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Lead, arsenic present serious threats to kids

ALBUQUERQUE, N.M. — Q: I worry about my baby’s exposure to chemicals! Just in the last few months, I’ve heard that many babies around the country have been poisoned by metals, especially lead and arsenic. What should I do?

A: You’re certainly not alone in worrying about non-natural substances in your baby’s food. I prefer that term to “chemicals,” since we’re all made up of substances that fit the definition of chemicals. Water (chemical formula H2O), salt (NaCl), sugar (C12H22O11) – not to mention even more complex substances like fat and protein – are all chemicals.

Metals are present in everything as well – that “Na” in salt is a metal, sodium, which is essential for life. Iron (Fe), calcium (Ca), potassium (K), magnesium (Mg) and Copper (Cu) are all metals required by our bodies. Lead and arsenic are not! Arsenic is actually classed as a “metalloid,” in some ways like a metal, in some ways not.

We English-speakers have, for reasons not completely known, been saying “get the lead out” to mean “hurry up” for about 200 years.

You may well have read about the effort to get the literal lead out of the water in Flint, Mich.gan in 2015. The tale is long, but the basic story is that that city, north of Detroit, changed its water supply to the nearby Flint River to save money.

A Flint pediatrician, the daughter of two Iraqi immigrants, Dr. Mona Hanna-Attisha, noticed an increase in the number of young children with high blood lead levels. She reported her concerns, and analysis of the new Flint water supply indicated that the lead level was very high, probably as a result of corrosion of the supply system.

Flint is currently “getting the lead out” by distributing bottled water to residents; when the supply system will be safe and ready for use is still unknown.

Lead causes silent, cumulative, serious damage, especially to developing brains. Before the end of the last century, lead poisoning was common in the most vulnerable, young children.

Pediatricians and others caring for children began testing for lead in the blood of young children. Initially, we would worry if the level was more than 20 micrograms per milliliter (20 mcg/ml); now public health experts like those at the Centers for Disease Control say there is no safe level, and that we should be concerned if a child’s level is over 5. And all children should be tested, usually at about age 1, sometimes later as well.

We don’t see many cases of children with high lead levels here in New Mexico, largely because we don’t have the usual causes for elevated lead. We don’t have a lot of lead-painted old houses, as were present in many older cities in the eastern U.S. When the paint peeled from the walls in these houses and small children chewed on the paint chips, they ingested a lot of lead.

Being a rather spread-out state, we have few places where car exhaust emissions accumulate. Until 1996, lead was added to gasoline to increase its octane rating. In housing near highways, again largely in the East, children were exposed to high-lead dust, which did not increase their octane.

In the past 10 years, I have seen high lead levels in my patients on three occasions:

First, a family living in a trailer park, probably because someone had worked on lead-containing car batteries nearby.

The second, in a family living in the southwest part of the city, remains unexplained. The third was the most bizarre: an infant had a high lead level that we eventually traced to a high-lead black pigment applied around the child’s eyes by parents whose culture dictated it be done to avoid evil spirits.

High lead levels threaten children with anemia, abdominal pain and high blood pressure among other symptoms, but the most worrisome effect is brain damage.

Above a certain level (about 45 mcg/ml), a medication (a “chelating agent”) is given, though frequently that only limits the damage. The New York State Department of Health has published an excellent summary of lead information for parents at www.health.ny.gov/publications/2526.pdf.

Many of us have heard of or seen a 1944 movie called “Arsenic and Old Lace,” and know that arsenic poisoning can be fatal, as it was in that mystery film.

But this year we could make the title “Arsenic and Old Rice,” given that the Federal Drug Administration has determined that some infant rice cereals have had a high level of that element. Apparently rice concentrates naturally occurring arsenic in the water surrounding the growing plant.

The FDA has proposed an upper allowable level of arsenic for infant cereal, but in the meantime, the American Academy of Pediatrics (at https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/reduce-arsenic.aspx) has recommended that infants continue to eat rice cereal, but only as part of a diet containing many other things, not in isolation.

As I have many times over the years, I’d refer you for more information or specifics on metal or metalloid exposure to the New Mexico Poison and Drug Information Center – 1-800-222-1222 gets you the nearest expert in drugs and, yes, chemicals throughout the United States.

I call them all the time for information I don’t have at my fingertips; they do have it!

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