675,000 U.S. Children Suffer From Man-Made Disease: Lead Poisoning

He wears a hospital gown decorated with trains. An intravenous needle is embedded in his arm. Ali Gonzalez, at age 7, has spent almost as much time in a hospital ward as he has in a schoolroom.

Ali was put in the hospital by lead poisoning, a man-made disease that each year afflicts more children than measles, mumps and chicken pox combined, according to the national Centers for Disease Control in Atlanta.

The latest CDC figures show that 675,000 preschoolers suffer some degree of lead poisoning, which retards mental development and interferes with normal metabolism.

4% Afflicted

That is 4% of all American children between the ages of 6 months and 5 years, according to the National Health and Nutritional Examination Survey, which was conducted from 1976 to 1980. That was the first time lead poisoning was studied on a national scale.

Only 2% of white children showed symptoms of lead poisoning, while 12% of the black children were poisoned. Among all inner-city kids, the average was 11.6%.

It is sometimes called the silent epidemic because most children who are poisoned do not show any symptoms beyond general malaise, irritability, stomachaches or lack of appetite. A poisoned child doesn’t look sick and parents may not know anything is wrong.

Ali, a foster child of Puerto Rican descent, doesn’t really understand lead poisoning, except that “it hurts a little. It makes you sick.”

Lead-Based Paint

The most common cause of the disease is ingestion of lead-based paint. The Consumer Product Safety Commission banned lead as an ingredient in interior paint in 1977, but it endures in an estimated 30 million urban tenements, farmhouses and barns.

Under new coats of latex paint, leaded paint remains a threat if it is allowed to flake off the walls or window sills.

It is the tendency of young children to put things in their mouths that puts them in jeopardy. The extent of damage depends on the child’s age and size and the concentration of lead in the body.

“If a child eats a piece of leaded paint the size of a pinhead every day for three months, he could be poisoned,” said Maxine Golub, director of the Lead Poisoning Prevention Project at Montefiore Medical Center in the Bronx.

“It’s a myth that poor children who are not supervised and who have nothing else to do . . . who have no toys and maybe are hungry, peel the paint off the walls and eat it.

Peeling Paint

“The reality is that peeling paint comes off the walls and the ceiling and windows sills and gets ground into dust. Children play on the floor, put their hands in their mouths, put toys in their mouths, eat cookies without washing their hands, all the while ingesting lead dust.

“If the paint were not peeling, it would not be a problem.”

Ali, a curly-haired second-grader, is beyond the age when children ordinarily stop putting things in their mouths, but he has not given up the habit.

“It is reasonable to conclude that he has a lot of problems and that lead is probably a major cause,” said Dr. John Rosen, chairman of the CDC’s Childhood Lead Poisoning Committee and head of Pediatric Metabolism at Albert Einstein College of Medicine.

Many cities, including New York, have laws requiring landlords to chip away peeling paint or cover it with wallboard or paneling.

Once a child has eaten too much lead, there is only one way to get rid of it--and even that does not reverse the damage, only stops it.

“You can remove lead from the system and prevent further damage, but you can’t undo the damage that’s already done,” Golub said.

Treatment means hospitalization for up to seven days at a cost of about $6,000. EDTA (calcium disodium ethylene diamine tetracetic acid), a substance that draws lead out of the body, is administered in a series of intramuscular injections or by continuous intravenous drip. Because the medicine is potentially harmful to the kidneys, such treatment, called chelation, is limited to a week at a time.

Frequent Blood Tests

Follow-up blood testing is required for years and treatment often has to be repeated, frequently as many as 10 times.

There are 15 million American children between the ages of 1 and 5, and, according to Dr. Vernon Houk, director of the CDC’s Center for Environmental Health, “Every child is at risk because lead is so widely dispersed in our environment.”

Among children, “Lead toxicity is the second most important public health problem that we have,” Houk said. Malnutrition is No. 1.

Adding to the tragedy is the fact that lead poisoning is preventable.

“It’s not like a genetic disease,” said Dr. Herbert Needleman, chief of psychiatry at Children’s Hospital of the University of Pittsburgh.

“It’s a man-made disease and the information has been around a long time. It’s a measure of society’s lack of commitment to children that we have not done away with it. There is no reason for anyone to suffer lead poisoning.”

Because of lead’s ubiquity, almost everyone has a certain amount of it stored in their bones. Lead cannot be metabolized. It is either excreted or absorbed.

“If you have a diet that is high in calcium, protein, iron and phosphorous, you are less likely to absorb lead,” Needleman said. “If you have a poor diet, which is what the poor have, you are more likely to absorb it.”

Not Just the Poor

But lead poisoning is not only a problem of the poor.

“We have learned that it is widespread throughout the country and not limited to blacks or poor children,” Houk said.

The highest risk group is probably the children of the urban pioneers, affluent young couples with one or two children who are moving back into the city, buying and refurbishing brownstones, Houk said. The sand-blasting and paint-scraping that goes with renovation releases lead dust into the air in dangerous levels.

“The second most at risk are the children of lead-industry workers who do not take the precaution of showering and changing clothes before going home laden with lead dust,” Houk said. The third group most at risk are the poor black and Latino children in the inner city, Ali’s peers.

Needleman first brought the disease to public attention in the 1960s with his then-controversial studies indicating that lead toxicity contributed to diminished IQ.

Rarely is lead poisoning fatal, but the damage it does is permanent. The metal interferes with normal growth and development of the central nervous system and causes brain damage and, in severe cases, mental retardation.

“Just one bout of serious lead toxicity may result in delayed speech development, poor verbal processing, decreased attention span and lowered IQ levels--all critical for effective classroom performance,” Golub said.

The latest studies also show that it interferes with metabolism, the body’s ability to use food as fuel. Vitamin D metabolism, production of nucleotides (which act like enzymes) and synthesis of blood are particularly susceptible to lead poisoning.

Although old paint is the primary source of lead poisoning, fumes of leaded gasoline is a second major source of poison, especially in neighborhoods bordering expressways.

On July 1, the Environmental Protection Agency cut the allowable level of lead in gasoline in half, to 0.5 grams per gallon. On Jan. 1, 1986, the allowable amount will be reduced to 0.1 grams per gallon. The ban on leaded gasoline is expected to reduce the amount of environmental lead by 20%.

But in most parts of the country it is still permissible to use lead solder in drinking-water pipes. Old canneries still use lead solder to seal canned foods and certain ceramic glazes also contain lead.

An estimated 1.3 million tons of lead is used annually in automobile paints, batteries, marine paint, welding and hundreds of other industrial uses. The National Academy of Sciences estimates that 600,000 tons of lead are added to the environment as pollution each year.

What can be done about lead poisoning?

“That’s simple,” Needleman said. “Lead is put into the environment by people, and people can take it out.”