Childhood Lead Poisoning Prevention Program

Possible Sources of Lead in the Environment

Lead Based Paint

• A common source of high-dose lead exposure to young children is deteriorating paint found in older homes and buildings.
• Paint with a high lead content was used in millions of U.S. homes before 1978.
• It was also used on some toys and furniture.
   

Dust and Soil

• Paint in good condition is usually not a hazard, except in places where painted surfaces rub against each other and creates dust.
• These areas are windows and windowsills, doors and door frames, stairs, banisters and railings, and porches and fences.
• Soil is contaminated by exterior lead paint chips and dust, lead-based insect sprays, highway pollution and remodeling projects.

Drinking Water

• Lead is usually not found in well or city water. 
• The water picks up the lead from inside your house. 
• Lead pipes, plumbing fittings made out of brass or bronze or lead solder used to connect plumbing can contaminate the water.

Air

• Air may be contaminated from dust caused by sanding, scraping or burning during removal of lead based paint. 
• Also lead contamination may occur from living near a manufacturing plant such as a lead smelter.

Food

• Some imported canned food cans may contain lead seams. 
• Food stored in lead crystal or food that is baked, served or stored in pottery or ceramic with a lead glaze can transfer lead into the food. 
• Food grown in soil that contains lead may become contaminated.
• Lead dust from your hands can transfer lead to the foods that you are preparing.

Hobbies and Occupations

• Dust and fumes from hobbies (such as stained-glass production, reload ammunition, pottery, refinishing furniture, making fishing weights, jewelry, etc.) can be a source of lead poisoning. 
• Workers may bring lead-contaminated dust home or in their car, on their clothing, shoes or other work related objects.

Traditional Medicines

Traditional folk medicines that contain high levels of lead.

• Greta
• Azarcon
• Paylooah
• Surma
• Moonshine
• Kohl 

Vinyl Miniblinds

• Miniblinds manufactured outside of the U.S. before 1996 may contain lead as a stabilizing agent.
• As these blinds are exposed to the sun, the vinyl deteriorates causing lead-contaminated dust to accumulate on the surface.  

Tips to Reduce Lead Hazards

Inside Your Home

• Be alert for chipping, flaking and peeling paint. 
• Make sure painted surfaces are properly maintained.Use only safe interior paints on toys, walls, furniture, etc. 
• Replace any plastic miniblinds made outside the United States with a type that is lead free. 
• Clean floors, window sills, window frames and other surfaces at least weekly using a powdered dishwasher detergent (Check the label to make sure the detergent contains "phosphate") or a special lead cleaning product. 
• Thoroughly rinse sponges and mop heads after cleaning dirty or dusty areas.
• Use a separate bucket of water for rinsing these items. 
• Clean or remove your shoes before entering your home to avoid tracking in lead from soil. 
• Clean up dust with a wet cloth and powder dishwasher detergent. 

In Your Kitchen

• Store food properly. 
• Avoid storing food in open cans, pottery, ceramics or lead crystal. 
• Do not drink, cook, or make baby formula with hot tap water.
• If the cold water has not been used for more than two hours, run it for 1-2 minutes before drinking or using.
• Serve well-balanced meals.

For Children

• Wash hands before preparing meals, eating and before nap or bedtime.
• Wash toys, stuffed animals and pacifiers often.
• Find safe play areas (such as lead-free sand or grassy areas).
• Don’t allow children to eat snow or icicles.
• Don’t let children eat things that fall on the ground or chew on painted surfaces (paint chips taste sweet).
• Don’t let children wear imported jewelry that may contain lead.
• You can get information from the Consumer Product Safety Commission about products that are recalled due to lead.

At Work

• If you work with lead, shampoo, shower and change clothes before going home and wash your clothes separately from the rest of the family.
• Take your shoes off before coming into the house.
• If you are pregnant and your job exposes you to lead, talk with your supervisor and your physician right away.
• Follow all occupational safety guidelines to limit your exposure.

Outside Your Home

• Cover bare soil with mulch, shrubs, or grass to prevent exposure.
• Build a sandbox (using lead free play sand) so children can play safely.
• Wash off foods grown in your garden.
• Wash the child’s face, hands and toys after playing outside.

During Renovation or Remodeling

• Hire a certified lead-based paint professional to remove the lead-based paint from your home.
• Don’t use a belt-sander, propane torch, dry scraping, or dry sanding on painted surfaces that might contain lead.
• This will generate large amounts of lead dust that could remain in the house for a long time.
• You may need to temporarily move your family (especially children and pregnant women) out of the apartment or house until the work is completed and the area is properly cleaned.
• If you can’t move your family out, at least completely seal off the work area. 

A Healthy Diet can Reduce Lead Absorption

• A healthy diet will benefit all children and it can help protect your child from lead poisoning.
• Encourage your child to eat healthy meals regularly at least three times a day. 
• A child with a full stomach is less likely to absorb lead.
• Offer 4-6 snacks or meals every day.
• A child who takes in adequate amounts of iron, calcium, vitamin C and protein will absorb less lead.Keep fat intake low.
• Offer healthy snacks like fruit, vegetable sticks (maybe with peanut butter, iron fortified cereal or bread, cheese or pudding instead of candy or chips.
• Be sure to wash your hands and your child's hands before preparing, handling, or eating food.

Healthy Diet Recommendations

Foods high in iron and protein:

• lean red meat, chicken, liver, or fish
• dried beans, peas, or lentils
• leafy green vegetables, such as broccoli and spinach
• fortified cereals and breads
• peanuts, sunflower seeds
• dried fruits, such as raisins, prunes, and apricots
• eggs

Foods high in vitamin C:

• citrus fruits and juices
• bell peppers, collards, tomatoes, raw cabbage, cauliflower, broccoli, and greens
• potatoes with skins and sweet potatoes
• strawberries, watermelon, cantaloupe

Foods high in calcium:

• milk, cheese, yogurt, ice milk, pudding
• leafy green vegetables, such as kale, collard greens, turnip greens
• tofu; peanuts and peanut butter
• salmon and sardines
• calcium enriched soy milk
• dried fruits and raisins.

Avoid high fat foods (bake or broil food):

• fried foods, such as French fries or potato chips
• sausage, bacon, and lunch meats like bologna
• margarine, butter, shortening, lard, or cooking oil
• cakes, pies, and pancakes

Testing, Reporting, and Screening

The Tennessee Department of Health requires reporting to the State of all lead screening test results. 

Who should be tested?

1. Children at 12 and 24 months old*
2. Children 36-72 months old without a documented blood lead level*
3. Children whose parent/guardian requests a blood lead level.
4. Children whose parent/guardian answers “yes” or “don’t know” to any questions on the risk assessment questionnaire used at well-child checks between 6-72 months of age or when child’s risk status changes.    
5. All foreign-born children (such as recent immigrants, refugees, and international adoptees) should be screened for elevated blood lead levels within 90 days of arrival into the United States. Screening should be repeated 3-6 months later after placed in permanent residence for children 6 months to 6 years of age.

*Required for all TennCare recipients

Childhood Lead Poisioning Data and Statistics

Planning and Surveillance

Fact Sheets

Infographics

Data Requests

Data requests can be requested at the following link:https://tnhealth.link/datarequest

More Resources

Academy of Pediatrics Lead Exposure and Lead Poisoning

CDC Lead Poisoning Prevention Program | CDC - Additional Public Health Lead Information

Children's Special Services

Healthy Homes

Tennessee Early Intervention System

Tennessee Statewide Screening Plan

Lead Testing for Schools and Childcare Centers

Free Lead Testing 

The Lead Testing in Schools and Child Care Centers (LTSCC) Program is a free, voluntary program offered by the Tennessee Department of Environment and Conservation (TDEC) to help reduce childhood lead exposure.

The LTSCC Program offers free lead in drinking water testing to eligible facilities, including Tennessee Department of Health (TDH)-licensed child care centers, Head Start and Early Head Start programs, Tennessee Department of Education (TDOE) public schools, and TDOE-certified school-administered child care programs.

Click to enroll in the program and to learn more about the program visit the LTSCC Program webpage.

Contact

LTSCC Program Support Team
Email: info@tnleadtesting.org
Helpline: (865) 213-3284.

Assessment and Abatement

Lead Paint Inspection**

Identifies the presence of lead-based paint. Certified and trained inspectors use x-ray fluorescence machines commonly called "XRF" or can send off paint chips to be analyzed.  However, an inspection won’t tell you whether the paint is a hazard, presence of lead contaminated dust or soil, or how you should deal with it.

Risk Assessment**

Determines if any lead-based paint hazards exist, which could cause harmful exposure to lead, particularly to young children and pregnant women. The assessment report will provide options for controlling the hazards found. You may need interim controls, abatement or a combination.

Interim Controls

Measures to temporarily control lead-based paint hazards and lead dust.

Abatement

A process to permanently (20 years or more) control a lead hazard by limiting exposure to harmful levels of lead. Abatement can include strategies such as paint removal, sealing or enclosing an area with an approved product, or permanently covering bare lead-contaminated soil. Painting over lead-based paint with regular paint is not enough.

** Lead inspections and risk assessments should not be confused with a home inspection. A home inspector may not have training in lead-based paint hazards and be certified with the state. Always check the inspector’s training and qualifications.

For more information on the difference between lead inspections and risk assessments, click here. For information on Certified Lead Paint Individuals and Firms, click here. 

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