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Lead Hazards for Pregnant Women and Children: Part 1: Immigrants and the poor shoulder most of the burden of lead exposure in this country. Part 1 of a two-part article details how exposure happens, whom it affects, and the harm it can do.

Cleveland, Lisa M. MN, RN, CPNP, IBCLC; Minter, Monica L. MS; Cobb, Kathleen A. BSN, RN; Scott, Anthony A. PhD; German, Victor F. MD, PhD

AJN, American Journal of Nursing: October 2008 - Volume 108 - Issue 10 - p 40–49
doi: 10.1097/01.NAJ.0000337736.76730.66

Poor, urban, and immigrant populations are at far greater risk for lead exposure than are other groups in the United States. Children with even slightly elevated blood lead levels are at increased risk for significant neurobehavioral problems that can extend through adolescence. Research has shown that elevated blood lead levels in pregnant women, even those well below 10 micrograms per deciliter—the Centers for Disease Control and Prevention's "level of concern"—can cause miscarriage, premature birth, low birth weight, and subsequent developmental delays in their children. Despite these well-established dangers, routine prenatal lead screening and lead education is not a standard of care.

Part 1 of this two-part article presents a short case example of a pregnant mother with lead poisoning and describes the epidemiology of lead exposure in the United States, the main sources of lead exposure, and the effects of lead on the pregnant mother and the developing fetus and child.

Prevention is crucial. Treatment options such as chelation must be used selectively and will not reverse damage once it's occurred. Part 2 will describe recommendations for screening, education, nutrition, reducing environmental exposures, and treatment.

Elevated blood lead levels in pregnant women can cause miscarriage, premature birth, low birth weight, and developmental delays in their infants. Despite these well-established dangers, routine prenatal screening and education are not standard.

Lisa M. Cleveland is a clinical nursing instructor at the University of Texas Health Science Center at San Antonio, where Kathleen A. Cobb is a research nurse, Anthony A. Scott is a clinical professor of pediatrics, and Victor F. German is a professor as well as the division chief in the community pediatrics division and the interim division chief in the pediatric pulmonary division. Monica L. Minter was formerly the project coordinator for the Project LIFE grant from the U.S. Department of Housing and Urban Development (HUD) that funded the writing of this article. Project LIFE consisted of voluntary lead screening offered to pregnant women and children at several clinics in San Antonio and a presentation designed to educate health care providers in the community on lead poisoning. This manuscript was developed from that presentation. HUD reviewed and approved the contents of this article. Contact author: Lisa M. Cleveland, The authors of this article have no other significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

© 2008 Lippincott Williams & Wilkins, Inc.