Despite a dramatic fall in American children's blood levels of lead after it was removed from gasoline, paint, and other consumer products, children are still exposed to the poisonous metal in their homes and communities. So says a leading group of pediatricians as it calls for stricter national regulation and stronger commitment to eliminate sources of lead before exposure occurs.

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A leading group of pediatricians says there is no safe level of lead in children, and the best way to treat lead poisoning is to prevent any exposure before it happens.

There is growing evidence that even low levels of lead can cause irreversible mental damage and behavioral problems, explain the American Academy of Pediatrics (AAP), as they urge policy makers and practitioners to increase efforts to protect children from lead poisoning.

In a new policy statement published in the journal Pediatrics, the AAP call for stricter regulation, increased federal resources, and for government and the medical community to join forces.

Dr. Jennifer Lowry, chair of the AAP Council on Environmental Health and an author of the policy statement, urges:

"We now know that there is no safe level of blood lead concentration for children, and the best 'treatment' for lead poisoning is to prevent any exposure before it happens."

Until recently, a blood lead level of 10 μg/dL or more in children was considered a "level of concern." But mounting evidence shows even less than half that level causes mental and behavioral problems, such as lower IQ, worse academic performance, aggression, hyperactivity, poor impulse control, and inattention.

The policy statement notes that in 2007-2010, approximately 2.6 percent of American preschoolers - about 535,000 children aged 1-5 years - had a blood lead concentration of 5 µg/dL or more.

'On a par with childhood vaccines'

The AAP want new federal standards for lead in house dust, water, and soil, and new legislation to force the removal of lead from contaminated housing and child care facilities. Also, they say lead concentration in water fountains in schools should not exceed 1 part per billion.

Every $1 spent reducing lead in housing would reap a benefit to society of $17-$221, a return on investment that is on a par with childhood vaccines, they note.

Exposure to lead increases as soon as children start teething and crawling. Living in older homes that are poorly maintained or being renovated increases exposure further.

An estimated 37 million homes in the United States still have lead-based paint.

Children are at raised risk of lead exposure if they live near airports and factories, where lead-contaminated fuel exhaust gets into the soils. Exposure to lead can also result from pollution in rivers and lakes leaching the heavy metal out of old pipes into tap water.

"The recent drinking water crisis in Flint was just one indication of how our country's aging infrastructure is jeopardizing children's health," says AAP President Dr. Benard P. Dreyer.

Lead screening in children at risk

Children can also come into contact with lead in a host of consumer products, ranging from toys, to imported aluminium cans, hobby materials, vinyl miniblinds, and dishware.

Adults can also bring lead home on their clothes if they work at places like firearms ranges, where bullets are made of lead.

The AAP urge screening for lead in children aged 12-24 months living in areas where a quarter or more of housing is from the 1960s or earlier.

They say doctors should keep an eye on children with blood lead levels above 5 μg/dL and should ask for individual assessments of older housing - especially if it is not well-maintained or if during the last 6 months it has undergone any renovation that may have generated lead-contaminated dust.

"Most existing lead standards fail to protect children. They provide only an illusion of safety. Instead we need to expand the funding and technical guidance for local and state governments to remove lead hazards from children's homes, and we need federal standards that will truly protect children."

Dr. Jennifer Lowry

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