ST. LOUIS, Mo. – Starting later this month, your child’s pediatrician will be required to ask questions about lead exposure in hopes of safeguarding children from lead poisoning.
At present, only Missouri kids who are receiving Medicaid or live in a zip code with high concentrations of lead were assessed for lead poisoning. This new policy requires all children under the age of six to be screened annually and doctors say this is a good thing.
“It’s not necessarily because anything about Missouri has changed, it’s recognizing the complexity of the mandates that we had before,” Dr. Heidi Sallee, pediatrician at Cardinal Glennon Children’s Hospital in St. Louis, said. “You can’t just go by, ‘Oh, this child lives in a poor neighborhood,’ because there are some very wealthy neighborhoods that just have a lot of old houses.”
Soon, it won’t matter where you live, your socioeconomic background, or which insurance coverage you have. Starting Aug. 28, all health care providers will be mandated under state law to assess kids under the age of 6 for lead exposure.
“You may not live in a high-risk zip code, but you do live in an old house and maybe your parents are doing some reconstruction or some remodeling and there is chipping or peeling of paint or there is dust from the construction, so the child is getting exposed,” Sallee said.
Governor Mike Parson signed House Bill 402 last month. The Department of Health and Senior Services (DHSS) said the multiple testing schedules create confusion for healthcare providers. Under the legislation, parents of all children under the age of 3 can be given the option to test annually, and every child under six will be given a lead risk questionnaire and offered testing if determined to be at high risk for exposure.
“The main way that children get lead poisoning is by ingesting it or putting something in their mouth and swallowing it,” Sallee said. “If you have a 1 or a 2-year-old you know everything goes into their mouth. It’s around 6 to 12 months of age when you want to get started because it has to do with that exposure to the mouth, so they are putting toys in their mouth.”
If a parent chooses to have their child tested for lead, the testing is done through a blood sample, either through the vein or by a finger prick. Sallee said the option of using a vein in the arm is the most accurate.
“One of my colleagues does have a patient in our hospital right now who is undergoing chelation (therapy) because that child’s lead level got so high that we couldn’t let it work its way out, we had to give him medication to help him get rid of it,” Sallee said. “But, we can’t send him home because that’s probably where the lead came from, so we have to find a safe home to send him to before we can send him home.”
Depending on how the patient answers the handful of questions, the doctor could recommend a blood test. Sallee said high levels of lead can be fatal. Some of those questions could include if your house was built before 1979, have you had lead testing done in your home, if your child’s daycare has been tested for lead and if another sibling or someone else in the home has tested positive for lead.
“What we are seeing right now, is that it can interfere with brain development, so you see developmental delays and learning problems,” Sallee said. “That learning disability doesn’t go away just because you lowered the lead. It’s already caused permanent damage to the brain.”
DHSS said effects of lead poisoning include damage to the brain and nervous system, slowed growth and development, learning and behavior problems and hearing and speech problems.
Sallee is also the vice president of the Missouri Chapter, American Academy of Pediatrics. She said there is no safe level of lead and there is not a great way for parents to be able to tell their child has been exposed.
“The first place I would look is on the inside of the house, looking at paint, looking at just the structure, is there anything that is breaking down, and really a quick fix is paint over, and you’ve sealed it in,” Sallee said.
Besides paint, lead can also be found in soil and water. Back in 2018, blood test found lead in more than 3,000 kids in Missouri. Sallee said if you are in the process of buying a new home, she recommends having the house tested before you buy it.
“Lead is sweet to the taste, so children will want to put it in their mouth,” Sallee said. “It might taste sweet, and it might kind of taste good to them.”
Also starting later this year, schools and daycare facilities constructed prior to 2014 will be required to test drinking water for lead. If a concentration above 5ppb (parts per billion) is found in the water, the facility must notify parents, provide alternative drinking water, install filtration systems and undergo remediation. There was $27 million put into the state budget to help schools meet this obligation.
Last month, President Joe Biden also announced $58 million in grants to help schools and day care centers removed lead from drinking water.