Lead, A Ticking Time Bomb?

[Dean CRCNA]

We’ve all heard some contractors say; “I’ve been working in older homes for decades and I, nor my customers have ever got lead poisoning”! Anyone who expresses a concern, are tagged “alarmist”.

Is lead really all that serious? If lead poisoning is truly a problem, why don’t we hear more about it?

I feel there are two major reasons we don’t realize how serious a situation this is.

1. Lead poisoning mimics other health problems.
2. Lead poisoning doesn’t always show its harmful effect immediately.

Often, symptoms are delayed for weeks … months … years … and even decades.

Mimicking

If a person goes in to see a doctor about flu like symptoms, most likely the doctor will prescribe Tamiflu or antibiotics. However, if the patient happens to mention that they were having construction work in their home, that same doctor would probably order a lead blood test.

Many of the symptoms of lead poisoning are also everyday health problems we always have.

Headaches; lack of energy; constipation; tiredness, crankiness, irritability, sore muscles, stomach pain; high blood pressure; lack of appetite are just a few of the mimicking symptoms.

Only in high lead blood levels, does lead poisoning become a possible consideration (blue lips, seizures, death).

(I don’t promote or want the following, but) If you had mandatory blood testing for workers and homeowners immediately after construction work, you would find that reported lead poisoning cases would dramatically rise.

Delayed Mimicking

Later on, we will learn about the toxicology of lead and how it can travel through the body. However, for now … just realize that lead symptoms don’t show up the day of construction.

As mentioned above, symptoms can show up weeks, months and years later.
When you absorb lead, it loves to attack the nervous system. One of the largest parts of the nervous system is the brain.

Science is starting to show a link between lead and memory loss, lower IQs, personality changes, behavior problems & even ADHD.

While lead poisoning may have occurred on xx-xx-xxx date … the above symptoms begin being noticed after most lead has left the body … possibly noticed years later.

Ticking Time Bomb

When construction lead dust is created, it can enter the body several different ways. While it can be absorb through the skin, cuts or eyes ... the predominate pathways are from breathing it in (pulmonary) and from swallowing (gastrointestinal).

The lungs are very efficient at absorbing smaller lead particles. If the particles are larger in size however, then they stay on the lung walls until you cough. Once you cough the lead particles release and go into your mouth and then are swallowed.

When lead heads to your stomach, different absorption rates can happen depending on age and stomach content. The less you have in your stomach and the younger you are … the higher absorption rates.

Example, children can absorb 50% of the lead, while adults absorb 10% to 20%. If you have just eaten, you may only absorb 6% of the lead, where if you haven’t eaten all day, it could be in the range of 60% to 80%.

Once lead is absorbed (whether through the lungs or the stomach) goes into 3 primary areas (other than the nervous system). The red blood cells, soft tissue and bone are these primary areas.

The nervous system is areas like your nerves, brain and spinal cord. Soft tissues would be lung, liver, heart, an unborn fetus and brain. Bone would be like the marrow of the bone and teeth.

Now for the ticking time bomb …

Lead mimics calcium characteristics. Because of this, a lot of lead is stored in the bones. It just sits there storing up over the years.

As you get older, your bones get less dense. Many researchers think that lead begins coming out of the bones (especially if cracked or broken) and start attacking soft tissue. Liver, brain, heart are weakened from these attacks.

In some cases, memory loss, dementia, Alzheimer’s, kidney failure and heart attacks could well be the result of stored lead being set free decades after you took in the actual lead.

[ChrWright]

Clearly this is an important issue to discuss, and yes it presents a health risk to our clients and their children if we don't take the care to work safe.

However, I take significant issue with some of the alarmist statistics and quantitative comparisons being pulled out of thin air by trainers and other proponents of the rule. Most are just regurgitating what they've been told by others, without taking the time to study the research for themselves.

I understand why it's done. These folks are just trying to get our attention and pound home how important this is. Unfortunately it is clouding the issues involved and places the majority of blame where it doesn't really belong. The unintended effect is we don't really get at understanding ALL of the causes of lead hazards and we end up with a rule that in some cases will INCREASE the risk to our nation's children.

Facts:
http://www.cdc.gov/nceh/lead/data/State_Confirmed_ByYear_1997_2006Total.pdf

This data from the CDC clearly shows a steady decline in the incidence of lead poisoning, even as the number of children being tested is on the rise.

Data from the EPA and other organizations' studies show that professional firms are not the ones creating the greatest hazards from RRP work. The links to this data have been posted ad infinitum here and on other forums.

This is the 2003 study most are referencing when they speak of decreases in IQ from lead poisoning:

http://content.nejm.org/cgi/content/full/348/16/1517

This is a LIFETIME blood level study for children in a certain age range. Yes, it shows a direct relationship between a certain level of lead and a decrease in performance on a standardized intelligence test. But most lead poisoning happens over time. And nothing in this study points to the source of the lead.

Look at the slope of the graph in Fig. 2-- what do you see?

The larger associations with IQ at lower lead concentrations may appear counterintuitive. Although we did not explore possible biologic mechanisms that could explain this finding, there is evidence that high concentrations of heavy metals may enhance cellular defense mechanisms and thereby lessen the rate at which additional damage occurs

No, I'm not trying to lessen the seriousness of these issues or make light of children being harmed by lead. My point is that the facts and data have been twisted and massaged in an attempt to justify this very flawed rule.

Saying a "spec of lead" will drop your kid's IQ by X points is more than a stretch.

Think for your selves. Look this stuff up for yourselves.

Then decide where the truth lies.

[Dean CRCNA]

Chris,

An excellent and well written post. I agree with you that we should not just hear, but research on our on. That is what I've been doing.

I’ve seen the NJEM, NHANES and CDC reports.

The CDC Link

Since you brought up the CDC link … the CDC also says; “A critical factor in reducing BLLs in children has been the decline in the number of US homes with lead-based paint”.

New homebuilders are one of the main reasons in the reduction of lead poisoning in America. My understanding of this is that we still have the same level of problems in older homes. However, since new homes have been added (can’t build old homes :) ) it has lowered the percentages. HUD’s LSHR compliance has also helped.

Long story short, we are not improving BLLs in older homes, but BLLs have improved because of new homes being built. The RRP is about improving older homes.

It also shows the effect that “dust in homes” plays in the overall lead poisoning issues.

The NJEM Link

I had not seen the NJEM link. However, I have read comments from the doctors themselves, who were involved in the NJEM study.

To me, their intention was to raise the alarm. Not diminish it.

"In our sample, most of the damage to intellectual functioning occurs at blood-lead concentrations that are below 10 mcg/dl," says Canfield. The amount of impairment was also much greater than the researchers had expected. "Given the relatively low exposure levels, we were surprised to find that the IQ scores of children with blood-lead levels of 10 mcg/dl were about 7 points lower than for children with lead levels of 1 mcg/dl,"

So, in my opinion, the NJEM link you provided helps support my point of view.

10 mcg/dl Is Not The Line Anymore

The NJEM link is also what part of my original post is all about.

New research is showing that < 10mcg/dl is the new line. Possibly it is 5 mcg/dl … 6 mcg/dl … who knows. According to new CDC figures, approximately 1 out of every 50 children in the United States between the ages of 1 and 5 years has a blood-lead level above 10 mcg/dl, whereas 1 in every 10 children has blood-lead levels of 5 mcg/dl or higher.

This fact alone could change the NHANES numbers to start reaching the millions.

Since the average child has almost 2 mcg/dl in their system anyway … a few specks … could actually hurt more than we once thought.

Also, since the half-life of lead differs for each of the compartments, ranging from 25–40 days in erythrocytes, 40 days in soft tissues, and as many as 28 years in bone … repeated exposure really plays a major role.

Example: Construction dust on carpets, to where each time you walk across them … you get repeated exposure.

Not Only The Children

Originally, the RRP was focusing mainly on children. With the opt-out being removed, it changes the focus on adults AND children. In my original post, I was trying to show that there should be concern … for even adults.

Conclusion

We both know that the vast majority of contractors aren’t concerned or even alarmed about lead poisoning. We hear it from the lack of participation in the RRP Rule and on responses in different forums. Their main concern is their pocket book and getting jobs.
By helping raising the concern level, it may help more contractors do the right thing.

Should I reduce my alarmist statements ... probably so. Should you increase your concern level? ... that is your decision.

You have a ton of respect from many contractors on this subject. The legitimate contractors need a reason ... motivation for complying. I will admit, that I was shocked when the leader and one of the forefathers of the RRP (as it relates to contractors) calls the new rule ... very flawed.

You are probably right and I wouldn't dare argue with you.

We both know this will be a great burden to comply with the new law. I personally need more motivation, than a penalty/fine ... it's a crappy law or lead doesn't really harm anyone. I need to believe this is a serious issue and that I may actually end up helping that one small little 2 year old girl in the future.

This is why I probably have done so much research into the toxicology of lead based paint and lead poisoning. To give me a purpose.

[Bodger]

I will admit, that I was shocked when the leader and one of the forefathers of the RRP (as it relates to contractors) calls the new rule ... very flawed.


I don't find that shocking at all, I think there area lot of contractors who can clearly see that the new rule is flawed. And the way the government is handling this whole thing seems haphazard and rushed and there is a ton of confusing info.

It's been said by others and I agree: This is revenue driven every bit as much as it is a public safety concern. That fact will be made clear when we start seeing contractors getting fined. The EPA will have that aspect of RRP down pat long before they clarify some of the conflicting information regarding this law that would set a clearer path to compliance.

[Dean CRCNA]

Bodger,

Yeh ... starting to see that I was reading you guys wrong. My fault.