Lead Poisoning Treatment and Prevention Program

Basic Facts for Parents

If your home was built before 1960, it is very likely that it contains lead-based paint. Report any peeling paint to your landlord or, if you live in New York City, call the 311 hotline to report concerns.
There is no safe level of lead in the blood of children. Talk to your child's pediatrician if the paint in your home is peeling. Children living under such conditions are considered to be at high risk for developing lead poisoning and should immediately have blood lead tests.
Children younger than 6 years old have the highest risk for lead poisoning. They may have no symptoms at all; even the best pediatricians may see no detectable signs.
Contaminated dust-created when lead-based paint breaks down-is a common source of lead exposure. The dust breaks down and sticks to hands, skin, hair, clothes and toys. Then, through normal hand-to-mouth activity, the dust is swallowed.
With chronic lead poisoning, children may have speech delays and/or hyperactivity. In cases of more severe lead poisoning, children have abdominal pain and constipation, and they may be sleepy and lethargic. THIS IS A MEDICAL EMERGENCY. Some of these lead effects may be irreversible.
Lead poisons all parts of the body, but the brain is especially sensitive. This could result in impairments in communication, fine motor skills, impulse control, memory, learning, attention, visual spatial skills, planning, organization, cognitive flexibility, abstract thinking and being able to sit, listen and learn in school.

Basic Facts for Pediatricians

Pediatricians are required by the New York City Department of Health and Mental Hygiene (DOHMH) and the New York State Department of Health (NYSDOH) to carry out a risk assessment beginning when an infant is 6 months old. A risk assessment entails obtaining information from the parents such as:

Does anyone in the home environment work with lead outside the home or have a hobby that utilizes lead?
Does the child live in or regularly visit a home built before 1960 or another site that is now being renovated?
Does the child eat non-food items such as paint chips, crushed pottery or soil?
Does the child have any evidence of developmental delays?
Has the family recently moved from a foreign country to live in the United States?
Is there any history of an elevated lead level in any other child within the family?
Is there any peeling paint in the home environment or at any site that a child visits?

If the answer to any of these questions is yes, a child is considered to be at high risk for lead poisoning, and a blood lead test must be carried out promptly. This type of risk assessment is mandated by the DOHMH and the NYSDOH to be carried out at every pediatric visit to 72 months of age.

A pediatrician can readily ascertain the date that a family's home was built by inserting a home address into a Web search engine.

All children, regardless of risk category, are required by the DOHMH and the NYSDOH to have blood lead tests at 12 and 24 months of age.

The medical management and follow-up of blood lead levels is detailed by the Centers for Disease Control and Prevention (2002, 2007) and the DOHMH and the NYSDOH.

Besides close medical follow-up of iron deficiency (if present) and follow-up of blood lead levels, the most critical aspect of the medical management of an individual child is to promptly identify the source of excessive lead exposure and remove this source collaboratively, as noted below.

If a pediatrician wants advice in the management of a lead-poisoned child, New York State-funded Resource Centers at academic centers are available for consultation.

Lead Resource Center

The Lead Poisoning Treatment and Prevention Program at the Children's Hospital at Montefiore is designated as a Lead Resource Center by the New York State Department of Health. The Center serves the downstate New York region's 13 counties, from Sullivan to Suffolk. We provide consultations to each county's Department of Health and accept individual referrals from those departments.

A main function of the Center is the hosting of its annual conferences. These conferences, given in Westchester County and at Montefiore Medical Center, are designed to provide updates on current lead research, regional epidemiology and local sources of lead exposure, and to review guidelines for the care of lead-poisoned children and pregnant women.

Speakers have included nationally recognized medical professionals, researchers and academics as well as representatives from the Departments of Health within the counties served by the Center and various community organizations.

Who and When to Treat?
Neurological/Developmental Assessments
Educational Approaches to Communities at Risk
Lead and Pregnancy
Transitional Lead-Safe Housing

Setting Up a Program
Medical Management
Lead Poisoning and Environmental Justice
Lead-Related Legislation
When and How to Chelate

Community-Focused Educational Programs
Community outreach is of paramount importance. Consequently, lead program personnel regularly organize workshops for parents, staff and teachers at Head Start and other preschool programs and partners with community-based organizations for educational outreach.

Safe House for Lead Poisoning Prevention

Since opening in 1991, the innovative Safe House for Lead Poisoning Prevention has been providing temporary housing for families whose homes are being made lead-safe.

Our facility consists of six apartments, conveniently located two blocks away from the Children's Hospital at Montefiore. Our administrative offices are in the connected building. When families stay in the Safe House, our staff will: