Indiana gets the lead out with 2023 legislation changes
By Kristen Cervenak, Editor, [email protected]
What do ceramics, soil, jewelry, imported cosmetics and old Hot Wheels toys have in common? They can all pose potential risk factors for lead poisoning in children, and state health regulations are emphasizing the importance of testing.
As of Jan. 1, House Enrolled Act 1313 requires all Indiana health care providers to determine whether a child under the age of 6 has been tested for lead poisoning and to offer the screening if testing has not been performed.
In the past, Indiana required case management for levels 10 micrograms of lead per deciliter (µg/dL) of blood. However, Act 1313 has lowered the amount of lead in a blood sample for a child to 5 (µg/dL) to warrant risk assessment.
“It’s one of those things that is kind of silent, which is why they want the children tested at least twice before the age of 6,” licensed risk assessor Theresa Buechele, director of the Maternal Child Health Clinic for the Harrison County Health Dept. said. “It’s really recommended that they get tested at their one- and two-year visits, because the earlier you can catch this, the better.”
In 2020, the World Health Organization listed lead as one of 10 chemicals of public health concern, in addition to arsenic, asbestos, benzene, cadmium, dioxins, inadequate or excessive fluoride, mercury and hazardous pesticides.
Left unchecked, lead can affect a child’s growth, cognitive development and neurological development. Children with high lead levels may also experience learning and behavioral issues, in addition to hearing and speech difficulties.
According to Buechele, during a risk assessment, a case history is first obtained on the child. Then the home, or any facility in which they spend a lot of time, is evaluated for presence of lead in order to determine the source and eliminate it.
“When people think about lead poisoning, the first thing they go to is paint, but lead is found in so many things that people don’t realize,” she said in reference to the federal government’s banning of lead-based paints in 1978.
In one particular case, she said, “We ruled out just about everything we could think of, and it just so happened I saw they ate a lot of Indian food. I hadn’t come across that before or heard anyone from the state say anything about it.”
Upon further research, Buechele discovered certain spices contain lead.
“Turmeric has lead in it,” she said. “One of the main ingredients in Indian food. Once they eliminated that from the diet, the child’s levels immediately started going down and eventually returned to normal.”
Another surprising source? Batteries, according to Buechele.
“Say the remote batteries fall out and you don’t see it, then a small child picks up the batteries,” she said. “What do they do? They put them in their mouths. There are so many things that you don’t think about.”
Lead testing can be requested by a child’s pediatrician or physician’s office. The Harrison County Health Dept. also performs testing when referred by programs such as Head Start.
Buechele said, “To help with this, especially since they lowered the levels, now when a child comes in for their immunizations in that age group (before 6 years of age), we will ask them if they’ve had their lead levels tested recently or if they were tested at their check up.”