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Release: March 2, 2000

UI researcher: more awareness, screenings for lead poisoning among Iowa children needed

IOWA CITY, Iowa -- Although lead is a well-recognized cause of childhood toxicity, the rate of lead poisoning among Iowa children remains high, which underscores the need for increased public awareness and screening of children for lead poisoning, according to a University of Iowa researcher.

"There are a number of sources of lead in our environment and in our homes, and this is reflected in the fact that Iowa has childhood lead poisoning rates about three times the national average," said Laurence Fuortes, M.D., UI associate professor of occupational and environmental health. "It could be that many children with normal blood lead levels have not been screened. Nonetheless, lead exposure in children appears to be a significant health issue in Iowa."

Fuortes referred to blood lead level statistics from the federal Centers for Disease Control and the Iowa Department of Public Health in "Healthy Iowans 2010," the state's public health action plan which Fuortes helped write. It noted that data gathered from mandatory reporting of blood lead testing from 1992 to 1998 shows an estimated 12.6 percent of Iowa children under age 6 have blood lead levels of 10 micrograms per deciliter or greater, while the national average is 4.4 percent. Normal blood lead levels are less than 8 micrograms per deciliter.

The Healthy Iowans document noted that around 23,000 Iowa children are screened each year for lead poisoning. However, as many as 200,000 Iowa kids are not screened for lead poisoning.

Peeling, lead-based paint on older homes and buildings is the predominant source of lead exposure among children in Iowa; nearly half of the homes in the state were built before 1950.

Fuortes' research interests include the prevalence of lead poisoning in subsets of the Iowa population. He and fellow UI researchers in 1997 studied the number of lead poisoning cases treated at the UI Hospitals and Clinics and found higher rates of hospital visits for lead poisoning among minorities and people of lower economic status. Patients on Medicaid also appeared to be at an increased risk, the researchers reported.

"The housing conditions in lower socioeconomic areas are typically worse -- older homes, peeling paint, lead-based paint on window sills and so forth," he said. "There are a number of environmental, and in some cases cultural, factors involved in the risk of lead poisoning."

In a study published in the February 2000 issue of the journal Veterinary and Human Toxicology, Fuortes examined samples of printed cellophane candy wrappers from Mexico as a possible risk for lead exposure. The research grew out of a unique patient case Fuortes encountered two years ago. He examined a young, pregnant Hispanic woman with a blood lead level of more than 60 micrograms per deciliter.

Fuortes discovered that the woman had been chewing and ingesting pieces of a small terra cotta candy container. The single-fired clay pot, easily chewable, was painted with a lead-based glaze.

"She was chewing on this clay because she had nausea from her pregnancy as well as iron deficiency. Her grandmother had recommended chewing on terra cotta as an effective remedy," Fuortes said.

Working with a colleague at the Iowa Department of Public Health, Fuortes traveled to Hispanic communities in Iowa and spoke to store owners and community members about the risks posed by the candy containers. The researchers also looked for other sources of lead in imported candy packaging.

"We found several places that sold the terra cotta containers, as well as a variety of other colorfully-inked candy wrappers," he said.

The researchers measured the concentrations of lead in the cellophane wrappers. While none had levels as high as the lead-glazed terra-cotta pieces, most of the cellophane pieces had lead concentrations that could present a health risk, the researchers reported.

Fuortes emphasized, however, that "the point here is not the risk of lead exposure from imported candy wrappers, per se. There are all sorts of things that all young kids like to put in their mouths. The candy wrappers are just one of a number of things that should be a cause for concern."

What is needed, he added, is universal screening of all Iowa children prior to entering kindergarten and increased awareness among parents and health professionals.

"The problem of lead exposure among children needs to be addressed by massive screenings and appropriate action," he said. "By appropriate action, I mean determining the specific source of the lead exposure and then determining how to reduce or eliminate those sources."