Old Paint, Young Victims : The No. 1 source of childhood lead poisoning is household paint applied 15 to 100 years ago. An estimated 3 million children in the U.S. suffer from lead contamination.

The symptoms that plagued Elizabeth Jimenez’s 2-year-old twin daughter weren’t really out of the ordinary. The irritability, bouts of insomnia and refusals to eat all mimicked the “terrible twos”--a stage most parents of toddlers know all too well.

Her pediatrician told her not to worry. But when little Alexandra vomited a dark substance, Jimenez became alarmed. A close family friend suggested the mother of five have her daughter tested for lead poisoning.

The test turned Jimenez’s life upside-down. It showed that Alexandra was suffering a high level of the disease.

“I was shocked,” Jimenez recalled. “I was scared. I was really scared.”

She had good reason to be. Apparently, when the family lived in an 80-year-old house in Pomona, Alexandra had ingested invisible lead dust from the painted walls. She also chewed on lead-tainted woodwork. Enough poison had entered her small body to cause some neurological damage.

A lead level higher than 10 micrograms per deciliter of blood is considered unsafe by the Atlanta-based Centers for Disease Control (CDC). Alexandra’s blood measures 49 micrograms per deciliter of blood.

(A microgram is to a deciliter about what an eyedropper of liquid is to a gallon.)

Nearly 100 years after lead poisoning in children was first recognized, the metal continues to contaminate an estimated 3 million young children in California and the nation, inflicting upon them, most experts believe, learning disabilities, hyperactivity, lowered IQ, impaired motor coordination and in the most serious cases mental retardation and even death.

“We’re finding lots of kids with lead poisoning who basically have had their lives limited,” said Dr. Sue Binder, chief of the CDC Lead Poisoning branch. “The fact that it’s all preventable--that we don’t have to have poisoned children--makes it a real tragedy.”

“It is the foremost preventable health hazard to children,” agreed Don Ryan, executive director of the nonprofit public interest group, Alliance to End Childhood Lead Poisoning in Washington. “It eclipses every other health hazard.”

Today, the No. 1 source of childhood lead poisoning is household paint applied between 15 to 100 years ago, with the older paint used before 1950 usually containing the highest lead levels, experts say.

The paint itself isn’t the problem. It’s the oxidation and deterioration of the paint, which creates a nearly invisible, highly toxic dust that settles inside the house--on floors, walls, furniture and toys. Young children often put dust-coated toys and fingers in their mouths and ingest the lead that way. Other children get it by eating paint chips and chewing on such lead-painted surfaces as window sills.

The Northridge earthquake is certain to have made matters worse, kicking up lead dust and cracking old paint as it twisted apart thousands of structures and jolted many more.

And the post-quake repairs are only worsening the problem, said Margo Derry, acting director of the Childhood Lead Poisoning Prevention Program for the County of Los Angeles Department of Health Services.

“We had a problem before with people renovating houses,” Derry said. “Now with the earthquake and all the (repair) work going on, the problem is infinite.”

California Department of Health Services officials recorded about 700 cases of childhood lead poisoning statewide in 1993, with 12% of those cases considered medical emergencies.

In Los Angeles County, 529 children were diagnosed as lead poisoned last year, about 60% of them from paint.

The rest were contaminated by a number of other lead sources: soil, lead-tainted home remedies--especially popular with some Latino and Asian communities--pottery and china finished with unsafe lead glazes and lead solders in some canned goods and plumbing fixtures.

But health officials believe that the diagnosed cases represent only a fraction of the actual number of poisoned children. They expect childhood lead poisoning cases to soar as routine testing of all children up to 6 years old takes hold in California.

It’s estimated more than a half-million California children face the risk of lead poisoning. Many of those afflicted with the condition don’t look or act sick. The disease offers no definitive symptoms, except at its most acute levels.

“A lot of times children can be exposed to lead and it’s causing an adverse neuro-psychological effect and you wouldn’t really know it because the children don’t become symptomatic,” said Bob Schlag, head of the Lead Hazard Reduction Department of the California Department of Health Services. “What we’re concerned about are the subtle cognitive deficits in children.”

Testing for lead poisoning, he said, is the only way to detect the disease and his office now recommends every child be tested at least once, with regular testing for those exposed to greater lead hazards.

The American Academy of Pediatrics revised its policy on blood lead testing in July and now recommends that all children be tested at about 1 year of age for elevated levels.

Lead poisoning in children was first recognized as a serious health hazard early in this century. Worldwide, a number of countries, including Great Britain, Greece, Tunisia, Spain, Poland, Cuba and Yugoslavia banned lead paint for indoor use or restricted children’s exposure to it in the 1920s and 1930s.

In the United States, however, it wasn’t until 1978 that the U.S. Consumer Products Safety Commission finally restricted the use of lead in household paint. Shortly after, leaded gasoline--the other main source of lead contamination outside the workplace--was banned.

“The one giant public health triumph of the late ‘70s and early ‘80s was taking lead out of gasoline,” said Ryan. “Population-wide, average blood-lead levels plummeted by more than half.”

But because lead-based paint remains in half of the 104 million dwelling units nationwide, according to federal estimates, the childhood lead poisoning problem didn’t go away, while much of the attention given the issue did.

That began changing in 1988, in part because of a report published by the federal Agency for Toxic Substance and Disease Registry that said in 1984, 15% of U.S. children had blood lead levels high enough to affect their cognitive abilities.

Moreover, the study showed that while the problem does indeed disproportionately affect children from impoverished families who live in older, dilapidated housing, lead poisoning isn’t restricted to the urban poor.

“It was real overpowering data,” Binder said. “As people began to look, they began to find more and more cases, not only in the cities but in suburban homes that were being renovated. Whole families of kids were being poisoned because of the things people were doing to their homes. The recognition of how widespread it was became a catalyst for action.”

That helped bring about the Residential Lead-Based Paint Hazard Reduction Act of 1992, also known as Title X, a far-reaching federal law that eventually will affect virtually everyone, including homeowners, landlords and tenants. It will bring about profound changes in the prevention of lead poisoning--including mandatory real estate disclosure laws and warning requirements for the sale or lease of any house or apartment built before 1978. That portion of the law will take effect in October, 1995.

Right now in California, lead-based paint is lumped together with other environmental hazards in the 1993 disclosure form issued by California Department of Real Estate.

The childhood lead poisoning issue has not received as much attention in California as it has on the East Coast, where a number of local and state agencies have in place aggressive lead prevention and abatement programs.

Schlag says that’s because California’s houses are on average newer than those nationwide, leading many to wrongly assume that lead poisoning isn’t an issue in the Golden State.

“It is one of the unfortunate myths that childhood lead poisoning is only a problem in the East,” Schlag said.

In Los Angeles County, there are more than a million homes built before 1950 that are known to contain the highest levels of lead. Further, many more built as late as 1978 also contain lead paint, although the amount of lead used in the paint is probably much less than that used in older paint.

“If you own a home that was built before 1978, there’s a very good chance that you’re going to find lead in the paint,” said Janet Comey, chief of the Lead Poisoning Abatement Program for the County of Los Angeles Department of Health Services. “If you have children under the age of 6 and you have peeling, chipping paint, you should have some concern.”

Lead is most dangerous to children under 6 years old. That’s because it attacks the brain and nervous system. Children between 1 and 3 years old, like Alexandra Jimenez, are most susceptible to the metal because their neurological systems are rapidly developing and because they’re more likely to put lead-tainted objects in their mouths or to chew on contaminated surfaces.

Once a child is identified as lead poisoned, the case is reported to the county Health Department for further action.

If the child has a blood level higher than 45 micrograms per deciliter of blood, as was the case with Alexandra, the child is usually prescribed a chelating agent, either intravenously at a hospital or orally at home, which helps remove some of the lead.

Alexandra got the latter treatment and her mother had to give the sick toddler capsules three times a day for 19 days.

“They smelled like sulfur and she would scream and sometimes vomit them up,” Jimenez said of the medication. “While she was taking those pills and getting blood tests once a week, it got to the point where we’d just drive past the doctor’s office and she would break out crying.”

For less serious cases, there is no active medical treatment, said Derry, of the L.A. County health department.

“If there is no further exposure, what seems to work well is health education for parents,” she said. “We talk to parents about the circumstances of their child’s exposure and we try to mitigate that exposure.”

In Los Angeles County, any family with a lead-poisoned child is assigned a public health nurse and specialist who make a visit to the child’s home. The team interviews the parents and inspects the home to find the source or sources of contamination.

Sometimes, health officials find that the child’s home is free of lead contamination and that the youngster is picking up the lead at a preschool or relative’s home.

The L.A. County Department of Health Services then orders the owner of the contaminated property to eliminate the hazard, which can be very costly depending upon how extensive the work.

“What we’re trying to do is work with the owners,” said county lead poisoning chief Comey. “We’re trying to come up with a sensible way where people can afford to do these abatements.”

But for now, she said, there are no government loan programs or other financial assistance aimed specifically at private lead abatement work.

Officials say Title X will eventually establish an infrastructure for dealing with the lead poisoning problem at all levels before children become sick.

“What we’d like to do is prevent the lead from coming into the child’s environment and we wouldn’t have to do the blood tests we’re doing now,” said Schlag, of the state health department. “Ultimately that’s our long-term vision. In the meantime, a huge population is being exposed. Before we get the lead out of the environment, several generations will be passing through at the risk stage.”

For Alexandra Jimenez, now 3 years old, the most visible sign of her lead poisoning is her slower verbal development, which has fallen behind that of her twin sister. But whether the damage is permanent remains to be seen and her family is hopeful.

“Fortunately,” said Elizabeth Jimenez, “I think I found it soon enough.”

Next: Dealing with lead hazards in the home.

O’Neill is a Los Angeles free-lance writer.

FACTS ABOUT LEAD

* As an element, inorganic lead cannot be processed by current technology and destroyed. It will continue to be a potential hazard in some form forever.

* Humans do not have natural defenses against lead exposure.

* The human body can accumulate lead over a lifetime and does so even with minimal exposure. For humans to experience the adverse effects of lead exposure, they need not be exposed to large quantities of lead at any one time.

* Estimates of lead exposure cases greatly understate the cumulative effect of a persistent and pervasive pollutant such as lead.

* Lead knows no socioeconomic or demographic boundary. It affects children and adults from a wide range of backgrounds.

* Lead serves no physiological purpose in the human body. The presence of lead in humans in any amount is not good. Lead levels in some segments of American society are 3,000% to 6,000% higher than that of pre-industrial humans.

LEAD EXPOSURE

Nearly 17% of all children in the United States are exposed to lead in some form, according to a U.S. Department of Health and Human Services report to Congress in 1987. Lead poisoning is a common occurrence that seems, at the outset, harmless. It is the accumulation of lead in the body that can cause serious medical problems.

EXTENT OF EXPOSURE:

LEADED PAINT--An estimated 12 million 7-year-olds in the United States have potentially been exposed to lead. Lead in paint is ingested by children as dust particles.

WATER PIPES--An estimated 3.8 million children have drinking water with dangerously high lead levels. Older homes and buildings may still use lead waterpipes.

FOOD--Most children under 6 in the United States are potentially exposed to lead in food at some level. An estimated 1 million children are exposed to enough lead in food to suffer a low level of poisoning.

GASOLINE--Some 5.6 million children under 7 years old are potentially exposed to lead left over from now-banned leaded gasoline.

POTTERY--Handcrafted pottery and china dishes with decorative paintings applied on top of the glaze are primary sources of lead exposure. Dishes with coroded glaze should also be avoided. Avoid using questionable dishes to heat or cook food.

ETHNIC REMEDIES--Azarcon, a bright orange powder, and Greta, a yellow powder, are two of the most common substances containing lead. Both remedies are used in the Latino community for intestinal illnesses.

SOIL--Soil normally contains low levels of lead. The accumulation of chipped paint and paint dust in soil around the house increases the level of exposure to children.

WHO’S AFFECTED

Infants and young children are most susceptible to lead poisoning. And because lead can easily penetrate the placenta, a developing fetus also faces a higher risk of lead poisoning. The primary organ affected by lead poisoning is the brain and central nervous system.

THE MAJOR HEALTH EFFECTS:

* Extremely severe poisoning can induce coma, convulsions and profound, irreversible mental retardation.

* Lower levels of lead exposure can slow cognitive development in children, reduce IQ scores and impair hearing. Prenatal lead exposure can also cause retardation in the mental and physical development of a child through at least 2 years.

Sources: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

For More on Lead

For more information, call the Childhood Lead Poisoning Prevention Program of the L.A. County Department of Health Services at (213) 738-2030.