Sydney GP Alerts Colleagues about Lead

The following article was first published in the St George Division of General Practice Bulletin.
Reprinted with kind permission from the Editor.

While testing a child for low blood iron recently, Beverley Hills GP and St George Division of General Practice member Dr Ben Balzer ordered an opportunistic screening for blood lead. When the 3 year olds blood level was discovered to be 0.96 µmol/L (20 µg/dL), the 2 year old sibling was also tested, and found to have a level of 1.5 µmol/L (30 µg/dL).

The National Health and Medical Research Council’s (NHMRC) goal for all Australians is 0.48 µmol/L (10 µg/dL). Despite the fact that the blood levels were respectively 2 and 3 times greater than the NHMRC goal, the children were showing no particular symptoms. Levels of blood lead which were previously thought to be safe have now been associated with impaired intellect-ual development as well as behavioural and learning difficulties.

The children live in rented accommodation with a good deal of old peeling paint. The federal Environment Protection Agency (EPA) states in its Lead Alert booklet, released in November 1995, "Paints used on Australian houses and other buildings constructed before 1970 are likely to contain high lead concentrations. Before 1950, certain paints contained as much as 50% lead. Today, the recommended maximum amount of lead allowed in domestic paints is 0.25 per cent. It will be reduced to 0.1% in December 1997.

"A single exposure to high concentrations of lead, such as eating a leaded paint flake the size of a 5 cent piece, can cause significantly elevated blood levels for some weeks."

Dr Balzer wrote to the landlord of the premises to inform him that he could be liable for the consequences of any child lead-poisoned on the property. Lead is particularly harmful to the developing brains of foetuses and pre-school children. Dr Balzer also referred the family and landlord to the LEADLINE Project (1800 626 086), the national community information and referral service funded by the federal EPA as part of its national lead abatement strategy. The family decided to vacate the premises. Since then, the children’s blood lead levels have gone down significantly.

Dr Balzer says "This highlights the fact that lead can affect a child anywhere in Sydney." He urges his colleagues to always consider doing blood lead tests on children when doing blood tests for other reasons, and to always keep lead poisoning in mind.