Introduction
Lead poisoning is a major health hazard and can have severe effects on Pre-kindergarten children’s health. Almost a million preschool-aged children in the United States have elevated blood lead levels. Toxicity rises with increased lead concentration in the blood. Biochemical and subclinical abnormalities occurs when the concentration reaches 10micro grams/dl to coma and death at levels over 100micrograms/dl (Markowitz, 2000). Lead poisoning is as a result of accumulation of lead metal in the blood caused by inhalation or ingestion of lead over a period of time. Children mostly affected are those between the ages of 1 and 4 years. The risk of lead poisoning increases in pre-kindergarten children because of the increased frequencies of hand to mouth activities (Wemp et al., 2007). In 2008, 5000 children were found to have lead poisoning. National surveys show that more than 3 million children of six years and below have lead poisoning (Illinois, 2009).
Lead poisoning is a public health issue which requires attention of the state, local and individual contributions. An analysis of lead poisoning reveals that Lead poisoning is a major health hazard to pre-kindergarten children.
Causes of Lead Poisoning in Kindergarten children
Lead poisoning in pre-kindergarten children mostly occurs from lead paints. The risk is higher at this stage because the child’s nervous system is at its rapid growth and development. This means the brain and the general development are likely to be negatively affected. When the brain of a child is affected, the effects may become irreversible. Unfortunately, lead effects are not felt at once and a parent may not be aware that the child is suffering from high lead amounts. Lead poisoning is a slow process of accumulation of lead in child’s body (Lead, 2011).
Lead poisoning is caused by various exposures of lead containing materials to pre-kindergarten children. Major causes of lead poisoning are lead based paints and lead contaminated dust. Other sources of lead poisoning include soil, water, home remedies and toy jewellery. Most of it is ingested by hand to mouth action. Because of their adverse effects, lead-based paints were banned from use in 1978; this was a good measure but not good enough as an approximate number of 38 million housing units still contained lead based paints. When paints on walls last for a long time they start to wear out. The risk of poisoning increases with chipping, peeling or flaking of the paint from the walls (Gaitens et al., 2011).
Lead in soils is also a risk factor for pre-kindergarten children especially where lead arsenate had been used as pesticide between 1905 and 1947. Dust is also a potential risk because it may contain soil, paint, and automotives emissions (Gaitens et al., 2011).
Some foodstuffs are also a potential source of lead poisoning to pre-kindergarten children. Contamination of food with lead metal can occur at any food processing stage. Cooking and serving utensils may expose food to lead as well as lead contaminated water or dust. Maternal exposure to lead can be transferred to the pre-kindergarten child through breast milk. Lead stored in mother’s bones presents a higher risk of exposure of lead poisoning. Lead in breast milk has a significant effect on the child because the child starts breast feeding from birth; a stage of rapid growth of the nervous sytem. Some medical drugs have been identified to have high concentration of lead and therefore are risk factors for lead poisoning (Levins et al., 2008).
Water can also cause lead poisoning to pre-kindergarten children. Water hardly contain lead but equipnment used in water distribution increases the riskof lead poisoning. Rusting and wearing out of the taps and pipes had a high risk factor in the past. Corrossion of metallic fixtures containing lead caused lead poisoning (Levins et al., 2008). Drinking water contributes about 10-20% of all the lead exposed people (Levins et al., 2008).
Chocolate and its products such as chocolate milk and chocolate bars were found to have high levels of lead. The process of their production exposed them to lead and a substantial percentage increase was seen with every progressive process of production. Canned foods were also found to contain some amounts of lead posing a risk of lead poisoning to pre-kindergarten children (Levins et al., 2008). Some spices such as Hungarian paprika and food colorings were also potential souces of lead poisoning to the pre-kindergarten children. Beverages such as Pepsi were found to have bottle labels with high lead amounts (Levins et al., 2008).
Some dietary supplements were also found to have lead content from a research of 84 dietary supplements. Out of these only 11 were found to be lead free (Levins et al., 2008). They offer a great risk to pre-kindergarten children who are given dietary supplements.
Some of the leaded crystal glass and dishes contained lead oxide. They were capable of releasing a lot of lead in a short period of time. Pottery, vinyl lunch boxes and painted glassware have been found to contain lead which is risky to the health of the children. Polyethene bags used to carry foodstuffs and which can be easily licked by pre-kindergarten children were found to contain some paint with some amount of lead. Even bread paperbags were found to have small amounts of lead. Reusing the paperbags causes the paint to come out of the paper and thus ingested by action of hands to mouth (Levins et al., 2008).
Synthetic turf in playgrounds of children put children at risk of lead poisoning because it was found to contain some lead (Levins et al., 2008).
Other risk factors include , “battery manufacturing and recycling,remodelling, renovation projects, demolition work, ammunation manufacturing, automotive/radiator repair, soldering, paiting plumbing and welding” (Khan et al., 2010, p. 501); this lead is exposed to children who live near industrial places by inhalation or brought home by their parents on their shoes, hands and clothes. Lack of healthy diet to pre-kindergarten children puts them at a risk of lead poisoning because exposure of lead causes a higher gastrointestinal absorption (Khan et al., 2010).
Effects of Lead poisoning in Pre-kindergarten Children
Small body size of pre-kindergarten children causes higher absorption and concentration of lead in children (Wemp et al., 2007). This causes lead to have severe effects in children than in adults. Neurotoxicity in children has a great impact because it can easily lead to permanent neurological damage and behavioural disorders.
Pre-kindergarten children are highly affected by lead in their bodies. Nervous, renal, haemopoietic, hepatic and reproductive systems of pre-kindergarten children are affected by lead. In the past, 10µg/dL of blood was known to be safe, but current research has revealed that this has chronic health effects. Children’s intelligence is impaired leading to lower Intelligence Quotient. Neural system development is negatively affected (Khan et al., 2010). Mental retardation may become irreversible depending on the level of severity of lead effect on a pre-kindergarten child.
Hematological system is highly affected by lead poisoning in pre-kindergarten children. It causes a drastic drop of haemoglobin and blood levels. Children who are lead poisoned may suffer from anaemia, because lead in the blood of children inhibits synthesis of heme (Khan et al., 2010).
Kidneys are affected by lead. Lead may impairs the renal functioning in pre-kindergarten children. Excessive exposure of lead may cause acute or chronic toxicity to the nephrons making them to malfunction. Chronic nephropathy comes after a long time exposure. Lead can cause proximal tubular damage, glomerular sclerosis, intestinal fibrosis and lowered glomerular filtration rate (Khan et al., 2010).
Liver is also affected by lead exposure. Most of the lead that gets into the body of pre-kindergarten child accumulates in the liver; about 33%, while the rest is stored up in soft tissues. This affects functioning of the liver causing depletion of protein and higher production of liver enzymes (Khan et al., 2010).
High lead levels causes stunted growth in pre-kindergarten children. This causes them to have a delayed sexual maturation as they grow up. In addition lead may cause impairment of physical fitness to the child (Little, 2009). Lead poisoning destructs language fluency causing inability to communicate. The pre-kindergarten child fails to pay attention and easily looses concentration. Pre-kindergarten children also suffer from memory loss. As they grow up they are not able to plan and organize their activities which leads to failure in school. Lead poisoned pre-kindergarten children have been found to have poor cognitive abilities meaning that they will find it hard to do something for the first time (Lead, 2009).
Epidemiology
From research done by the U.S Centres for Disease Control and Prevention, about 320,000(1.6%) children aged between 1 and 6 years had high lead blood levels above 10 micrograms per decilitre (Gaitens et al., 2011). In a research carried out in 1999-2002 by Centres for Disease Control, 1.4 million children were found to have blood lead levels of 5-9 micrograms per decilitre.
The research showed a difference in the number of children who were lead poisoned. Year of construction of houses was significant in lead poisoning. Those houses which were constructed before 1978 had shown a higher number of children being lead poisoned. Renovation works which failed to follow lead safe work increased the risk of lead in the houses. Rental units also had a higher number of children being lead poisoned than those who owned a house because of enough space the owners had. Homes of non Hispanic whites and African Americans had higher lead levels than those of whites (Gaitens et al., 2011).
A research was done by CDC in the United States from 1997 to 2007. The results showed a decline in the number of children who were lead poisoned. In 1997 children with high blood lead levels was 7.61% of 23, 345,397 children. After three years, the number of lead poisoning decreased to 3.96% of 23, 612, 242 children. Lead poisoning in children had gone as low as 1% 0f 24, 761,587 children in 2007. However, this was a great health hazard because, though the percentage was low, many children were at risk because of the high population (CDC 1). From the above research the ratio of boys to girls who were lead poisoned was seen to be higher in boys than in girls. Lead poisoned pre-kindergarten children had lower weights and heights than those who were not lead poisoned (Khan et al., 2010).
A research from Uganda in Africa examined blood lead levels. The result was a mean of 7.15 micrograms per decilitre. 20.5% of children aged 4-8 years had elevated blood lead levels. This was after Tetraethyl lead was banned from use in the country in 2005. Children were therefore seen to be at risk of lead poisoning (Graber et al., 2010).
Remedies for Lead Poisoning in Children
First priority in control of lead poisoning is reducing exposure of pre-kindergarten children to lead. Timing is an important factor when it comes to control of lead. Community health workers should ensure timely tackling of the problem before it has severe effects on the pre-kindergarten children. This will reduce the cost of remediation. Recommending people to repaint walls with latex paint reduces the risk of lead exposure to children because it prevents flaking and chipping of degraded lead paints from the walls. This duty can be effectively done by housing organizations (Levins et al., 2008).
Intensive testing of the dust and soil should be carried out make the environment lead free. Public health workers should ensure monitoring of lead in air, water and food (Levins et al., 2008). Thorough research should be done so as to help in progressive improvement on the measures taken from time to time. Community Public health nurses should work with health local authorities so as to exonerate lead poisoning source
Since the highest risk of lead poisoning is in paints, community public health nurses should work towards alleviating the risk to the community. Firstly, they should gather information from other health organizations on lead related issues in pre-kindergarten children. This would lead them to clear identification of all sources of lead exposure which poses risk to the children (Levins et al., 2008).
Government institutions which include, local, state and federal should work together to maximize effectiveness of the work towards control of lead poisoning in children. They should work with housing organizations to regulate requirements for lead safe housing. They should also work with the government to help in enforcement of the laws which promote elimination of lead hazard from the environment. Implementation of Wisconsin Act 113 in 1999 showed a great improvement in elimination of lead from the environment. The law required lead free property registry. This helped in maintaining housing which met the standards and also catering for lead poisoned children in case one’s child was found to be Lead poisoned (Zierold, Havlena & Anderson, 2007). Environmental agencies should help in monitoring, regulating, licensing and enforcement of laws put to prevent lead poisoning in pre-kindergarten children (CDC, 2011).
Public and private investments can lower the risk of pre-kindergarten children to lead poisoning (Levins et al., 2008). It can be initiated by community public health nurses who can create awareness and teach on the need of lead poisoning prevention. Funding helps in initiation of research projects and carrying out of investigations where lead poisoning cases has been reported.
Education is an important sector where public health workers should intensify their efforts in elimination of lead poisoning (Levins et al., 2008). Family education is effective as it creates awareness to the parents about health hazards related to ingestion of paints to the children. Parents become aware of the sources of lead and so protect their children from contacting areas with lead. Community Public Health workers should also play an advisory role to parents. Parents should work to ensure that children get a diet rich in calcium and iron. This would protect children by inhibition of lead absorption from the intestines and also in removal of ingested lead (Lead, 2011).
The state should also provide contact information of state and local health departments to those renting houses to report incidences of landlords who refuse to comply with laws set to eliminate lead from the environment (Zierold, Havlena & Anderson, 2007).
Community health workers have a duty of testing homes where a child is known to have elevated lead blood levels. Local health departments should take responsibility to inspect the pre-kindergarten children’s home or any other place of a child’s dwelling. This is recommended to be timely. Centres for Disease control and prevention requires that public health officials to start a detection process in the whole environment where blood lead levels are 20 micrograms/dL or above. Home is the major target of detection because pre-kindergarten children spend most of their time at home.
In U.S., Lead poisoning prevention programs such as Wisconsin Childhood Lead Poisoning prevention program had been useful in the past in a research which was used to determine the time required to get a lead free home. The results were that it required 6 days to1963 days. Wisconsin Childhood Lead Poisoning prevention program researched and maintained all the records of the children tested of lead and housing interventions (Zierold, Havlena & Anderson, 2007). Other than this, they have kept a good record of description of these children. This was a remedy process for determining the most appropriate method that should be applied to eliminate lead from residential environment. Laboratories which carried out blood tests to determine lead levels in blood are also an important part of the creating a lead free environment (Zierold, Havlena & Anderson, 2007).
Funding of local health departments can also be useful in lead control. State funding has in the past encouraged investigations in homes by providing lead poisoning prevention funds (Zierold, Havlena & Anderson, 2007). This made investigations to be a must which was an improvement from the year 2004 which only 42% cases had been investigated. Later on, 90% of reported cases were investigated within 14 days (Zierold, Havlena & Anderson, 2007). Screening of children’s blood should be done by using lead tests.
The prevalence of elevated blood lead levels in pre-kindergarten children has decreased sharply in the United States. However this decrease is mainly in some communities and populations. Pre-kindergarten children who are from low-social economic places and who live in houses built before 1950 are at a higher risk of lead poisoning (Rischitellietal, 2006). This means the programs which have been put up to reduce lead poisoning should intensify their services to these populations. This will help in elimination of Lead poisoning from all communities and populations.
Conclusion
Lead poisoning is still a great health hazard to children. Effective efforts need to be made so as to lower this risk. This can be done by contribution from the government, health agencies, environmental agencies and programs that work towards elimination of lead from the environment which may bring contact of lead to pre-kindergarten children. Those children who are already lead poisoned should be provided with medication and screening of all children should be done. These would eliminate the effects of lead poisoning as well as economic burden to the health departments.
Works Cited
CDC. (2011). Childhood lead poisoning Data, Statistics and Surveillance. Web.
Gaitens et al. (2011). Exposure of U.S Children to Residential Dust Lead. Environmental Health Perspectives 117.3 , 461-466.
Graber et al. (2010). Childhood lead exposure after phaseout of Leaded Gasoline. Environmental Health Perspectives: 118.6 , 884.
Illinois. (2009). Health Bent. Web.
Khan et al. (2010). Lead exposure and its adverse health effects among occupational workers’s children. Toxicology and Industrial Health , 497-502.
Lead. (2011). CDC. Web.
Levins et al. (2008). Lead exxposure in U.S Children: Implications for prevention. Environmental Health Perspectives.116.10 , 1285-1292.
Little, B. (2009). Blood lead levelsand growth status among African-American and Hispanic Children in Dallas, Texas-1980 and 2002:Dallas Lead Project II. Annals of Human Biology:1.1 , 1-10.
Little et al, B. (2009). Blood lead levels and groth status among African-American and Hispanic Children in Dallas. Annals of Human Biology: 1.1 , 1-10.
Markowitz. (2000). Lead Poisoning. Web.
Rischitellietal. (2006). Screening for elevated lead. Web.
Wempetal. (2007). Elevated Blood Lead conccentrations and Vitamin D Deficiencyin Winter and Summer in Young Urban Children. Environmental Health Perspectives 115.4 , 630-634.
Zierold, K. M., Havlena, J., & Anderson, H. (2007). Exposure to Lead and Length of Time Neede to Make Homes Lead Safe for Young Children. American Journal of Public Health: 97.2 , 267-270.