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Workplace Medical Mystery: Unknown Exposure Leaves Child with High Blood Lead Levels

Posted on by Stephanie Stevens, MA

 

MM1It was just a routine well child exam.

A simple blood test showed 13 micrograms per deciliter (µg/dL) of lead in two-year-old Sarah’s blood; 8 µg/dL more than the 5 µg/dL the U.S. Centers for Disease Control and Prevention (CDC)recommends as a reference level for determining if a child’s blood lead level is much higher than most children’s levels. This serves as a warning that the child may be exposed to lead at home or in the environment, and may require case management. It also allows parents, doctors, public health officials, and communities to take action earlier to reduce the child’s future exposure to lead.

Sarah’s mom, Michelle, was in shock. “How could this be happening?” she thought to herself. Michelle had heard of kids being exposed to lead through crumbling paint in old houses, but their home was built in 1975 and was in good condition. The couple had even just finished a do-it-yourself renovation project, transforming the dated ‘70’s kitchen into something a little more modern.

Michelle and her husband Ted bought their house three years ago when Michelle found out she was pregnant. They had been living in a tiny one bedroom apartment and had scraped together enough money from their jobs for a down payment on a house—Michelle worked as an art teacher at a neighborhood charter school and recently started teaching an evening community education course on the art of stained glass. Ted worked at a nearby e-scrap recycling facility crushing cathode ray tubes from discarded TVs and computer monitors.

The family’s house was located in a part of the city that had been redeveloped a few decades earlier. Older dilapidated homes from the turn of the century were torn down to make way for a handful of new homes as the neighborhood underwent revitalization. The only aspect of the house Michelle didn’t like was its location on the last block before the interstate highway. The constant hum from the thousands of cars that passed by each day could be unnerving at times, especially when she was outside playing in the yard with Sarah.

Sarah’s pediatrician referred the family to the local health department’s childhood lead poisoning prevention program. A certified risk assessor conducted a lead risk assessment of their home to determine the presence, type, severity, and location of lead hazards that might be in the paint, dust, and soil.

What do you think might be the source of Sarah’s elevated blood lead level? Tell us what you think in the comments and stay tuned for the next installment on Friday.

 

Stephanie Stevens, MA, is a Health Communication Specialist in the NIOSH Office of the Director.

 

This blog is part of the NIOSH Workplace Medical Mystery Series. The names and certain personal details of the characters are fictitious and do not represent an actual person or persons.

Posted on by Stephanie Stevens, MA

24 comments on “Workplace Medical Mystery: Unknown Exposure Leaves Child with High Blood Lead Levels”

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    According to the EPA, CRT funnel glass in cathode ray tubes generally contains high enough concentrations of lead that the glass is regulated as hazardous waste when disposed. I suspect the father is bringing particles of the lead home in his work clothes.

    I think Sarah’s elevated lead levels are coming from her father. CRTs (Cathode Ray Tubes) that her father is recycling (“Ted worked at a nearby e-scrap recycling facility crushing cathode ray tubes from discarded TVs and computer monitors.”) have a high lead content and most recyclers of the glass from CRTs have no place to send the contaminated glass.
    http://www.eiae.org/whatsnew/attachments/Lead_in_CRTs.pdf

    http://www.electronicstakeback.com “Recyclers Stockpiling Millions of Pounds of Toxic Glass …”

    Either parent (or both) or the environment could be the source Sarah’s elevated BLL:
    – The “recent renovation” of the kitchen likely involved lead-soldered pipes.
    – Stained glass work often includes exposure to lead. Lead strips (or “came”) are sometimes used to join the pieces of glass. This process is called “leading” or “caming”.
    – Obsolete electronics is also often a source of lead. Exposure to lead from electronic waste recycling is a significant problem in some third-world countries.

    Resuspended environmental lead dust could also be the culprit. Past renovation may have resulted in lead dust deposited on the road. The significant traffic may cause this contamination to become airborne (a process termed “resuspension”).

    Maybe too straigthforward, how about take home lead contamination from the dad’s job in e-recyling (CRT)? I have investigated a radiator repair shop in which the dad was tracking lead dust home by not changing his clothing, in particular shoes, which resulted in his child with elevated BLL.

    I believe it is could be due to multiple sources: the mother’s second job working with stained glass creation potentially involves lead (Pb) and working as an “art teacher” also has potential for lead (Pb) exposure. The father’s work in e-recycling potentially faces the similar issues with heavy metals. If the parents are bringing home clothing contaminated with lead dust it can lead to a child becoming exposed. However, the most likely exposure was from the renovation of the “70’s kitchen”. Lead paint wasn’t banned for use in household paints until 1978. Sanding off older paint causing dust would lead to a much larger exposure through inhalation of lead (Pb).

    Several years ago lead was removed from the “came” which joins stained glass pieces together to form ornaments, windows, etc.
    My best assessment is the father’s work in recycling and exposures to heavy metals. Even if her father changes from his work clothing into “clean” clothing, and transports it in a sealed bag for laundering at home, his daughter’s exposures may be related to lead dust in the closed environment of his automobile, which accumulates lead-contaminated dust from the facility’s parking lot.

    I am inclined to examine the mom’s additional art occupation- working with stained glass. Lead is often utilized to connect the glass pieces to fashion the project.
    There may also be exposure from dust on the father’s clothing from the type of work he does.

    I believe there certainly exists the potential for significant exposure from the kitchen remodel activity, but I suspect the more likely culprit is the lead-contaminated clothing from the father after his handling of the crushed CRT’s.

    Gee whiz – what isn’t a suspected source?! Dad’s work smashing CRTs, Mom’s stained glass, the house is barely possible, the year’s of car exhaust, the old homes razed? I feel like I’m watching Clue (it was a folk remedy prepared using water through a lead pipe in a handmade clay pot next to wear Dad makes his own ammo and fishing lures while drinking moonshine made using old piping while the child was mouthing old toys made overseas and she has pica and is malnourished). This is all meant to be tongue in cheek were they all not real sources and problems. Thanks!

    Uptake from torn down homes where lead is in the soil and Sarah is playing outside. While uptake from the lead in the art supplies and solder in stained glass work is very possible, it is less likely these are transferred home in sufficient quantities (although it may add to the total burden of exposure). Soldering processes on stained glass are usually below the heat required to fume the lead, so the exposure is primarily contact-transfer. The CRT crushing exposure could be significant because the dust generated from the CRT’s could be carried to the home. CRTs can have several pounds of lead per monitor. The physical destruction process is likely to generate small particulate.

    The lead exposure could be coming from the father’s occupation of crushing cathode ray tubes which contain lead. If he is not taking the proper precautions of changing his clothes before he leaves work and showering at the job site, he can carry lead on this clothing, hair, skin, etc. and that could be the point of exposure for his daughter.

    Lead in the soil next to highway -AND Dad’s recycling job.. [Remember all the studies on lead levels along highways & crime ] shows that once lead is deposited in soil, it will be there for a very very long time….

    If I had to wage an educated guess… I’d say the recycling yard in general. Most are known to be contaminated with lead, cadmium, and chromium. Then, the ceramic tile dust from that 70’s kitchen remodel. Most forget that tile is loaded with lead in the paint and glaze.

    The father’s occupation certainly invites the possibility that he is taking home Lead from the workplace on clothing, shoe soles, etc. I feel it is also likely that if the mother teaches stained glass making then she does this at home as a hobby/second income source and the child either has access to the materials or is around Mom when she is engaged in this hobby. Lead paint on residential housing was not banned until 1978 so there is also the possibility that their home had/has Lead paint on it and their remodeling created lead dust.

    Experts now use a reference level of 5 micrograms per deciliter to identify children with blood lead levels that are much higher than most children’s levels. This new level is based on the U.S. population of children ages 1-5 years who are in the highest 2.5% of children when tested for lead in their blood.
    Frank Lamark

    workplace on clothing, shoe soles, etc. I feel it is also likely that if the mother teaches stained glass making then she does this at home as a hobby/second income source and the child either has access to the materials or is around M

    The father’s occupation certainly invites the possibility that he is taking home Lead from the workplace on clothing, shoe soles, etc. I feel it is also likely that if the mother teaches stained glass making then she does this at home as a hobby/second income source and the child either has access to the materials or is around Mom when she is engaged in this hobby. Lead paint on residential housing was not banned until 1978

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