six, your doctor or nurse should ask you at every well child visit about ways your child may have had contact with lead. Children who have had contact with lead should be tested.

A test result greater or equal to 8 µg/dL using blood from a fingertip should be checked again with a second test using blood taken from a vein (often in the arm). If the second result is still high, you should follow the steps below.

0-4 µg/dL:
There is very little lead in your child's blood.
The average lead test result for young children is about 2 µg/dL.

5-9 µg/dL:
Your child has a little more lead than most children.
Talk with your doctor and local health department to find out how your child might have come into contact with lead, and ways to protect your child.
Your doctor might want to test your child again in 3 to 6 months

10-14 µg/dL:
Your child's lead level is high.  A result of 10 or higher requires action.
Your doctor and local health department will talk with you to help you find sources of lead, and ways you can protect your child.
Your child should be tested again in 1 to 3 months.

15-44 µg/dL:
Your child's lead level is quite high.  You and your doctor should act quickly.
Talk with your doctor or nurse about your child's diet, growth and development, and possible sources of lead.
Talk with your local health department about how to protect your child.  They will visit your home to help you find sources of lead.
If the lead level is 15 to 24, your child should be tested again in 1 to 3 months.
If the lead level is 25 to 44, your child should be tested again in 2 weeks to 1 month.

45 µg/dL or higher:
Your child needs medical treatment right away.
Your doctor or health department will call you as soon as they get the test result.
Your child might have to stay in a hospital, especially if your home has lead. Your local health department will visit your home to help you find sources of lead. Your child should not go back home until the lead sources are removed or fixed.
Your child needs to be tested again after treatment, and monitored regularly until his/her lead level is below 10 µg/dL.

Links to Other Resources on Lead Poisoning and Prevention:
Environmental Protection Agency (EPA) OPPT Lead
National Lead Information Center

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Information For Contractors, Painters, Electricians, Plumbers And Carpenters

Starting April 22, 2010, federal law requires all persons involved in paid renovation and repair work to be certified in lead-safe practices.

Contractors should give the pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools (PDF) to operators of child care facilities and parents of young children who attend child care facilities built before 1978.

The following links will provide you with more information about these regulations and where contractors can get the training they need to comply with these regulations:

EPA requirements
http://www.epa.gov/lead/pubs/renovation.htm

The Renovation, Repair and Painting Rule
http://www.hud.gov/offices/lead/training/rrp/rrp.cfm

Training courses:
http://www.epa.gov/lead/pubs/training.htm

Small Entity Compliance Guide
http://www.epa.gov/lead/pubs/sbcomplianceguide.pdf

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Contact Us:

If you have any questions or would like to schedule a presentation, workshop or display, please call:
Barbara Plasker
(845) 364-2501