Below is a letter I wrote to a family who I recently had a home visit with. I felt it synthesized a lot of information that I often share with families and would be a useful addition to my blog.
February 6, 2019
After our visit I wanted to get back to you with and some priorities for you to think about, and a suggested game plan.
Primarily (first and foremost), It’s very important for you to get blood lead tests (BLLs) for everyone in the family – so that you all have BLL baselines moving forward (before you do any work on the home). Here are some thoughts on that, to reiterate a bit of what we discussed when we met (and expound on it a bit too):
- You want to get “BLL Testing”, using venous draw blood samples (i.e. from a vein in the arm – not a finger-prick test) as soon as possible, to help quantify the degree of concern.
- The reason for this is that the venous testing is much more accurate and reliable than the common finger stick screening test. [If a finger stick tests positive for lead, you always have to follow-up with a venous draw anyway, so if you get a venous draw first you save the kiddos from having to be tested twice].
- Your wife should also get tested, because she is pregnant. Ideally, both she and the children should get tested before she leaves town later this month. Blood lead levels as low as 0.5 (micrograms per deciliter) – and even lower – in pregnant women have been shown to cause birth complications and other issues, so having a baseline for her is very important at this time, and if she leaves the exposure source her BLL will start to go down immediately – so testing later will not give an accurate number.
- Because your kiddos are so small, I recommend getting their blood lead testing done by a pediatric phlebotomist at a children’s hospital. The pediatric phlebotomists at children hospitals have a lot of experience working on premies and other small babies, and are very skilled in making the process as painless as possible for tiny children. As a result it is usually much less traumatic (and often not traumatic at all) for kiddos to be tested by specialists (vs. having them tested at a typical lab or medical clinic.) Because they are so young, this specialized testing via a referral to the children’s hospital should be covered by insurance; just ask your doctor to call a BLL testing order in to the children’s hospital for you.
- Prior to getting the testing done, for both your children and your wife (and I also recommend you get tested, given the levels of lead in the paint in your home), I would check in advance with the lab that you will be tested at (just give them a call) and confirm what the low testing threshold is for their Blood Lead Level tests. You want to make sure they have the lowest possible testing threshold and the highest possible level of accuracy — you don’t want to know if your kids’ levels are “less than 2” or “less than 3.3” [micrograms of lead per deciliter of blood], but preferably you want to know the actual number for their result (especially if it is on the low side), and ideally a real or decimal number that is at least as accurate as “less than 1.0“, with a margin of error of no more than 10%. For context, when my children were recently tested we were given the results “0.8” and “0.4”. With a 10% margin of error, a BLL test result of 0.4 micrograms per deciliter would be accurate within the range of 0.36 to 0.44 – which is considered “normal” population levels for adult city dwellers at this time.
- Please understand that there is no safe level of lead in blood — in recent years this has been widely acknowledged in public statements by all of the public federal agencies (EPA, CDC, FDA). Current urban population levels for babies and toddlers [those who have not been either acutely poisoned by an incidental exposure, or chronically poisoned by an ongoing persistent low level exposure] is in the range of 1.2 micrograms of lead per deciliter of blood. Adult women should be about 0.43 or lower if they have had no incidental, acute nor chronic/cumulative low-level exposure.
- Note: The “natural” blood lead level for humans (i.e. pre-industrial revolution) has been forensically confirmed to be 0.016. So a BLL of 1.6 is 100 times higher than that level. Levels 1,000 years ago — before the widespread use of mining and other metalworking activities — have been confirmed to have been even lower by a recent study from Harvard. Long-term negative health impacts have been studied and documented with blood lead levels as low as 2.0 and lower. Here’s the article from Harvard about newly discovered original human population baseline levels for lead in blood before mining activities of humans: https://tamararubin.com/2017/09/natural-2/
- Ideally, you want/hope everyone in the home tests below 1.0, but should expect/be prepared for smaller kiddos’ (who are crawling and spending more time on the floor) levels to likely be higher — especially since you live in an “historic” [= originally lead-based-paint-covered] home in a big city with lots of other “historic” homes and buildings (which might contribute to their total exposure beyond any exposure they get at home.)
- The CDC’s current “reference level” in the United States is 5 micrograms of lead per deciliter of blood. Many physicians erroneously understand this to be the level at which a child is officially considered Lead-poisoned. That is a misinterpretation. The reference level is not intended to be interpreted as a BLL below which lead in blood is somehow “safe” for kids — but merely the level at which the government will allocate federal funding for intervention to help families with low income children who have been poisoned. It is my understanding that Germany has long had an offical level of 3.5 (for what they consider “lead-poisoned”) and the CDC is working on lowering the U.S. reference level to 3.5 shortly as well. My public statement has always been that any BLL over 2.0 should be considered a medical concern that should be addressed immediately.
This is a great article from 2007 about the potential impact of low-level lead exposure. It provides good supporting information for any conversations you might have (with family members, doctors or contractors) about why you want to handle this in the best possible way, to protect your children from any possible additional exposure: https://tamararubin.com/2017/01/toxic_lead/
Once you know your family’s levels, you can be better prepared to take appropriate action to protect them in the future (in terms of the lead remediation plan for your home and any other actions you may take.)
Please let me know if you have any questions. I understand this is a lot of information and you will likely have follow up questions.
Tamara E. Rubin
Thank you for sharing, Tamara!
Question: the labs I have used come back at whole numbers (no decimal point breakdown), with the lowest possible reading available being <1. This made me wonder recently, when the number comes back at a 2.0, for example, does that mean the actual result could be anywhere between 2-3? And if it's a 3.0, the actual result could be anywhere between 3-4?
Sandy Sober says
Hi Tamara –
I have an excellent Functional Med Dr. and she had me do a provoked urine test. She said that blood heavy metals tests are only good for recent exposure.
(Heavy Metals are HEAVY and the sink into tissues in short order.).
A provoked urine test, “provokes” the HMs up out of the tissues & into the urine for a more accurate overall reading. Your thoughts?
You said “Prior to getting the testing done… I would check in advance with the lab that you will be tested at (just give them a call) and confirm what the low testing threshold is for their Blood Lead Level tests. ”
Lets say we call and they do not offer testing for the levels you laid out above, then what? Where do we turn? Whats the next step?
Hi there. Thanks for commenting.
A children’s hospital is often a good bet (they tend to have the most accurate labs.) Or – if the test is not for a child – a hospital that contains a child-focused wing will (most likely) have a lab with a lower level of detection for their blood lead level testing (and more accurate/smaller margin of error.) In my experience, hospitals in a major metropolitan area are also more likely to have more accurate labs.
evelyn rosas says
Just want to say to anyone getting their child’s levels checked that has not already done the dance: discussing blood levels with nurses at the pediatrician’s office can be a pain. Often they leave messages that will say “levels were fine” or “ND”…and I have to play phone tag with them to get the real picture. Usually I end up educating them and that’s awkward. Once a nurse said to me that levels of 14 were when to raise an alarm…I ended up telling the doctor about that.
I can’t find a lab that our insurance takes whose threshold is less than 1. Quest and Legacy have diagnostic testing where the lowest threshold is 1. So I will continue freaking out about shoes off in the house, washing hands, taking things out of the toddler’s mouth, etc…
Olga Cid says
Have you tested dinnerware from discontinued Studio Nova, Classic Garden? If yes, does it have lead?
Rose Ong says
I am currently investigating environmental contaminants and how they can relate to dementias. A friend recommended your writings and blogsite and I’ve also found out about your documentaries on lead poisoning here on your site. It never occurred to me that lead poisoning could also contribute to the rise in Dementia diagnoses, probably because I have been diagnosed with Young Onset Dementia and I’m function with less than a full deck, if you catch my drift.
My question to you is this: what are your thoughts on the possibility of even “safe” levels of lead and other heavy metals contributing to Early/Young Onset Dementia and ultimately Alzheimer’s?
I was quite distressed over the thought of exposure to heavy metals in our children, being a parent and grandparent myself. I would have thought that to be impossible today and I’m very sorry to hear that your children have experienced this in a country like the USA. Here in Canada, it probably is a hidden epidemic, inspite of our extremely high standards for heavy metal exposure. I immediately, today, ordered a 30 piece swab kit for lead testing and intend to test all my utensils and containers (will probably need more than 1 kit!). The kit Amazon recommended was from Scitus.
Anyway, thank you for all the work you have done on this topic.
It’s more micro plastics from a medical standpoint. Lead has its own host of problems, but the micro plastics are directly proven to be linked.
Stan Barton says
Do the products recommended that are BPA free contain BPS or something similar, which I understand is as bad as or worse than BPA.?
Lynne Garrison says
Hi. I came across a stainless steel pot from Fosslang. I wanted to know if you have ever heard of this manufacturer or ever came across any pots in which they make. If so, any lead, BPA or BPS issues? Any lead readings from the pot’s inside etched measuring lines.
I think Tamara gets so many questions and some answers can be found on her blog and in her documentary film. Read everything you can she has written and listen to her film for help. Alot of what she recommends is glassware
(these recommended items can be found on here). I don’t believe BPA is a problem with typical glassware though there can be lead associated with glass. This is just my observation and I hope it helps.
Cheryll Bennett says
I was also told by my naturopath to do a urine test, although she didn’t suggest the ‘provoked’ version mentioned by another in your comments. Awaiting the results now. I’m also wondering what your thoughts are re: pencils; I’m looking for a new spec ed pencil with a different, easier grip but want to make sure that the one I pick is safe. Here is one I’m looking at, have you researched it or another? (sorry to put it in this thread but couldn’t find another place to ask.