Should I be concerned about lead toxicity in my Internationally adopted child?

What does lead do to our bodies?

High lead in the body can disrupt the kidneys, teeth, brain (seizures, attention deficit disorder, behavior problems and a decreased IQ), and the body’s ability to produce blood. Depending on the level it can have devastating consequences.

How do children get exposed to lead?
Usually from motor vehicle emissions, lead based paint, canned foods and water (either contaminated with lead or leeched from lead pipes). All of these sources have decreased as governments have banned lead from these sources.
Children are more at risk from lead exposure. Adults absorb only 5-10% of dietary lead and retain little however children absorb 40-50% and retain 20%. Fetuses seem to be more at risk.

More than 4 percent of children in the United States have lead poisoning. Rates of lead poisoning are even higher in large cities and among people with low incomes.
The most common cause of lead poisoning today is old paint with lead in it. Lead has not been used in house paint since 1978. However, many older houses and apartment buildings (especially those built before 1960) have lead-based paint on their walls. Burning painted wood with lead in it can liberate lead into the air where it is well absorbed into the lungs.

Toddlers explore their world by putting things in their mouths. Therefore, young children who live in older buildings (like orphanages tend to be) are at especially high risk of getting lead poisoning. Children can get lead poisoning by chewing on pieces of peeling paint or by swallowing dust or soil that contains tiny chips of the leaded paint from these buildings.
Lead can also be in air, water and food. Lead levels in the air have gone down greatly since lead was taken out of gasoline in the 1970s. Lead is still found in some old water pipes, although using lead solder to mend or put together water pipes is no longer allowed in the United States. Lead can also be found in food or juice stored in foreign-made cans or improperly fired ceramic containers.

What is the risk that my child will have lead poisoning if they are internationally adopted?
It is difficult to give a number that is meaningful to a parent because all of these things are changing all the time and although it can be said for example that children from China or certain parts of Russia are at increased risk. If the child from that area came from a low risk institution their individual risk may be lower.

Another example would be a child in New York, what is their risk? If the child grows up in an affluent suburb the child’s risk of lead exposure is virtually zero but if he grows up in a poorer part of New York, they might be at high risk, and yet they both come from New York. In New York it is recommended that all children be screened for lead in their blood.
It can be said that circumstances of poor nutrition definitely puts children at risk for lead poisoning and this is a recurring theme in international adoption.  It is recommended that all internationally adopted children be screened for lead.

What will my doctor do if my child’s blood has a high level of lead?
If your child’s blood lead level is above the acceptable range, your doctor will give you information on how you can lower your child’s lead level. Your doctor will then test your child’s blood lead level every few months until the level drops into the normal range. Children who grow up with a poor dietary intake of iron and calcium can have increased absorption of lead if they are exposed to it so it is important to give a diet with an ample supply of these nutrients. If the lead level is high there are medicines that we can use to chelate the lead out of the body, but only a small number of children have high enough levels of lead in their blood that they need treatment.

Unfortunately even with low blood lead levels there can be an effect on the child’s IQ and this effect may not be reversible after the lead is removed. In fact it has been shown that early exposure to lead, leads to later scholastic and behavior problems, as well as an increased risk for social mischief and problems with the law later in life.

by James Reilly, M.D.