Deadly Lead in Children

In most cities east of the Mississippi that are old enough to have run-down slums, doctors have long thought they had correctly estimated the annual incidence of lead poisoning in children. New York City has had an average of about 600 cases a year reported for the past decade. Baltimore has averaged 25, Cleveland 50, Chicago 155. But at a conference held last week at Manhattan's Rockefeller University, researchers suggested that these figures are gross underestimates. New York City may have as many as 30,000 cases, and the total for the U.S. may run as high as 225,000. The fact is that no one really knows, and the experts cannot even agree as to the best way to find out. Nor can they tell yet how many of the lead-poisoned children will suffer permanent brain damage, or die in young adulthood from kidney damage.

Like many another metal, lead is a cumulative poison. The human body can dispose of the minute quantities that it ingests in food and water. But any unnatural overload piles up, causing abdominal cramps ("painter's colic"), lassitude, irritability, vomiting and twitching. In severe cases, the victim may lapse into a coma. Prolonged lead poisoning damages the brain so insidiously that its effects may not be evident for years.

Only Three a Day. Painter's colic is rare now that the hazard of paints containing lead is recognized in industry. Lead poisoning in children--especially from age two to about five--persists, because even when they are not hungry, they will put anything into their mouths, including chips of paint that have flaked off window sills or radiators in old houses. Dr. J. Julian Chisolm Jr. of Johns

Hopkins University estimates that it takes only two or three paint chips a day, over a three-month period, to cause severe illness and perhaps induce a life-threatening coma.

It has been 20 years since manufacturers stopped putting lead into paint intended for interior use, and ten years since New York City prohibited such use. But in countless old houses, there may be a dozen layers of dried-out lead paint, still dangerous, underneath whatever lead-free paint has been applied since.

If a child is not poisoned severely enough to go into a coma, his symptoms may be so vague that they raise no suspicion of lead poisoning. For borderline cases, or for children under suspicion because they live in the same building as a known victim, there are several blood and urine tests, and an ingenious method of detecting lead (by spectrophotometry) in a snippet of their hair.

Simple Abstinence. Treatment is still the subject of disputation among experts, except for the obvious measure of keeping the child away from lead long enough to give his system a chance to excrete the overload. It usually takes at least twice as long to remove the lead as it took for the child to take it in, says Chisolm. For the milder cases, this appears to be sufficient. For more severe poisoning, especially if there are signs of brain damage, some doctors use drugs called chelating agents. These drugs work by substituting calcium for the lead, which is then excreted. Dr. Chisolm questions whether this is necessary in the milder cases.

In either case, before a child goes home, the house should be deleaded by removing all old paint from surfaces within four feet of the floor, and any peeling paint at whatever height.

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