Family lead poisoning associated with occupational exposure.

Lead is a potent poison that affects multiple body systems. It is well documented that children under age 6 years and the fetus are especially vulnerable to neurologic damage affecting learning and behavior with potential for life-long impact. In 1991, the Centers for Disease Control and Prevention (CDC) lowered the blood lead level (BLL) of concern for children from 25 to 10 micrograms per deciliter (μg/dL) (CDC 1991).1 Efforts to reduce lead in the environment, primarily by eliminating lead from gasoline and paint, have resulted in lowering the overall geometric mean BLL for the general population in the United States from approximately 13 micrograms per deciliter (μg/dL) in the late 1970’s to <2 μg/dL by 1999 (NCHS 1984; CDC 2001).2,3 Although the average BLL has markedly declined, National Health and Nutrition Examination Survey (NHANES) 1999– 2000 data indicate that 2.2% of U.S. children aged 1 to 5 years had BLLs ≥10 μg/dL (CDC 2003).4 Recent research suggests that levels once thought safe are considered hazardous as new information emerges about lead’s harmful effects at BLLs less than 10 μg/dL.5,6 Despite success in reducing the number of children with elevated BLLs, some remain at high risk for lead exposure, including those living in homes containing lead-contaminated dust. Invisible toxins may be carried home to household members by inadequately protected workers on their clothes, shoes, or bodies, called “take-home exposure.” Documented cases of take-home exposure include lead, beryllium, asbestos, pesticides, and other toxic materials.7 In this case series, we describe take-home lead exposure incidents in California from 1992 to 2002. Lead is used in more than 100 industries. Lead dust carried from work settles on surfaces in the vehicle and home where it can be ingested or inhaled by young children with normal mouthing behavior and by household members handling workers’ clothing. Children of lead-exposed workers have disproportionately high BLLs when compared to other children.8-10 One study estimated that 48,000 families have children under age 6 living with household members occupationally exposed to lead.11 Reports of take-home lead exposure include work in mining,8,12 automotive radiator repair,13 battery reclamation,14 construction,9 and antique furniture refinishing.15