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During the spring of 2001, ATSDR screened more than 400 children in the Anniston area for lead. Below are some questions and answers related to the project:

What is lead poisoning?
Lead is a heavy metal used in many materials and products. When absorbed into the body, it can be highly toxic. Even children who appear healthy may suffer from lead poisoning. A blood test is the only way to determine a child's lead level. Except for severely poisoned children, there is no medical treatment for lead poisoning. Even then, the treatment may only reduce the level of lead. The only way to prevent lead poisoning is to remove the source of exposure.

Where is lead found?
Lead may be found in paint, dust, soil, water, air, and food. In fact, many homes built before 1978 contain lead-based paint; after 1978 lead-based paint was banned from use on the interior and exterior of homes.

How can lead get into my child's body?
Lead can enter the body by breathing or swallowing contaminated soil or dust. For example, children can swallow lead if they eat paint chips or play in dusty areas (even indoors) and then put their fingers, clothes, or toys in their mouths. Children can also swallow lead if they eat without first washing their hands.

What are the common health effects of lead?
Lead affects practically all systems of the body. Lead is most harmful to children under age 6 because lead is easily absorbed into their growing bodies, and interferes with the developing brain and other organs and systems.

More commonly in the U.S., children are poisoned through continued, low-level exposure, which may cause a reduced IQ and attention span, hyperactivity, impaired growth, reading and learning disabilities, hearing loss, insomnia, and a range of other health, intellectual, and behavioral effects.

The more lead you have in your body, the more likely you are to get sick from it. At very high levels of exposure, which are now very rare in the U.S., lead poisoning can cause brain damage, affect a child's growth, cause mental retardation, coma, convulsions, and even death.

In adults, excess exposure to high levels of lead can increase blood pressure and cause digestive problems, kidney damage, nerve disorders, sleep problems, muscle and joint pain, and mood changes. Pregnant women and women of childbearing age are also at increased risk because lead ingested by the mother can cross the placenta and affect the unborn fetus.

What is considered a high level of lead?
Exposure to lead is estimated by measuring levels in the blood (micrograms per deciliter). The Centers for Disease Control and Prevention (CDC) has set a level of concern at 10 micrograms per deciliter for children under the age of 6. This means children with lead levels greater than or equal to 10 micrograms per deciliter are considered to have elevated levels and require appropriate follow-up. However, some recent evidence supports the possibility of subtle effects at even lower levels.

Why were children in my community tested for lead?
As a result of soil sampling conducted by the Environmental Protection Agency (EPA), elevated levels of lead were found in your community. Because lead in the soil can enter a child's body, Community Against Pollution (CAP) asked the Agency for Toxic Substances and Disease Registry (ATSDR) to test children in the Anniston community.

How was lead measured in Anniston children?
The RMC Wellness Foundation used a finger stick method to collect a very small amount of blood from each child. This blood was stored in a plastic tube and mailed to the CDC Laboratory in Atlanta for analysis. The finger stick method is commonly used as a screening tool. For children with blood lead levels 10 micrograms per deciliter and above, a second test is performed by drawing blood from the child's vein. When both tests are performed on the same child, the second test (from the vein) is considered the true result.

Who was tested in my community?
During April and May, children were screened at the following locations: Hall Head Start, Constantine Head Start, Norwood Boys and Girls Club, Wellborn Elementary (kindergarten classes), Cobb Elementary (kindergarten classes), and Carver Community Center.

What do my child's test results mean?
The results you received in the mail from ATSDR tell you the level of lead (in micrograms per deciliter) in your child's blood at the time he or she was tested. If your child's level was below 10, which is below the level of concern, no follow-up was conducted. If your child was 10 or above, you should have been contacted by the Alabama Department of Public Health and encouraged to have your child re-tested.

Were many of the children screened by ATSDR above the blood lead legal of 10?
ATSDR found four children with levels above 10 micrograms per deciliter. Three of these children were re-tested by the Calhoun County Health Department and the Alabama Department of Public Health; two were still above 10. Which means, two out of the 410 children screened by ATSDR were elevated. The average blood lead level among the 410 children was 2.9 micrograms per deciliter, the lowest value was 0.6, and the highest level was 13 micrograms per deciliter.

What about blood lead levels in other communities across the United States?
Over the past 20 years, childhood lead poisoning has declined dramatically in the United States due to limits on lead in gasoline, paint, food cans, and other consumer products. However, lead poisoning is still a very important and preventable health problem. A national survey that collects information from a representative sample of the U.S. population reported that 7.6% of children tested in 19 states (including Alabama) were above 10 micrograms per deciliter in 1998. The national average blood lead level in 1999 was 2.0 micrograms per deciliter. Elevated levels remain more common among those children living in houses built before 1950, low-income families, and families of color.

I had my child tested before by our physician. What if my child's level changed since last time?
A child's blood lead level can change over time. A child's diet, for example, can reduce his or her lead level. Around 2 years of age, children are likely to have higher levels because this is the age when they are moving around more, playing outdoors, and putting things (such as toys) in their mouth. If you're concerned, please speak with your physician.

What if I didn't receive my child's test results?
ATSDR is working hard to reach everyone. However, we were not able to locate all addresses. If you did not receive a letter, please call PerStephanie Thompson, ATSDR Community Involvement Specialist, toll-free at 1-888-42ATSDR.

How can I reduce lead exposure?
There are simple steps you and your family can take to reduce the chance of exposure to lead:

• Take extra care to keep your house clean.
• Mop floors and wipe window ledges and other areas with soapy water.
• Keep the areas where children play as clean and dust free as possible.
• If your child's bottle or pacifier falls on the floor, wash it before giving it back.
• Wash toys, stuffed animals, and bedding regularly.

If you work in construction, demolition or painting, with batteries, or in a radiator repair shop or lead factory, or if your hobby involves lead, you may unknowingly bring lead into your home on your body or clothes:

• When possible, shower and wash your hair before leaving company property.
• Be sure that any clothing worn under your work uniform is not worn at home; this includes boots and underwear.
• Wash work clothes separately so they do not contaminate your home.
• Don't eat or smoke while working.
• Have you blood lead level checked regularly.

Teach your children about lead poisoning:

• Keep children away from areas where paint is chipped or peeling. Stop children from chewing on painted surfaces.
• Make sure all members of the family wash their hands before meals and at nap time and bedtime.
• Make sure children remove and wipe their shoes and wash their hands whenever they come inside after playing outdoors.
• Children should eat a balanced diet with plenty of foods that contain iron and calcium. A child who gets enough of these minerals will absorb less lead. Foods rich in iron include eggs; lean red meat; and beans, peas, and other similar vegetables. Dairy products such as milk, cheese, and yogurt are recommended for their high calcium content.

What if my home has lead-based paint?
If your home has lead paint, do not try to remove the lead from your home yourself. Improper removal often makes the situation worse. If possible, hire a person with special training for correcting lead paint problems to remove lead paint from your home. All occupants, especially children and pregnant women, should leave the building until all work is finished and a thorough cleanup is done. To locate trained lead service providers, including lead-based paint inspectors, risk assessors and abatement (lead removal) contractors in your area, call (888) LEAD-LIST, or if you have access to a computer, visit http://www.leadlisting.org on the World Wide Web.

Does my drinking water contain lead?
Municipal water supply testing conducted by the city of Anniston in 2000 showed levels of lead are safe. For more information, please contact the Water Works and Sewer Board of the City of Anniston at (256) 236-3429. However, lead in your water can also come from the pipes and plumbing fixtures in your home. For more information, call the EPA Safe Drinking Water Hotline at (800) 426-4791.

What if my child wasn't tested?
If your child is on Medicaid, the screening can be done for free through your pediatrician. If your child is not on Medicaid, please contact the Calhoun County Health Department at (256) 237-7523 for a free screening. They are open Monday through Friday, 8:00 A.M.-5:00 P.M. You may also contact the Anniston Quality Health Care Center at (256) 236-0221.

Where can I get more information?
Community Against Pollution (CAP), a group which includes Anniston-area residents and concerned community members, is a local resource for information. CAP has been a valued contact for the public health response in Anniston. For more information about activities in your community, please contact CAP at (256) 236-6773.

There are several places for you to obtain more information about lead poisoning:

• The CDC Childhood Lead Poisoning Prevention Program, (888) 232-6789, or visit their web site at http://www.cdc.gov/nceh/lead
  
• The U.S. Department of Housing and Urban Development's Health Homes hotline, (800) HUDS-FHA, or visit their website at http://www.hud.gov
  
• The Alliance to End Childhood Lead Poisoning, (202) 543-1147, or visit their website at http://www.aeclp.org
• The EPA's National Lead Information Center, (800) 424-LEAD, or visit their web site at http://www.epa.gov
  
• The National Safety Council's Environmental Health Center at http://www.nsc.org

See the ATSDR News Archive for previous news items.

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This page last updated on February 15, 2002

Joanne Cox / JDCox.@cdc.gov

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