Recognizing Health Effects of Lead Paint
While the use of lead-based paints was banned over 40 years ago, the remnants of lead paint continue to be a major environmental and public health problem.
The Institute of Health Metrics and Evaluation estimated that in 2019, lead exposure counted for 900,000 deaths and 21.7 million years of healthy life lost worldwide due to long-term effects on health. New rules and regulations continue to make lead poisoning a focus and educate the public to protect themselves from its health effects.
Lead Paint History
Certain lead compounds could be added to paint to create rich pigmentation and allow for larger areas to be covered. It was also recognized as being more durable, which is why it typically was used for buildings, construction materials or toys.
Lead mining began in the United States in 1621, and by the 20th century the country would become the world’s leading producer and consumer of lead. The two main uses of lead in the U.S. were for paint and tetraethyl lead gasoline.
While lead paint has been documented as far back as the Roman Empire, the negative health effects weren’t widely recognized in the 1920s.
The Centers for Disease Control and Prevention reported that between 1925 and 1927, more painters died from lead poisoning than all other occupational groups combined. In the years that followed, lead exposure became more of a concern in our workplaces, environment and residences.
The International Labor Union (the League of Nations) banned interior lead paint in 1922. More than 20 countries agreed to this ban between 1922 and 1955, while the U.S. declined to enact the ban.
In 1971, Congress passed the first federal regulation on lead paint with The Lead-Based Paint Poisoning Prevention Act. The U.S. Consumer Product Safety Commission issued a final ban in 1978 for consumer and residential uses of lead-based paints, with some states banning even earlier.
Following the ban, the Occupation Safety and Health Administration and the National Institute for Occupational Safety and Health prioritized protecting workers from lead poisoning. Workers would also carry lead dust home on their clothes, shoes, hair and skin, causing “take-home” exposure that was nearly impossible to detect as it looked like regular dust.
According to the U.S. Environmental Protection Agency, if a home was built before 1978, it is more likely to have lead-based paint. Homes built prior to 1940 have an 87% likelihood to contain lead paint. While still present in millions of home, it can be under layers of new paint and typically not be a problem.
However, when paint peels and cracks, it creates lead paint chips and dust. Lead dust can also come off of surfaces exposed to friction, such as windows, doors, floors, porches, stairways and cabinets. Prior to renovations or repairs, one should test for lead paint or contact a professional.
Lead can be swallowed, inhaled or absorbed through the skin, with inhalation being the largest intake of lead. The lead is then stored in the bones, blood and tissue, where it is released back into our body over time.
A small level of lead in an adult’s system is less than 10 mcg/dL. Anything higher than that number and up to 25 mcg/dL is an indicator of regular lead exposure, while 80 mcg/dL or higher requires medical treatment. However, lower levels can also present symptoms of lead poisoning.
In a 2019 study, approximately 30 out of every 100,000 working adults had a blood lead level great than or equal to 5 mg/dL. According to NIOSH’s Adult Blood Lead Exposure Surveillance (ABLES) program, four of the largest industries with lead exposure cases include construction, manufacturing, mining and services (e-waste recycling or firing ranges).
For children and those who are pregnant, those levels should be much lower as there is higher risk. A level of five mcg/dL can cause development problems for an unborn child, while children are at risk with 3.5 mcg/dL of lead in their blood.
Over time, high levels of lead in the bloodstream can cause serious health conditions:
The CDC also reports that the Department of Health and Human Services, the EPA and the International Agency for Research on Cancer have determined that lead is probably cancer-causing in humans
Other indicators of lead poisoning include:
The effects of lead poisoning are more severe for kids under the age of six because of growth and development. This age also is at higher risk due to the tendency of younger children putting their hands and other objects in their mouths.
“Children can be exposed to lead at home, school, daycare or even grandma’s house. Lead particles can come from paint chips or paint dust. If those particles are ingested and they get into the bloodstream, that can cause long-term problems for a child,” said Pediatrician Roopa Thakur, MD, FAAP.
For a child, long-term problems could include damage to the brain and nervous system, delayed growth, hearing problems, headaches, behavioral issues, vomiting or hyperactivity.
Thankur also emphasized that it’s important to limit lead exposure early in life because, with proper management, lead poisoning is preventable
While lead poisoning cannot be reversed, treatment is available and steps can be taken to prevent further exposure. Lead sources should be professionally removed from a home and, if there are concerns about lead poisoning, a healthcare provider and the local health department should be contacted.
“We can’t tell what the outcomes are going to be based on lead levels. The only thing we can do is prevent lead exposure to begin with. There is no safe lead level. That’s why getting tested is very important,”?Thankur said.
EPA Lead Paint Standard, Safety Measures
Back in 2008, the EPA released the Lead-Based Paint Renovation, Repair and Painting Rule. The RRP (amended in 2010 and 2011) aimed to protect the public from any and all lead-based coating hazards associated with renovation, various repairs and activity.
The RRP rule protects residents of pre-1978 homes from lead-based paint disturbed during renovation, repair or painting activities. The rule requires that firms that perform or offer to perform renovations in pre-1978 houses need to be certified by the EPA and assign individuals who have been trained to use lead-safe work practices; disclose important safety information to residents prior to the work; and document their compliance with the rule.
The rule officially went into effect on April 22, 2010.
In 2009, petitioners requested that the EPA provide more adequate protection for children by providing more stringent lead paint standards. By 2011, the EPA acknowledged this need but failed to provide a timetable or made any moves to propose a new rule.
By June 2018, the EPA released another proposal to the dust-lead hazard standards; the action was stemmed from a December 2017 ruling by the U.S. Court of Appeals for the Ninth Circuit, which ruled that the agency must reevaluate the risks from lead paint.
According to the EPA, lead-contaminated dust from chipped or peeling lead-based paint in homes built prior to 1978 presents one of the most common causes of elevated blood lead levels in children. Infants and children are especially vulnerable to lead paint exposure because their growing bodies absorb more lead than adults do, and their brains and nervous systems are more sensitive to the damaging effects of lead.
The June proposal was reportedly in response to a lawsuit filed in August 2016 against the EPA by a coalition of environmental and community-led organizations, who charged that the EPA had duties to uphold regarding the TSCA and its amendments contained in the Paint Hazard Act.
In June 2019, former EPA Administrator Andrew Wheeler and U.S. Housing and Urban Development Secretary Ben Carson announced new standards for lead, specifically found in dust on floors, windowsills and miscellaneous surfaces to protect children from its harmful effects.
To continue to protect children’s health and make progress on the dust-lead issue, the EPA lowered the dust-lead hazard standards from 40 micrograms of lead per square foot to 10 micrograms per square foot on floors and from 250 micrograms to 100 micrograms on windowsills.
The new standard applies to all inspections, risk assessments and abatement activities in various hospitals, childcare facilities, certain schools and housing built before 1978.
In January 2021, the final rule to lower the clearance levels for the amount of lead that can remain in dust on floors and windowsills after lead abatement was approved and the new standards were incorporated into the Section 402/404 lead-based paint activity regulations as well as the Section 1018 real estate disclosure regulations.
By October, the EPA announced that it had launched a new training initiative, Enhancing Lead-Safe Work Practices through Education and Outreach, in Southern California communities.
The new program aims to raise awareness about childhood lead exposure and protect environmentally overburdened and underserved communities across the nation from lead exposure. The initiative arrives in accordance with the Biden-Harris Administration’s commitment to advancing environmental justice.
The two-pronged approach to reducing lead exposure includes the following initiatives: