1. Lead and Arsenic exposure
Susan Buchanan, MD, MPH
University of Illinois at Chicago
School of Public Health

2. Lead in Paint and Gasoline
1978 lead paint ban
1976 leaded gas phase-out

3. Common Sources of Lead
Plenary A - Susan Cummins, MD, MPH 3

4. Common sources of arsenic

5. Children’s touching and mouthing behaviors touches to surfaces 83/hr
hand to mouth area 35/hr
hand/object in mouth 21/hr
Ko et al, J Expo Sci Environ Epid 2007
Plenary A - Susan Cummins, MD, MPH 5

6. Lead Exposure  Death 100 Encephalopathy 60 40 Abdominal pain 30
Lead in
Blood
(g/dL)
CDC
Reference Level
1960
1978
1985
1991
2012
Health
Effect
Death
Encephalopathy
Abdominal pain
Anemia
Reduced IQ
Behavioral problems 
100 60 40 30 25 10 5
Deaths are now rare, but still occur. Last known deaths related to exposure: 2000: NH lead paint exposure; 2006, MN – ingestion of charm containing lead.
1960s=60, 1970=40, 1978=30, 1985=25, 1991=10. Levels roughly correlate with clinical symptoms.
Should it be lower than 10? (1) no intervention, (2) lab variability, (3) no threshold even exists, and new # would be arbitrary 6

7. Children 1 to 5 years Blood Lead Level (BLL)16 14
14.9 12 10
Geometric Mean BLL, g/dL 8 6
NHANES: program to assess health an nutrition: combines interviews and physical exams.
>88% of all children had a BLL>10; by IV 1.6% had BLL>10.
Geo mean: numbers multiplied to the nth root of product is taken, only applies to positive #s. 4
3.6 2
1.9
NHANES II
NHANES III
NHANES IV 7

8. Health Effects of Lead
No “safe” blood lead level for neurobehavioral effects
Loss of IQ
Behavioral problems
Poor school performance

9. Health effects of arsenic
Cancer
liver, bladder, and lungs
Nerve damage
Skin rash

10. Prevention *REMOVE FROM EXPOSURE* Wash hands frequently
Wash toys, wet mop
Yearly blood lead test