Lead poisoning in children
==========================

* Kathleen Cooper

Pascal Lavoie and Benoit Bailey1 report that paint scrapings from the home of a young child with elevated blood lead levels were less than 0.5% dry weight, which is considered “lead- free” in Canada. However, far from being “lead-free,” 0.5% lead is the same as 5000 parts per million, plenty high enough to elevate a child's blood lead level. The “lead-free” standard in the United States is 600 parts per million, established by regulation in the late 1970s.2 Canadian paint manufacturers have generally followed the US standard, but as of March 2004 Canada had yet to pass regulations,3 proposed in 2003, that would see the adoption of the standard that the United States put in place over 25 years ago.4

Another useful comparison is the residential soil replacement guideline in Ontario. Soil with a lead concentration over 200 parts per million is considered unsafe for children because it can contribute to elevated blood lead levels.5 It is certainly advisable to look for other sources of lead in a child's environment, but when there is clear evidence of pica, you don't need to look further than the paint in a home built in the 1950s. Indeed, houses built until the late 1970s should be similarly suspect. Nor can we rely on the effectiveness of standards established under Canada's antiquated *Hazardous Products Act*.6

The global dimensions of the problems of environmental lead exposure are summarized by Tong and associates.7 Although the problem is even worse in developing countries, lead remains a concern worldwide. The long history of lead use in a wide variety of applications has created a vast reservoir (including paint), and awareness and preventive action are needed to minimize exposure.

**Kathleen Cooper** Senior Researcher Canadian Environmental Law Association Toronto, Ont.

## References

1.  1. Lavoie PM, Bailey B. Lead poisoning from “lead-free” paint. CMAJ 2004;170(6):956.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNzAvNi85NTYiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTcxLzUvNDI5LjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. *Ban of lead-containing paint and certain consumer products*, 16 C.F.R. 1303 (1977) [US regulation]. Available: [www.gpoaccess.gov/cfr/index.html](http://www.gpoaccess.gov/cfr/index.html) (accessed 2004 Apr 20). 
    
    

3.  3. Surface coating materials regulations (Regulatory Impact Analysis Statement). Can Gaz 2003; 137 (24):1875-87. Available: canadagazette .gc .ca /partI/2003/20030614/pdf/g1-13724.pdf (accessed 2004 July 30). 
    
    

4.  4. Cooper K, Vanderlinden L, McClenaghan T, Keenan K, Khatter K, Muldoon P, et al. Case study #1: Standard setting for lead — the cautionary tale. In: *Environmental standard setting and children's health*. Toronto: Canadian Environmental Law Association and Ontario College of Family Physicians Environmental Health Committee; 2000. p. 226-83. Available: [www.cela.ca/coreprograms/detail.shtml?x=1326](http://www.cela.ca/coreprograms/detail.shtml?x=1326) (accessed 2004 Jul 18).
    
    

5.  5. Appendix 1: Summary of approvals information. In: *Guideline for use at contaminated sites in Ontario*. Toronto: Ontario Ministry of Environment; rev. 1998 Sep. Available: [www.ene.gov.on.ca/envision/gp/3161e01\_appendix.pdf](http://www.ene.gov.on.ca/envision/gp/3161e01_appendix.pdf) (accessed 2004 Apr 20).
    
    

6.  6. Hazardous Products Act, R.S.C. 1985, c. H-3.
    
    

7.  7. Tong S, von Schirnding YE, Prapamontol T. Environmental lead exposure: a public health problem of global dimensions. Bull World Health Organ 2000;78(9):1068-77.
    
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