Fixing Up 'This Old House' May Increase Exposure To Lead In Young

The study conducted by researchers at Cincinnati Children's Hospital Medical Center found that interior renovation of older housing is associated with a modest increase in children's blood lead level (BLL) and associated long-term health risks. These findings will be presented by co-author Stephen Wilson, M.D., at the Pediatric Academic Society (PAS) annual meeting in Honolulu on May 3.

"Any person working on a home where children reside or visit frequently should know that their renovation work could cause lead hazards for the kids if the home was built before 1978, when the government banned lead-based paint in housing," said Adam Spanier, M.D., Ph.D. M.P.H., the study's lead author and director of the Pediatric Environmental Health and Lead Clinic at Cincinnati Children's Hospital Medical Center.

The study of 249 children, all living in homes built before 1978, found that those who resided in houses where renovations had been done had higher blood lead levels than those in houses where no renovating had been done. Researchers used multivariable analysis to find that the kids who had lived through renovation projects had a 12 percent increase in mean BLL by age 2 compared with other children (p<0.01). The increase in BLL seemed related directly to the renovation work, given that if renovation took place within one month prior to measurement, 2-year-old children had a 1.6 micrograms per deciliter increase in average BLL and if the renovation was more recent (within a month before blood tests were done), compared to an average jump of 0.8 micrograms per deciliter in children whose houses had been renovated two to six months before measurement (p<0.01).

The researchers also noted an association between high lead concentration in the building's existing paint and the child's BLL. Specifically, for every 10 milligram per square centimeter increase in paint lead concentration, there was a 7.5 percent increase in average blood lead levels (p=0.02).

Some research studies have shown that children's BLL below 7.5 is associated with intellectual impairment and affects brain development.

"Toxic agents such as lead could have long-term effects on children's brain development even as early as when they are fetuses," said Dr. Spanier. "If lead poisoning goes undetected and untreated in children, it has the potential to result in a number of neurodevelopmental issues, including ADHD and learning problems."

During renovations, most children are exposed to lead paint dust that is disturbed by the work. If precautions are not taken, this lead paint dust may settle on surfaces and could be spread in the air inside the house through interior ventilation systems. Although the study looked at children between the ages of 6 to 24 months, Dr. Spanier cautioned that all young children, particularly those under 6 years, are considered most at risk.

"There are risks to renovating older homes, but there also are lots of ways parents can reduce the risk of lead exposure to their children," Dr. Spanier said. "It's also more cost effective to avoid the problem than to treat an already exposed child. Preventing exposure is the key."

If parents are unsure about the paint or other lead hazards in their home, Dr. Spanier suggested they should call the National Lead Information Center, provided by ABVI Good Will, at 1-800-424-LEAD or visit the Environmental Protection Agency's website at http://www.epa.gov/lead for more information on local labs that can test lead paint. If there are hazards professional abatement is the best option.

However, if abatement of the lead is not an option, there are a few precautions do-it-yourself rehabbers can take while renovating homes.

• Attach a High Efficiency Particulate Air, or HEPA, vacuum to all power tools and use a HEPA vacuum to clean up the area
• Use heavy plastic to cover doorways, windows, floors, and any furniture that can't be removed from the renovated area and to dispose of all trash and debris
• Block off and shut off air conditioning or heating vents in the work area
• Close windows and doors in or near the work area
• Mist paint before sanding or scraping
• Keep everyone not working in the area out and, if possible, have the children stay at a friend or relatives while the work is being done
• Use personal protective devices (masks, gloves, etc)
• Seek training in lead safe work practices
• Also, if parents hire a contractor to do their home renovations, it's important to choose someone who has gone through lead safety training.

If parents who have done renovations are worried about their child's lead levels or are concerned they may have been exposed to lead dust from building renovations, a pediatrician or family practitioner can order a lead test for the child. This will allow them to determine the child's lead level and recommend treatment if needed. Several treatment options available, depending on the blood lead levels detected.

"Not having lead hazards in homes would be the goal, but for now, it is important to know lead's health risks to children and what adults can do to avoid them," said Dr. Spanier.

Lead levels linked to ADHD

Parents need to be particularly concerned about lead given the findings of another study, led by Tanya Froehlich, M.D., a developmental and behavioral pediatrician at Cincinnati Children's, which found that childhood lead exposure is a risk factor for ADHD in children ages 8 to 15. Dr. Froehlich's study, which examined data from 2,704 children from the 2001-2004 National Health and Nutrition Examination Survey, found that children in the top tercile of lead exposure, who had levels greater than 1.3 micrograms per deciliter, had a more than two-fold increased risk of ADHD compared to children in the lowest tercile, who had levels less than 0.8 micrograms per deciliter. The study estimated that lead levels of over 1.3 micrograms per deciliter may account for more than 500,000 cases of ADHD among children ages 8 to 15 nationwide.  These findings will also be presented at PAS on May 3.