A lifetime of lead exposure

When elevated blood lead levels are in the news, it is typically related to the youngest members of our community. Children aged 5 and under tend to suffer the most devastating and permanent consequences of lead poisoning. Reporters at Cleveland’s Plain Dealer newspaper have consistently reported on the conditions that result in elevated blood levels and the prevalence of lead poisoning among youth in the city. Currently, about 93 percent of children entering kindergarten in the Cleveland Metropolitan School District have a detectable amount of lead in their blood. Due to the high stakes of elevated blood levels in young children, local resources for lead remediation are reserved for homes that “have a child under 72 months of age (5 or younger) who spends significant amounts of time in your home.” While it is wholly appropriate and necessary for resources to be designated to reducing the harmful impact of lead in children, the impact of lead on older adults should not be ignored. When we discuss lead exposure, we typically associate it with the youngest members of our community, but what about the oldest? Click To Tweet

Currently, about 93 percent of children entering kindergarten in the Cleveland Metropolitan School District have a detectable amount of lead in their blood.

Medical studies have demonstrated that lead exposure as an adult has a negative impact on a range of health issues involving the heart, kidneys and brain. One such study found a link between elevated blood lead levels in adults and premature death from cardiovascular disease. Researchers found that adults age 44 and older with high lead levels (6.7 µg/dL) had a 37 percent greater risk of death from any cause and 70 percent greater risk of death from cardiovascular disease than those without elevated blood levels. The study estimates more than 250,000 adults die prematurely each year from cardiovascular disease as a result of lead exposure over their lifetime.

Researchers found that adults age 44 and older with high lead levels (6.7 µg/dL) had a 37 percent greater risk of death from any cause and 70 percent greater risk of death from cardiovascular disease than those without elevated blood levels.

Older adults who have lived in homes built before 1978 for much of their adulthood have likely been exposed to low levels of lead throughout their lifetime. Consistent exposure to lead through environmental sources such dust, soil or water is best detected by measuring lead levels in bones. A longitudinal study compared cognitive test results of men with both high bone lead levels and no bone lead levels. Men with higher levels of lead in their bones showed cognitive declines comparable to aging five years. Participants of this study had not encountered occupational exposure to lead, causing researchers to conclude the lead exposure was community based, likely in their homes, over the course of their adult lives.

Conditions in Cleveland create a setting ripe for environmental lead exposure that can result in lead poisoning.

As has been well documented by reporters at The Plain Dealer, conditions in Cleveland create a setting ripe for environmental lead exposure that can result in lead poisoning. A majority of homes were built before 1978, high poverty rates, poor nutrition and lack of local policy to force lead abatement and remediation has resulted in entire neighborhoods experiencing environmental exposure to lead. Glenville, St. Clair-Superior, Buckeye-Woodhill, Broadway –Slavic Village and Stockyards are neighborhoods that have been identified as having particularly high numbers of children with elevated lead levels in their blood. Many of these neighborhoods have a high concentration of older adults as well, with nearly 20 percent of the neighborhood age 60 and older.

Since testing for lead levels is not standard practice, data does not currently exist to measure the impact of lead exposure on older adults except in very specific study populations.

Since testing for lead levels is not standard practice, data does not currently exist to measure the impact of lead exposure on older adults except in very specific study populations. In fact, older adults are not likely to seek testing specifically for elevated levels, even when there is a documented lead crisis that impacts them directly. The AARP Foundation and AARP Michigan held listening sessions with older adults in Flint, Michigan following the water crisis and found that even with the highly publicized crisis, half of those aged 60 and older had not had their blood tested for lead poisoning. The most common reason for not getting tested was that they did not know where to go to be tested.

Physicians may also be unlikely to consider testing for elevated lead levels in either bone or blood because many of the symptoms of lead poisoning have are closely related to other conditions commonly seen in the aging population…

Physicians may also be unlikely to consider testing for elevated lead levels in either bone or blood because many of the symptoms of lead poisoning have are closely related to other conditions commonly seen in the aging population such as joint and muscle pain, high blood pressure, difficulties with memory or concentration and mood disorders. Undoubtedly, communities with high levels of childhood lead poisoning will continue to raise awareness about lead exposure and advocate for policies and programs to combat the impact of lead. As this advocacy advances, we must keep in mind that generations may have been exposed to lead in their homes for decades. We must consider the impact it has had on their health. Programs and policies that address the health issues resulting from lead exposure in older adults can and should be developed alongside the policies and programs that benefit children.