RCPCH - BPSU Webinar: Lead toxicity in children - a continuing problem

Although the amount of lead in the environment has reduced following legislation on lead paint and lead-free petrol, children are still being exposed to lead from soil, dust, water, air, food, toys, and other household items. Lead can cause neuro-toxicity even at low blood lead concentrations and there is no safe threshold of exposure.

In this webinar, Professor Alan Emond, Dr Araceli Busby and Dr Sally Bradberry present current evidence, guidance and information to increase awareness of lead exposure in children.
Date: -
Time: -

Overview

Although the amount of lead in the environment has reduced following  legislation on lead paint and lead free petrol, children are still being exposed to lead from soil, dust, water, air, food, toys, and other household items. Lead can cause neuro-toxicity even at low blood lead concentrations and there is no safe threshold of exposure. Young children and the foetus are most at risk of irreversible neurological damage.

Children at highest risk of exposure are those exhibiting pica, or frequent hand to mouth behaviour (e.g. crawling children, or children with autism or global developmental delay). Young children with iron deficiency anaemia and calcium deficiency are also at risk. Those with high risk behaviours who have migrated from countries with less regulation to prevent lead exposure should also be tested.

In July 2021, the threshold for public health intervention in England for children and pregnant women was reduced to a blood lead concentration of ≥5μg/dL (≥0.24μmol/L). The threshold for adults remains at 10μg/dL (0.48μmol/L). If a child has a lead concentration above ≥5μg/dL, local Public Health England health protection teams should be informed so that an enviromental assessment and mitigation of exposure can be carried out. Chelation is only indicated if the child is symptomatic, or if blood lead concentrations are ≥2.4 μmol/L (≥50 μg/dL). Below this, removal of the source of exposure is the mainstay of treatment.

Learning Outcomes

By the end of this webinar, delegates will:

1.    Understand the current evidence about lead exposure to children in the UK and the impact of lead on child health,  development and behaviour
2.    Appreciate why the public health intervention level has been reduced to  a blood lead concentration of  ≥5μg/dL
3.    Be clear about which children should have their blood lead concentration checked
4.    Know what to do about a raised blood lead concentration result
5.    Have an overview of the network of specialist laboratories and the  lead surveillance system in England

Audience

  • Community paediatricians and developmental paediatricians
  • Paediatric trainees
  • GPs and GP trainees
  • Public health trainees and consultants
  • Laboratory staff

It is also suitable for an international audience, with caveats on surveillance data (which is England) and treatment approaches which will be most relevant to the UK context.

Speakers

Professor Alan Emond is a clinical academic paediatrician who  holds the position of Emeritus Professor of Child Health at the University of Bristol, where he was director of the Centre for Child and Adolescent Health from 2003-2018. He was one of the founders of the the Avon Longitudinal Study of Parents and Children (ALSPAC- Children of the Nineties), and has published widely on developmental and behavioural topics using this cohort, including studies on the impact of lead exposure in pregnancy and childhood. National leadership roles have included chair of the British Paediatric Surveillance Unit (BPSU), chair of the British Association of Community Child Health (BACCH), and senior editor for the 5th edition of Health for All Children (2019). He has advised successive UK governments on policy for children, and continues to work with Public Health England on child health surveillance.

Dr Araceli Busby is a Consultant in Health Protection at Public Health England (North East and North Central London Health Protection Team). She has a PhD in Environmental Epidemiology undertaken at the London School of Hygiene & Tropical Medicine whilst working as a Research Fellow investigating environmental risk factors for congenital anomalies. She is chair of the Public Health England Lead Exposure in Children Surveillance Scheme (LEICSS)

Dr Sally Bradberry is Director, National Poisons Information Service (Birmingham Unit) and West Midlands Poisons Unit. She is an expert in poisoning in children and adults, and has a special interest in lead. She is a member of the LEICSS steering group