Ask the Expert: Lead Poisoning in Children

by Dr. Alison Matsunaga, Department of Hematology-Oncology at UCSF Benioff Children’s Hospital Oakland 


How do you get lead poisoning?  

Since toddlers often put things in their mouths, they are at an increased risk to ingest lead if it is present in their environment. If any individual is exhibiting “pica behavior,” which is eating non-food items that might contain lead, they are also at risk for high levels of lead in their blood. 


How can you prevent a child from getting it?  

Talk with your pediatrician if your child is at risk for elevated blood levels. A blood test will determine if your child has a high lead level in the blood and can be performed at any time. 


The test is often done when your child reaches one year old and can also be obtained in these situations:  

  • Your child is exhibiting pica behavior – i.e., eating non-food items, especially dirt. 
  • You and your child are residing in a home built before 1978, after which lead was removed from household paint. This should especially be checked if you see paint chips or dust, and/or there have been recent home renovations. 
  • A parent works in an environment at risk for lead exposure.  
  • You have toys or toy jewelry on the lead recall list ( 
  • There is exposure to medicinal herbal remedies or ceremonial makeup that might contain lead. 


How do you treat lead poisoning?  

The first approach to treating lead poisoning is to identify the lead source to stop the exposure. Subsequent chelation therapy is dependent on how high the lead level is, and how acute and sudden the exposure is. Children with higher lead levels can often have concurrent iron deficiency, which also needs to be treated. If your child has been found to have a high lead level, your pediatrician will contact your local county health department’s Lead Poisoning Prevention Program for assistance in investigating the source of the lead exposure, to ensure that your house is safe for your child. Your pediatrician and the health department will also contact our hematology center should there be further management issues.  


What are the effects of long-term lead poisoning?  

When children present with very high, toxic levels of lead in the blood, this can lead to acutely severe symptoms such as coma or seizures. Even chronically low levels of lead in the blood can affect your child’s IQ, attention span and academic performance. Previously, the Center for Disease Control and Prevention’s definition of a high lead level was above 10 to 20 micrograms per deciliter, but now even a level of 5 micrograms per deciliter warrants further investigation and follow-up.  


Call the Poison Control Center 

If your child swallowed it, breathed it in, or spilled it on his/her skin – Call the Poison Control Line at (800) 222-1222.

They will ask you some questions to assess the situation and tell you quickly, right over the phone, what to do. Usually, they will be able to help take care of the problem with one phone call, and they will advise when they think you need to go to an emergency room. The poison control expert will call the Emergency Department ahead to alert them that you’re coming so you don’t have to wait. If necessary, they will call you back to check on your child’s progress.