Lead-Based Paint Dangers – A Wilcoxian’s First Hand Account

By: Nathan Muller, Project Manager, Scientist

In the early 2000’s my wife and I were in the market to purchase our first home, in which we planned to start our family. We wanted a home that was unique and unlike other homes found in the area. We have always loved the craftsmanship and features of older homes, so our search range included homes constructed between 1900 and 1980. We understood and accepted that older homes can present difficult problems when it comes to repairs and upgrades, but overlooked potential health issues that could arise from older homes. We ended up falling in love with a unique tri-level home that was constructed in 1968, with the architectural features and quirks that we were searching for. The home was in a neighborhood flooded with children, friendly people, and well maintained homes – the perfect setting to raise a new family. When it came time to purchase, we filled out the seemingly endless mountains of paperwork, and a form that we did not pay much attention to at the time: “Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards.” That form came back to haunt us once our child turned one year old.

Many people are familiar with the dangers associated with childhood exposure to lead based paint. Children can ingest or inhale lead based paint chips, dust, or soils surrounding homes. Depending on the concentrations that they have been exposed to, they can suffer from lead poisoning. While lead poisoning can occur at any age, childhood lead poisoning can have extremely detrimental consequences regarding a child’s mental and physical development, including: behavioral issues, lowered IQ, learning disabilities, hearing loss/problems, growth delays, and chronic kidney and bone issues, as noted in extensive studies conducted by the Centers for Disease Control (CDC), the United States Environmental Protection Agency (USEPA), as wells as many physicians and pediatricians. These are very frightening propositions for any parent, especially ones whose children spend significant amounts of time in and around homes and buildings that were constructed prior to 1978. That is because these structures are 87% more likely to contain building materials coated with lead-based paints (https://www.epa.gov/lead/protect-your-family-exposures-lead). If a home does contain lead-based paint, it is a very simple process to encapsulate any existing lead-based paint by simply painting over the problem with latex-based coverings. This helps prevent the paints from chipping and becoming a “treat” for young children to place in their mouth, something all children do when they find something new and interesting.

During our child’s one year check-up, the nurse performed a blood lead level test to ensure that he had not been overly exposed to lead-based paints. This test is commonly done by performing a finger prick or capillary blood test, where a small sharp object creates a tiny puncture in the child’s finger and the resulting bleed is collected for laboratory analysis. In a few days, your pediatrician calls back with the results, and you go about your life like nothing happened. That is, unless the laboratory results come back with blood lead levels that are elevated; which the CDC defines as a blood lead concentration of 5 micrograms per deciliter (µg/dL) or higher (https://www.cdc.gov/nceh/lead/data/definitions.htm). Our son’s blood lead level test result came back as 17 µg/dL; which, triggered all kinds of commotion at our house, with the pediatrician, and with the Marion County Health Department (MCHD) as the result indicated that he had accumulated enough lead to be classified as having a low-level lead poisoning. Of course, this had us extremely worried about his mental development and what effects it would have on him the rest of his life. I had a good working knowledge on lead-based paints and its health effects, but now that my family was directly affected by the topic, I went back to refine my understanding. During my research, I came across a study by Lenphear et al., published in 2005, (Low-level Environmental Lead Exposure and Children’s Intellectual Function: An International Pooled Analysis) which found that children with blood lead levels between 10 to 20 µg/dL, can lose an average of 2 IQ points per year when the blood lead levels remain in that range. This further worried us, and we immediately started looking for the lead-based sources in our home, so we could eliminate or reduce his exposure.

Being in the environmental consulting field, I had easy access to an X-ray Fluorescence (XRF) gun, which is used to determine lead levels in various substrates, and I went to work testing surfaces in my home for any lead-based paint (defined as any paint that contains lead in excess of 1 milligram per square centimeter). After a few days of testing every painted surface with no luck, I began to research the blood lead testing method that was employed by our pediatrician’s office to see if there was a potential for a false positive result. In the meantime, we had to schedule an appointment with the MCHD to further assess the living conditions in our home and schedule a confirmatory venous blood lead level test with an outside laboratory. This further compounded our fear that our child had lead poisoning, and was being continually exposed to this unknown source. Needless to say, a lot of sleep had been lost in our home at this time. That was until I discovered an article by Schonfeld et al., published in 1995 (Screening for Lead Poisoning by Fingerstick in Suburban Pediatric Practices), discussing the alarming high false positive rate when testing for blood lead levels utilizing the finger prick or capillary blood test. The study outlined in the article identified a 70% false positive rate when utilizing the finger prick method! The study identified improper, or lack of, washing the child’s hands prior to sample collection as the source of the false positive results.

Armed with this new knowledge, I contacted the pediatrician’s office to determine their sample collection procedures when testing for blood lead levels. I was informed by the head nurse that her staff was well trained on the process of collecting a sample with the kit, and that my son’s finger was thoroughly scrubbed with an alcohol pad prior to sample collection. When I asked if his hands were washed with soap and warm water prior to the alcohol treatment, I was met with a brief silence followed by a response of “no”. While anger began to build in me regarding the lack of proper sampling on behalf of the doctor’s office, a sense of relief that this whole situation was likely caused by a false positive test also began to settle in. After a slightly heated discussion with the head nurse and a promise to forward the article regarding false positive tests, we were still faced with the confirmatory venous blood test legally required by the CDC and the MCHD. This is an exercise both physically and emotionally exhausting for a parent of a one year old child, as it is quite a challenge to restrain and comfort a child who is having a needle stuck in their veins for the first time.

Fortunately, our story ends well at the relief of everyone involved. The results from the venous blood test came back to be less than the laboratory detection limit of 1 µg/dL, confirming a false positive blood lead level from the finger prick test. In the end, my wife and I learned more about lead-based paint and its health effects than any parent would care to know. I was able to further hone my lead-based paint inspector skills; which, I had taken slightly for granted. Our pediatrician’s office and their nursing staff were grateful that we helped them to identify sampling technique flaws that created bad data/results, and to help prevent this type of occurrence from falsely affecting another family. Most importantly, our son does not have to live with the burden of the potential effects caused by pediatric lead poisoning.

If you require lead-based paint sampling for your residence or business, Wilcox has qualified staff that can assist in addressing your needs. For assistance regarding lead-based paint sample collection, data analysis, regulatory reporting, remediation, and lead-based paint impacted material disposal, please contact our offices in Indiana, Wisconsin, and Ohio for more information.