Many people never thought about the possibility of lead poisoning affecting their children. Professor Mikki Meadows-Oliver said that attitude is changing.

"People thought they really weren't at risk," Meadows-Oliver said. "Now, they're realizing that they are." In young children, even small amounts of lead can damage the brain and the nervous system.

Mikki Meadows-Oliver '98, MPH, PhD, RN, an assistant professor at Yale University School of Nursing, is also a nurse practitioner at the Yale Lead Program at Yale-New Haven Hospital.

The program tests children referred by pediatric health care providers for high lead counts. If the count is high, the staff will talk to the parents about where the lead is coming from and what they can do about it. They will also contact the family's landlord, if applicable, to try to rectify the problem.

Pediatric health care providers typically do a finger-stick test on children when they are one or two years old, but since they are not experts in the field of lead poisoning, they often refer the children to the Yale program if the lead count comes back high.

Blood is then drawn at the clinic to confirm the count, and if high, the local health department in that child's city will be contacted for an inspection of the home. Lower levels of lead poisoning can be offset by good diet and hand hygiene, while higher levels sometimes require medication and hospitalization.

The Lead Program also sends outreach workers to the home to educate the parents and talk about funds for abating the home or getting rid of the lead. YSN students help in the program by taking the children's diet histories and educating the families about lead.

Beginning in January, a new law will require pediatric health care providers to test all children ages one and two for lead. Currently, tests are conducted based only on answers to preliminary questions, though some practitioners were doing tests on all one- and two-year-olds prior to the law taking effect.

"It's important that kids are tested because there usually aren't any symptoms," Meadows-Oliver explained. She went on to say that at high levels of contamination, children may experience abdominal pain, constipation, and diarrhea, but "these symptoms go along with a variety of illnesses, and lead poisoning is not usually high on the list of things to look for with stomach complaints."

Meadows-Oliver explained that many of the lower-income families she sees already know someone who has had lead poisoning. Carl Baum, MD, associate professor of pediatric emergency medicine at Yale-New Haven Children's Hospital and the director of the Yale Lead Program since 2005, said children, especially from low-income families, "benefit tremendously from the services of the Yale Lead Program."

"These services include case management and treatment for acute and chronic lead poisoning, but also outreach and social work services that provide families and landlords assistance with housing and renovations, which are critical steps that prevent exposure to lead," he said. "Lead poisoning is certainly not limited to children from low-income families."

"Usually, middle-class families don't know about it because they may be in a renovated home, but there may be lead dust in the air," Meadows-Oliver added. "We see a lot of kids from New Haven or Bridgeport because they're in older housing and the landlord just hasn't kept them up." Many paints were lead-based prior to 1978.

Meadows-Oliver said the program sees an average of 140 children per year from around southern Connecticut, mostly under six years old because younger children tend to put their hands in their mouth more. She also said the body starts to absorb less lead as it matures.

The program does see some older children with developmental delays because they have similar behaviors as younger children. It also receives some referrals of internationally adopted children, especially from China and the former Soviet Union, because they may have lived in orphanages near battery plants or played in leaded soil.

In China, many mothers are exposed to lead. Since lead crosses the placenta, some children are born with lead poisoning, and it gets worse due to environmental factors.

The program sees more patients during the summer months because children play outside, where the soil may be contaminated with lead from paint chips or old leaded gasoline emissions.

Both Meadows-Oliver and Baum agreed that people have become more aware of lead poisoning lately, mainly due to a rash of toys made in China being recalled for containing lead.

"There is more awareness about lead poisoning, but much of the media attention has focused on lead in toys," Baum said. "Although lead has no place in toys, most children with lead poisoning are exposed via lead paint and lead dust in their homes. Homeowners and tenants may not always be aware of the dangers of lead, which is not visible to the eye, but is almost certainly present in any pre-1978 housing."

"For years, there's been lead coming in from products made in China," Meadows-Oliver said. "Now, people are just becoming more aware of it."

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