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.
- 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.