Lead - nutritional considerations

Lead is a natural element with thousands of uses. Because it is widespread (and often hidden), lead can easily contaminate food and water without being seen or tasted. In the United States, it is estimated that half a million children ages 1 through 5 years have unhealthy levels of lead in their bloodstream.

Lead can be found in canned goods if there is lead solder in the cans. Lead may also be found in some containers (metal, glass, and ceramic or glazed clay) and cooking utensils.

Old paint poses the greatest danger for lead poisoning, especially in young children. Tap water from lead pipes or pipes with lead solder is also a source of hidden lead.

Immigrant and refugee children are at much greater risk for lead poisoning than children born in the United States because of diet and other exposure risks before arriving in the US.

When enough is taken in, lead can damage the gastrointestinal system, nervous system, kidneys, and blood system and can even lead to death. Continuous low-level exposure causes lead to accumulate in the body and cause damage. It is particularly dangerous for babies, before and after birth, and for small children, because their bodies and brains are growing rapidly.

Many federal agencies study and monitor lead exposure. The Food and Drug Administration (FDA) monitors lead in food, beverages, food containers, and tableware. The Environmental Protection Agency (EPA) monitors lead levels in drinking water.

To reduce the risk for lead poisoning:

• Run tap water for a minute before drinking or cooking with it.
• If your water has tested high in lead, consider installing a filtering device or switching to bottled water for drinking and cooking.
• Avoid canned goods from foreign countries until the ban on lead soldered cans goes into effect.
• If imported wine containers have a lead foil wrapper, wipe the rim and neck of the bottle with a towel moistened with lemon juice, vinegar, or wine before using.
• DO NOT store wine, spirits, or vinegar-based salad dressings in lead crystal decanters for long periods of time, as lead can leach out into the liquid.

Other important recommendations:

• Paint over old leaded paint if it is in good condition, or remove the old paint and repaint with lead-free paint. If the paint needs to be sanded or removed because it is chipping or peeling, get advice on safe removal from the National Lead Information Center (800-LEAD-FYI).
• Keep your home as dust-free as possible and have everyone wash their hands before eating.
• Dispose of old painted toys if you do not know whether they have lead-free paint.

Lead poisoning - nutritional considerations; Toxic metal - nutritional considerations

Centers for Disease Control and Prevention website. Childhood lead poisoning prevention. www.cdc.gov/lead-prevention/about/. Updated May 23, 2024. Accessed June 19, 2024.

Markowitz M. Lead poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 739.

Theobald JL, Mycyk MB. Iron and heavy metals. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 146.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 04/17/2023.