Childhood Lead Poisoning Prevention Program

Lead poisoning happens when children have too much lead in their bodies. It’s usually caused when toddlers come into contact with lead-based paint chips or lead dust found in homes built before 1978.

Lead is toxic to everyone, but unborn babies and young children (6 months to 3 years) have more risk of exposure to lead than older children. Young children absorb lead more easily than older kids and adults, and lead is more harmful to them. A child's quickly growing body can be harmed by even small amounts of lead.

It is very normal for young children to put things in their mouths. Eating lead paint chips and lead dust is a very common cause of lead poisoning in young children. According to the Centers for Disease Control and Prevention (CDC), children are at a higher risk for lead exposure if they:

• are low income or poor
• are members of racial-ethnic minority groups
• are recent immigrants
• live in older, poorly maintained rental properties
• have parents who are exposed to lead at work

Lead is highly toxic and can cause developmental delays, learning difficulties, headaches and more. Even small amounts of lead can harm a child. CDC states there is no safe levels of lead in a child’s system.

The most common way that kids get lead poisoning is from lead-based paint. This type of paint was used in many U.S. homes until the late 1970s, when the government banned the use of paint containing lead in houses.

Young children are also very active and like to explore. A child can crawl on the floor and reach windows, walls, railings or doors. All of these areas can be sources of peeling and chipping lead-based paint or leaded dust. Even toys and food that have fallen on the floor can be coated with lead dust. Children can also be exposed to lead when they:

• put soil contaminated with lead in their mouth
• eat food stored in bowls glazed or painted with lead, or imported from countries that use lead to seal canned food
• play with toys or jewelry that contain lead
• come into contact with a parent or guardian with a job or hobby where lead is used
• live in a home where cultural practices, remedies or products that contain lead are used
• drink water that flows through old lead soldered pipes or faucets

Most children have no signs of being sick. Others may have symptoms like:

• headaches
• behavioral problems and trouble concentrating
• loss of appetite
• weight loss
• nausea and vomiting
• constipation
• a metallic taste in the mouth
• feeling tired
• muscle and joint weakness
• looking pale

A simple blood test can diagnose lead poisoning. Doctors get the blood by pricking the finger or putting a small needle into a vein. Iowa HHS recommends children be tested early and often for lead. At a minimum, blood tests to check for lead in the body should be done when children are 1 and 2 years in age.

Treatment for lead poisoning depends on how much lead is in the blood. The most important part of treatment is preventing more exposure to lead. A child with a small amount of lead can often reduce the level of lead in their bodies through proper nutrition, good housekeeping, and washing of child’s face and hands before eating and bedtime. The body will naturally get rid of the lead if these practices are put in place.

Children with severe cases and extremely high lead levels in their blood may be hospitalized to get a medicine called a chelator. The chelator binds to the lead and makes it easier for the body to get rid of lead naturally.

Parents can protect children from lead poisoning by:

• Keeping your home lead-free. Use a checklist to help you look for lead hazards in your home or ask your local health department about what to look for when checking your home for lead sources.
• Asking your doctor about having your children tested for lead exposure. If a child has lead poisoning, all children in the home should be tested.
• Washing your children’s hands and toys often with soap and water. Always wash hands before eating and sleeping.
• Keeping dusty surfaces clean using a wet cloth or paper towel and soap and water. Make sure to wash cleaning rags often to remove the lead dust.
• Feeding your child foods high in calcium, iron and vitamin C. If kids are exposed to lead, good nutrition may reduce the amount of lead absorbed by their bodies. Eating regular meals is helpful because less lead is absorbed by the body.
• Knowing where your kids play. Keep them away from windows with chipping and peeling paint, and bare soil around homes and in play areas.
• Finding out if your pipes contain lead. Old plumbing may include lead. If your neighborhood has old lead water pipes going to homes or if you have plumbing with copper pipes and lead solder, you may want to get your water tested. For information on testing your water, contact the Iowa State Laboratory at 800-421-4692.

Talk to your healthcare provider to request a blood lead test for your child. Some community agencies or the local health department may also offer lead testing as part of their services.

Contact your municipal housing agency or local public health department to find out if they have a rental maintenance or lead hazard repair ordinance in place to address lead hazards in rental properties.

EPA and the Centers for Disease Control and Prevention (CDC) agree that there is no known safe level of lead in a child's blood. Lead is harmful to health, especially for children.

A child's environment is full of lead. Children are exposed to lead from different sources (such as paint, gasoline, solder and consumer products) and through different pathways (such as air, food, water, dust and soil). In Iowa, lead-based paint from older housing is the primary source of exposure to children.

Iowa HHS recommends families be provided with information and educated on the dangers of lead poisoning regardless of the child’s blood lead level. Most intervention services are recommended when a child’s venous blood level reaches 15 micrograms per deciliter of blood or higher.

Many counties in Iowa have a local childhood lead poisoning prevention program that coordinates services for families of children with elevated blood lead levels.

Prevention

If the home was built before 1978 and is owner-occupied, follow these steps to minimize or prevent lead exposure:

• Assume all painted surfaces contain lead-based paint and maintain them to keep the paint in good condition.
• Regularly check your home for chipping, peeling or deteriorating paint, and address issues promptly without excessive sanding. If you must sand, sand the minimum area needed, wet the area first, and clean up thoroughly.
• Regularly check all painted areas that rub together or get lots of wear, like windows, doors and stairways, for any signs of deterioration.
• Regularly check for paint chips or dust – if you see some, remove carefully with a damp paper towel and discard in the trash, then wipe the surface clean with a wet paper towel.
• Wipe down flat surfaces, like window sills, at least weekly with a damp paper towel and throw the paper towel away.
• Mop smooth floors (using a damp mop) weekly to control dust.

Repair

If you are going to prepare for repainting, removing paint or tearing out walls in an old home, you should do one of the following:

• Have the paint tested to see if it is lead-based paint. Hire a certified lead inspector to safely and accurately assess the lead dangers in your home. You can find a list of certified lead inspectors on the Iowa HHS. website.
• Assume that it is lead-based paint and take the appropriate precautions. Only owner-occupants can perform renovation, remodeling and repainting without certification.
  1. Never dry scrape, dry sand, power sand, power wash, grind or blast with power tools and equipment not equipped with a shroud and HEPA vacuum attachment. Do not use a torch, needle gun, planer or use a high temperature heat gun to remove lead-based paint.
  2. Clean up thoroughly every day. Dispose of waste in a heavy duty bag or sheet.

If you’re hiring a contractor:

• Make sure your contractor is an Iowa certified lead-safe renovator and can explain clearly the details of the job, and how they will minimize lead hazards during the work.
• Ask if the contractor is trained to perform lead-safe work practices and to see a copy of their certification card.
• Ask them what lead-safe methods they will use to set up and perform the job in your home. You can also request to see references from at least three recent jobs involving homes built before 1978, and speak to each personally.

Prevention

Most cities and communities in Iowa have building and housing codes that require rental properties to be maintained and kept safe for tenants. Maintaining and keeping painted surfaces intact in homes built prior to 1978 is key to minimizing and preventing lead exposure.

In rental properties built before 1978, landlords should follow these steps to protect tenants and minimize or prevent lead exposure:

• Hire a lead certified professional who can test painted surfaces for lead, and properly repair surfaces with chipping, peeling or deteriorating paint.
• Maintain and keep paint intact on all interior and exterior components covered with paint.
• Tell tenants about known lead-based paint and lead-based paint hazards before leases are signed.
• Leases must include a disclosure form about lead-based paint unless an Iowa certified inspector has checked the property and said in writing that it is lead-based paint free. Disclosure forms can be found in the booklet “Lead Poisoning: How to Protect Iowa Families” located in the Resources section.
• Notify tenants before any maintenance, renovation or repair work is done on the property that may disturb lead paint. 

Repair

Iowa rules requires the following of all landlords and contractors performing renovations, repairs or painting that may disturb lead-based paint in pre-1978 rental properties:

• Must be trained and Iowa Lead-Safe Certified
• Must use lead-safe work practices

The rules apply to any renovation that is not considered minor repair and maintenance activities. The definition of minor repair and maintenance activities is:

Activities, including minor heating, ventilation or air-conditioning work, electrical work and plumbing, that disrupt less than the minimum areas of a painted surface established in this definition where none of the work practices prohibited or restricted by this chapter are used and where the work does not involve window replacement or demolition of painted surface areas. When painted components or portions of painted components are removed, the entire surface area removed is the amount of painted surface disturbed. Projects, other than emergency renovation, performed in the same room within the same 30 days must be considered the same project for the purpose of determining whether the project is a minor repair and maintenance activity. Renovations performed in response to an elevated blood lead (EBL) inspection are not considered minor repair and maintenance activities.

The minimum area for minor repair and maintenance activities is:

1. Less than 1.0 square foot of an interior painted or finished wood surface pre-renovation;
2. Less than 6.0 square feet of a painted or finished drywall or plaster surface per room; or
3. Less than 20.0 square feet of an exterior painted or finished surface per renovation.

Specific work practices include:

• Warning signs posted
• Dust, paint chips and debris contained to the work area
• Cover objects in the work area (i.e., furniture)
• Ground cover for exterior work areas
• Waste material contained, stored and transported safely
• Prohibited work practices (i.e., uncontained water blasting and dry scraping)
• HEPA vacuums for cleaning
• Work area cleaned and verified with post renovation cleaning verification

Additional requirements include:

• Certified Lead-Safe Renovators can test for presence of lead-based paint using approved test kits.
• On-the job training required for all non-certified individuals that do renovation work.
• A renovation report is required for each renovation.

• Do not panic!
• If you rent, tell your landlord about the hazards that you find. Any hazards that are found must be fixed by a certified lead professional.
• If you own, do NOT sand, scrape or remove any paint, walls, windows or plaster until you know how to do it safely. Call the Iowa Department of Public Health at 800-972-2026 to find out how to do this work safely or find a list of lead safe renovators.
• Have all children under the age of 6 years tested for lead poisoning.
• Supervise your children very carefully. Keep them away from areas where there is peeling and chipping paint.
• Do not allow children to chew on painted surfaces such as window sills, stair rails, furniture, jewelry or toys.
• Do not allow children to put paint chips or soil in their mouths.
• Weekly, clean floors, baseboards and window sills where small children play. Wash woodwork and painted surfaces with warm water and a general all-purpose cleaner. Remember: Never mix ammonia and bleach together since they form a dangerous gas.
• Wash toys, pacifiers and bottles that children drop on the floor.
• Wash children’s hands often, especially before they eat.
• Pick up paint chips that you see on the floor, inside windows or in other places where your children play. Put the paint chips in a garbage bag and dispose of them in the landfill with your regular garbage.

Do not let children play outside in areas where there are paint chips on the ground. Pick up as many of the paint chips as you can. Cover the soil in these areas by seeding grass, laying sod, planting some shrubs or covering with mulch.

Lead-based paint that is peeling, chipping, chalking, cracking or otherwise deteriorating is a hazard to small children.

Lead-based paint in good condition may be a hazard on:

• Surfaces children can chew on (window sills, stair railings, porch railings)
• Surfaces where paint is often damaged by hard impacts (doors, door frames, corners)
• Surfaces where paint is worn by being walked on, such as floors and stairs can be a lead hazard

Lead dust may be on the floors and other surfaces if there has been any remodeling or repainting in your home recently.

Lead in soil is a hazard when children play in areas of bare soil next to old buildings.

Areas of bare soil where buildings have been torn down are also a hazard to children.