Lead

Known since antiquity as a poison, lead is a toxic metal for which there is no safe human exposure level. Scholars believe that the decline of the Roman Empire was in part due to the heavy use of lead-leaching pottery and water pipes that resulted in widespread neurological damage. The word “plumber” derives from the Latin word for lead: plumbum. Many people think this issue has been solved or does not affect them. Unfortunately, through use in cosmetics, imported paints, shotgun pellets, some gasoline and cleaning compounds, and water, lead continues to actively poison children, entire communities and wildlife. Lead is a leading public health issue in children’s health.

Dangers from Christmas Lights that Emit Lead Paint
Mislead: A film about lead poisoning today
Young boy lead-poisoned from home contractor
Lead paint around the world toxic to children
THE FACTS ON LEAD

There is no known safe level of lead.

Lead is a neurotoxin, meaning it damages the nervous system. Children exposed to even low levels of lead can have irreversible impacts for a lifetime, including behavior and learning problems, lower IQ and hyperactivity, slowed growth, hearing problems, anemia and fertility issues. Lead builds up in soft tissue—kidneys, bone marrow, liver, and brain—as well as bones and teeth. In 2012, the US Centers for Disease Control and Prevention eliminated the term “level of concern” when referring to childhood blood lead levels following the long-held understanding that there is no safe level of lead for a child. Lead can cross the placental barrier, which means pregnant women who are exposed to lead also expose their unborn child.

Solution: Be sure to get your child tested for blood lead levels prior to age two, no matter where you live. Use a vacuum cleaner equipped with a HEPA (High Efficiency Particulate Air) filter that screens out lead and other toxic materials. Remember that even if you have a newer home, lead dust can build up from ceramics, painted furniture, imported children’s toys and antiques. Practice regular hand washing and washing of areas that accumulate dust. Most importantly, educate yourself on the sources of lead and eliminate them as much as possible in your home.

Lead can contaminate our water supply and some communities are more at risk than others. Lead can leach into our water from lead piping, brass fittings and lead solders. The water supply in Flint, Michigan was contaminated after the City switched to river water which had a chemical composition that interacted with the lead pipes, resulting in higher lead levels in the city, water- poisoning hundreds of children. Flint is not alone as an estimated three to six million miles of lead pipes are used for water in various towns and cities across the USA.

Solution: Start with a simple lead test kit to test your paint, especially window sills and door frames. Always assume a house built before 1978 has lead paint and if your test kit comes out negative understand there may be lead deeper in the paint layers. Renovating? First learn more about lead at the EPA Lead Information site. Ensure you or the contractor are using lead safe practices. Don’t ever use a belt sander, propane torch, dry scraper, or dry sandpaper on painted surfaces that may contain lead.

Lead exposure from paint continues to poison families at all socio-economic levels. Homes, apartments, and other buildings built before 1978 may contain lead paint, which, if disturbed with renovation or simple chipping, can create lead dust. Doctors used to recommend lead testing for children living only in certain zip codes but now are recommending that all children be tested for lead exposures regardless of the neighborhood. Even million dollar historic homes (such as the White House) have lead paint and it only takes a tiny amount to poison a child.

Herbert Needleman, a pioneering neuropsychiatrist, developed an innovative study testing the amount of lead in baby teeth showing that children from both impoverished and affluent backgrounds equally experienced lead poisoning and that the greater the amount of lead in baby teeth the more poorly children performed in school and the lower their IQ. The researchers found that the higher-lead children had lower IQs, less verbal competence, worse speech processing and worse attention than did the low-lead children. Even relatively small amounts of lead were associated with significant cognitive and behavioral problems.

Solution: Start with a simple lead test kit to test your paint, especially window sills and door frames. Always assume a house built before 1978 has lead paint and if your test kit comes out negative understand there may be lead deeper in the paint layers. Renovating? First learn more about lead at the EPA Lead Information site. Ensure you or the contractor are using lead safe practices. Don’t ever use a belt sander, propane torch, dry scraper, or dry sandpaper on painted surfaces that may contain lead.

Many toys and children’s products contain high levels of lead. Every year imported toys are recalled and pulled off the shelf after high lead levels are found. Colors like yellow, orange and red can have lead in their pigment and unfortunately proper safeguards are not in place to catch this before products get on the shelves. For example, recent testing shows that some children’s backpacks have lead in the colorful graphics.

Solution: Choose toys made of natural materials, and avoid vinyl and imported colorful painted plastic. The US Consumer Product Safety Commission issues recalls of toys that could potentially expose children to lead (see details at the CPSC website). If you buy imported or used toys you cannot assume they are lead-free. Do-it-yourself test kits are available, but they are not known to be reliable in detecting low levels of lead in these products.

Fashion jewelry, metal trinkets even Mardi Gras beads are often found to have high lead levels. Costume jewelry can contain high levels of unsafe chemicals including lead, chromium and nickel. When a child puts an object containing lead in his or her mouth, the child is exposed to lead. When a child’s sweaty hand plays with this jewelry, then later their hand goes into their mouth and they are exposed. Inexpensive jewelry is usually made of a metal mix which can contain many toxic metals.

Solution: As a general rule avoid purchases of costume jewelry for children or pregnant women. Choose textiles, leather or natural products. If you can afford it, precious metals such as gold, sterling or platinum do not contain lead and are a safer option. Make sure that children in your home do not have access to jewelry or other items that may contain lead.

Many plastics such as extension cords, vinyl blinds, plastic bags and even Christmas tree lights contain lead. Lead is used as a stabilizer in polyvinyl chloride (PVC) plastics. Research shows that lead can come off these plastics and onto your skin. This is why your Christmas tree lights say in fine print, “Warning: Handling the cord on this product will expose you to lead, a chemical known to the State of California to cause cancer, and birth defects or other reproductive harm. Wash hands after handling.” The non-profit Center for Environmental Health found that some plastic reusable shopping bags had excessive lead levels at 15 times the federal limit for lead in children’s products.

Solution: As a precaution, wash your hands immediately after handling power cords, extension cords, and even strings of holiday lights. Choose RoHS compliant, lead-safe holiday lights. Go with a real Christmas tree as most fake trees are made from PVC and treated with flame retardants. Choose cotton grocery bags that you can run through the wash. Until adequate regulations and safeguards are put into place, children will continue to be poisoned by this toxin.

Research shows high lead concentrations in soil around homes near lead based industry such as those involving batteries or metal manufacture. During the 20th century, leaded gasoline was the predominant source of airborne lead. Today, industrial emissions predominate. The highest air concentrations of lead are found near smelters and battery manufacturers. In 2004, four waste treatment plants were among the 20 largest dischargers of lead submitting data to the Toxics Release Inventory (TRI) of the US EPA. When lead is airborne, it eventually drops down and becomes a soil contaminant in nearby communities. Studies find effects even 20 years after smelter plant closing.

Solution: Advocate for proper soil testing in communities and adequate clean up of contaminated soil. Support measures to make companies responsible for cleaning up their own toxic emissions.

Lead is associated with increased criminal behavior. Lead damages the brain and as result it can lead to higher impulsivity, poor judgement and higher aggression. Children who are lead poisoned are 7 times more likely to drop out of school and 6 times more likely to become involved in the juvenile justice system. Researchers have repeatedly found that childhood lead exposure is correlated to criminal behavior in adults. This has lead scientists to state that preventing childhood lead poisoning would also result in lower rates of aggravated assault and criminal behavior.

Solution: Support organizations that give support to families whose children have been lead poisoned. Families need early intervention and access to resources—often for years. Families need to be educated and steps must be taken to ensure their home is safe so that the lead poisoning will not continue. Support state and local initiatives that will mitigate lead hazards in communities.

Lead poisoning is an environmental justice issue. While all children are at risk, children from minority and/or poor populations are even more at risk, and also are more affected after exposure. Older housing and dilapidated housing conditions result in higher rates of lead exposures in inner-city and poorer communities. Inner-city neighborhood soil has higher lead contamination rates from auto emissions and industrial sources. These conditions plus poor nutrition and inadequate health care result in higher lead poisoning rates. Lead exposure leads to increased neuro-physiological symptoms such as higher aggression, decreased attention span and  learning disabilities.

Children in higher socioeconomic classes, with more access to resources, will end up getting more educational and mental health services for their symptoms. Children from poor communities will not get adequate resources and as a result their educational and mental functioning will deteriorate over time because they did not receive proper care early on. In addition, stereotypes lead to children from minority groups (and boys) being labeled as aggressive and being penalized for their actions (suspended, expelled from school), rather than being referred for the intensive wraparound services they need. In other words, the rich lead poisoned child ends up in therapy and tutoring for their learning disability. The poor lead poisoned child ends up in jail without knowing how to read.

Solution: Support advocacy at the local state and federal level so that community residents have a voice and meaningful involvement in decision making processes. Support state and national efforts to reduce environmental exposure to lead and clean up contaminated communities. Disparities in environmental hazards are driven by cultural, social and economic conditions. Removing disparities in access to healthy, safe and affordable homes is essential to improving the quality of life for minority and low-income populations and reducing the risk of lead poisoning.

Lead poisoning is an epidemic in the non-industrialized countries where industries are poorly regulated and where poverty results in children living and working in unsafe conditions. Countries in Asia and Africa are dealing with crises far surpassing Western statistics. In the US the lead tainted backpack gets recalled, but what of the town the backpack was made in? As an example, China has long had regulatory levels of lead in paint. However, paint with higher levels of lead often sells for a third of the cost of paint with low levels. In an intensely competitive and poorly regulated market, Chinese factory owners will cut corners and use cheaper leaded paint. Coal-burning, smelting factories, lead paint and e-waste recycling are the main source of economic income in some towns. As an example, 15,000 people were relocated after 1,000 children living around China’s largest smelter plant were found to have excess lead in their blood. Lead poisonings in Zamfara State, Nigeria were thought to be caused by the illegal extraction of ore by villagers.

The most rapidly increasing source of waste worldwide is discarded electronic equipment—known as electronic waste (e-waste)—and a large proportion is transferred to less developed countries for dumping or recycling, resulting in these communities having increased exposure to toxic chemicals, including lead. Most e-waste recycling occurs in small-scale family-based workshops where the workers, children and adults, are highly exposed.

Solution: Before you upgrade to a new cell phone or other device, ask yourself, Do you really need the latest model or does the one you have now do the job? Take action where you live to help people responsibly recycle e-waste. Support international law created in support of sustainable E-Waste recycling. Learn about the United Nations University – Solving the E-waste Problem Initiative (StEP) and the International E-Waste Management Network.

Natural disasters can increase lead (and other toxic metals) exposures in a community. For example, as a result of Hurricane Katrina, 100,000 homes were destroyed or damaged and a significant amount of sediment was deposited throughout the city of New Orleans, Louisiana. Researchers have documented increased lead hazards from the environmental lead contamination of soils from the dispersion of material in the city. Soil has been replaced in many local playgrounds and around homes but unfortunately there are still many contaminated areas.

Solution: Ensure that adequate and thorough testing is done in communities after natural disasters and that mitigation work is done to ensure safety for returning families.

Wildlife, especially birds, are being poisoned and dying from lead bullets and lead fishing tackle. Annually, an estimated 10 to 20 million animals are killed by ingesting lead shot fragments or other animals are contaminated with lead ammunition. Lead from shooting ranges accumulates in small mammals and enters into the food chain. For example, scavenging birds become poisoned by eating discarded carcasses that were shot with lead ammunition. Even Bald eagles are at risk. Read a timeline on this issue and US Fish and Wildlife Service efforts to protect wildlife. On March 22, 2013, scientists issued A Consensus Statement “Health Risks from Lead-Based Ammunition in the Environment” that “Lead-based ammunition is likely the greatest, largely unregulated source of lead knowingly discharged into the environment in the United States.”

Solution: Use non lead-based ammunition for hunting. Advocate and support local state and federal bans on lead ammunition. A 1991 federal prohibition on the use of lead shot for waterfowl hunting has dramatically reduced the amount of lead in wetland habitats. However, until a more comprehensive ban is in place, lead ammunition will continue to be used for hunting mammals like deer and increase lead contamination in our environment.

leadFor Decades Industry Has Corrupted the Science and Blocked Protective Action in the USA. Lead has been known to be a neurotoxin that lowers IQ and impairs mental performance  since the 1700s. France and Belgium restricted the use of lead-based paint in 1909 and most European nations followed suit in the early 1920s, banning lead paint altogether. Yet the United States did not ban lead in interior paint until 1978, almost 70 years later. Why? The lead industry consistently underplayed scientific reports showing that exposure to lead had serious health effects, especially in children. The National Lead Company fought product labeling and bans; brought lawsuits; and even when the danger was undeniable, then blamed children and their families when children consumed lead paint chips.

Read the Industry Spin on Lead: Scientific reviews prepared by the industry consulting group American Council on Science And Health (ACSH) on lead are invaluable as they document how Industry provided “science” which stated that personal changes (handwashing and running water before use) are needed instead of industry changes. Such reports state that claims of neurobehavioral effects in children “are not based on firm evidence” and “the weight of the evidence” does not prove low levels are a concern.

Please review these two reports:

1996 LEAD AND HUMAN HEALTH: An Update Prepared for the American Council on Science and Health Note the statement on page 22: “One of the more unfortunate outcomes of the lead controversy is the widespread and scientifically inaccurate use of the term “lead poisoning.” The document goes on to minimize science showing harm to children at low levels.

2000: LEAD AND HUMAN HEALTH: An Update Prepared for the American Council on Science and Health (ACSH) The same information, regurgitated with “updates” minimizing harm from low levels of lead.

The need for warning about our children is past. The epidemic of lead poisoning of American children demands that we do better.Dr. Devra Davis to the US House in 1982
CDC LEAD PREVENTION TIPS

It is important to determine the construction year of the house or the dwelling where your child spends a large amount of time (e.g., grandparents or daycare). In housing built before 1978, assume that the paint has lead unless tests show otherwise.

  • Talk to your state or local health department about testing paint and dust from your home for lead.
  • Make sure your child does not have access to peeling paint or chewable surfaces painted with lead-based paint.
  • Children and pregnant women should not be present in housing built before 1978 that is undergoing renovation. They should not participate in activities that disturb old paint or in cleaning up paint debris after work is completed.
  • Create barriers between living/play areas and lead sources. Until environmental clean-up is completed, you should clean and isolate all sources of lead. Close and lock doors to keep children away from chipping or peeling paint on walls. You can also apply temporary barriers such as contact paper or duct tape, to cover holes in walls or to block children’s access to other sources of lead.
  • Regularly wash children’s hands and toys. Hands and toys can become contaminated from household dust or exterior soil. Both are known lead sources.
  • Regularly wet-mop floors and wet-wipe window components. Because household dust is a major source of lead, you should wet-mop floors and wet-wipe horizontal surfaces every 2-3 weeks. Windowsills and wells can contain high levels of leaded dust. They should be kept clean. If feasible, windows should be shut to prevent abrasion of painted surfaces or opened from the top sash. Take off shoes when entering the house, to prevent bringing lead-contaminated soil in from outside.
  • Prevent children from playing in bare soil; if possible, provide them with sandboxes. Plant grass on areas of bare soil or cover the soil with grass seed, mulch or wood chips, if possible. Until the bare soil is covered, move play areas away from bare soil and away from the sides of the house. If you have a sandbox, cover the box when not in use, to prevent cats from using it as a litter box. That will help protect children from exposure to animal waste.
The unchecked involvement of industry in the science halted timely protective action in the USA (and countries worldwide) which resulted in thousands of preventable cases of lead poisoning.

Please consider the timelines showing how federal regulations were decades too late.

Timeline on WorldWide Bans on Lead Paint

200 BC The Greek physician Dioscerides stated,  “Lead makes the mind give way”

  • 1904 Australian physicians linked childhood lead poisoning to paint
  • 1909 France, Belgium and Austria ban white-lead interior paint.
  • 1914  Pediatric lead-paint poisoning death from eating crib paint is described.
  • 1921 – National Lead Company (USA) admits lead is a poison
  • 1922  League of Nations bans white-lead interior paint; US declines to adopt
  • 1931 Tunisia, Greece, Great Britain, Sweden, Spain, Yugoslavia and Poland have all banned lead paint.
  • 1978 US banned consumer uses of lead paint.
  • 2012 —  Lead paint is still being sold in many developing nations, Occupational Knowledge International reports.

Timeline on the US CDC Action

  • 1975 CDC level of concern is 30 micrograms per deciliter
  • 1977 World Health Organization recommends the tolerable dietary intake of lead  at 430 µg/day micrograms/day
  • 1985 CDC level of concern is 25 micrograms per deciliter
  • 1991 CDC level of concern is 10 micrograms per deciliter
  • 2004 – World Health Organization includes lead on the list of Hazardous Chemicals: main risk for children’s health as the most important neurotoxin for children
  • 2012 CDC level of concern is 5 micrograms per deciliter
  • 2014 CDC now states that no level is considered safe and has focused on prevention.

USA Federal Ban of Lead in Products

  • 1970 began phase out of lead in gasoline.
  • 1978 banned Lead-Based Paint.
  • 1978 prohibited Lead pipe/solder/flex.
  • 1991 U.S. food canners voluntarily stopped using lead solder.
  • 1995 completed phase out of lead in gasoline.
  • 1996 banned lead solder use in food cans.
  • 1996 banned U.S. winemakers banned from using tin-coated lead foil capsules.
  • 1998 banned in lead mini-blinds, crayons, toy figurines, children jewelry.
  • 2003 banned the use of leaded candlewicks.
  • Timeline compiled from Fairfax County

A brief history of lead in gasoline shows how industry involvement impacts regulation. In short, the toxicity of lead was scientifically documented but the industry managed to insert doubt about “environmental airborne” levels and successfully stopped a ban on leaded gasoline for decades.

  • 1923-1924  13 workers die and 40 “under observation” from lead poisoning at GM, Standard Oil and Dupont plants. Public health leaders spoke out about the serious safety issues and leaded gasoline was taken off the market. GM and Standard dismissed the critics and claimed that no substitutes existed.
  • 1925   Yale university public health scientist claims Ethyl gasoline represents “the greatest single question [whether leaded gasoline is safe] in the field of public health which has ever faced the American public.”
  • 1926 A Public Health Service commission study and found “no good reason” to prohibit sales of leaded gasoline and leaded gasoline returned to the market.
  • 1959 US Public Health Service approves Ethyl Corp. request to increase lead in gasoline.
  • 1965  Clair Patterson publishes “Contaminated and Natural Lead Environments of Man,” the first to show that high lead levels in industrial nations are man-made and endemic. (Arch Environ Health. 1965 Sept 11:344-60.)
  • 1965 Sept. 9 The American Petroleum Institute responds to Patterson, saying that while the findings “may be of academic interest … they have no real bearing on the public health aspects of lead. Contrary to Mr. Patterson’s conclusion, the mass of evidence proves unquestionably that lead isn’t a significant factor in air pollution and represents no public health problem in any way.” (WSJ Sept. 9, 1965)
  • 1966  June 8: U.S. Senate Hearings included testimony from Robert Kehoe, a scientist working for industry, and Clair Patterson, a UCLA scientist who exposed Kehoe’s fraudulent industry research. Patterson tells the committee, “It is not just a mistake for public health agencies to cooperate and collaborate with industries in investigating and deciding whether public health is endangered – it is a direct abrogation and violation of the duties and responsibilities of those public health organizations.”
  • 1971  Ethyl Corp. officials claim to be victims of a “witch hunt,” and say environmentalists are using “scare tactics” by blaming lead for the fall of the Roman Empire.
  • 1980 National Academy of Sciences says that leaded gasoline is the greatest source of atmospheric lead pollution, and estimated daily intake of 0.3mg per person.
  • 1995  Ethyl v. EPA Court case: According to a federal judge, the only reason to ban a gasoline additive is to prevent the failure of emissions control systems, the US Court of Appeals for the District of Columbia says. Public health concerns were not a sufficient reason for the denial.”
  • 2000  42 countries phased out lead from petrol
  • This information was compiled from the Environmental History Timeline Website
RESOURCES

U.S. Environmental Protection Agency on Lead

Coalition to End Childhood Lead Poisoning

National Center For Healthy Housing: Issue Brief: Childhood Lead Exposure and Educational Outcomes

World Health Organization: Lead poisoning and health Factsheet

Lead Safe America, a nonprofit working to educate parents and is an excellent resource for families.

Consumer Reports: Reducing your child’s lead levels: Here’s what you can do to protect your child now

Environmental lead after Hurricane Katrina: implications for future populations.

NRDC: Katrina’s Toxic Legacy

National Geographic: Protecting a New Generation of Poisoned Kids After Katrina

LEAD HAZARD REDUCTION TIMELINE FOR WILDLIFE AND HUMANS.

EPA: What is Environmental Justice?

Centers for Disease Control and Prevention – Blood Lead Levels in Children Fact Sheet

Read Dr. Davis’ 1982 Testimony on Lead Poisoning and Children. Hearing Before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce. House of Representatives, (December 2, 1982).  Washington, DC. House Committee on Energy and Commerce.

Lead poisoning and other silent public health threats. Given the breadth of what has unfolded in Flint over lead poisoning, we contacted a wide range of experts — from toxicology experts to pediatric and environmental health specialists — via email to ask whether Flint is symptomatic of a bigger issue. MedPage Today.

How lead can get into the water supply, explained in 5 charts. An estimated 10 million Americans get drinking water from pipes that are at least partially lead. These graphics explain how lead can get into drinking water — and why that can be a huge public health problem, as it is in Flint. Vox.

NEWS ARTICLES

Oxford Press: Lead poisoning of Flint, Michigan—penny wise, pound foolish, and criminal by EHT’s Dr. Davis and Dr. Morris

America’s lead poisoning problem isn’t just in Flint. It’s everywhere.

Chinese toys tainted by lead or made by child labour

Lead contamination around closed Philadelphia factory threatens health of children, pregnant women

Washington Post: Freddie Gray’s life a study on the effects of lead paint on poor blacks

Mother Jones: America’s Real Criminal Element: Lead January 2013

Chicago Tribune: Studies link childhood lead exposure, violent crime

CNN: China: The electronic wastebasket of the world

Standing Up to the Lead Industry: An Interview with Herbert Needleman

The Atlantic: The Toxins That Threaten Our Brains

CITED SCIENTIFIC RESEARCH

Bellinger, D., Leviton, A., Waternaux, C., Needleman, H., & Rabinowitz, M. (1987). Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. The New England Journal of Medicine, 316,  1037-1042.

Needleman, H. L., Gunnoe, C., Leviton, A., Reed, R., Peresie, H., Maher, C., & Barrett, P. (1979). Deficits in psychologic and classroom performance of children with elevated dentine lead levels.  The New England Journal of Medicine, 300,  689-695.

Needleman, H. L., & Gatsonis, C. A. (1990). Low-level lead exposure and the IQ of children. A meta-analysis of modern studies. Journal of the American Medical Association, 263, 673-678.

Needleman, H. L., Riess, J. A., Tobin, M. J., Biesecker, G. E., & Greenhouse, J. B. (1996). Bone lead levels and delinquent behavior. Journal of the American Medical Association, 275,  363-369.

Levin et al., Lead Exposures in U.S. Children, 2008: Implications for Prevention, Environ Health Perspect; DOI:10.1289/ehp.11241

Gilan SR, Zaidi SR, Batool M, Bhatti DAI & Mahmood J (2015). Report: Central nervous system (CNS) toxicity caused by metal poisoning: Brain as a target organ. Pakistan Journal of Pharmaceutical Sciences, 28(4) 1417-1423.

Mennick, F. (2006). Two expanded cautions for pregnant women: even low levels of lead exposure — and ACE inhibitors in the first trimester — may harm fetal development. American Journal of Nursing, 106, 22.

Adrienne S. Ettinger, Maternal Blood, Plasma, and Breast Milk Lead: Lactational Transfer and Contribution to Infant Exposure, Environ Health Perspect; DOI:10.1289/ehp.1307187

Needleman, LEAD POISONING, Annu. Rev. Med. 2004. 55:209–22 First published online as a Review in Advance on Aug. 18, 2003

CDC (Centers for Disease Control and Prevention). 2012. Low-Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Available: http://www.cdc.gov/nceh/lead/acclpp/final_document_010412.pdf[accessed 10 May 2013].

Tesman, Johanna Rich; Hills, Amanda, Developmental Effects of Lead Exposure in Children,  Social Policy Report, v8 n3 1994

Jusko et al., Blood Lead Concentrations < 10 µg/dL and Child Intelligence at 6 Years of Age

Mielke and Zahran, The urban rise and fall of air lead (Pb) and the latent surge and retreat of societal violence, Environment International, Volume 43, August 2012, Pages 48–55

1988 The Nature and Extent of Lead Poisoning in Children in the United States: A Report to Congress. INSTITUTION Agency for Toxic Substances and Disease Registry (DHHS/PHS), Atlanta, GA. PUB CATE Jul 88

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