Conference moira::parenting_v3

>How do you "interrupt" the results of the lead poisoning test?
             ^^^^^^^^^

Dot, do you mean "interpret"?

I'd suggest asking the pedi.  I've found that it's useful be very nosy and 
inquisitive about whatever is in my kids' medical record.  It's the doctors job 
to explain this sort of stuff to you.  

I can think of explanations other than a number within a range for "EP27", for 
example it may identify the test that was administered.

Clay

Clay:

Yeah, I meant "interpret" ... (thanks)

Asking the Pedi is a good idea.  Juli's 2-year checkup is this afternoon.
I was going to ask him, but "curiosity" was getting to me this morning.
Guess I'll just have to patiently "wait"!

If I remember, I'll update this note when I get an answer this afternoon.

Dottie

PS:  In the meantime, any input is welcomed and appreciated.

    RE. the actual Lead poisoning laws, Up to what age (for the child)
    is the building supposed to be Lead proofed?
    
    Since AJ is 4.5, and is "supposed to know better", do I presume the
    extremely old building that houses his daycare, 3 to 5 year olds only,
    does not have to de-lead any painted surfaces?
    
    My pedi has always tested annually, his blood for lead and has simply
    told me the "numbers were OK", maybe I should question her more
    specifically on this.
    
    Lyn

    Much of this is determined by local (that is, state) laws.
    
    There are two ways to measure lead level. One, the finger stick method,
    measures a by-product associated with lead. If this is above a certain
    level, a more accurate full blood test checks for the actual lead
    level. I beleive the EP27 you cited is the first test. If it said PBXX
    it would be lead.  The figures for the finger stick are higher than for
    lead. For the full lead test, your child is considered to have lead
    poisoing if the level is 25 or above (and they may have recently
    dropped this). Actual Pb levels above 35 or so are considered serious,
    above 60 severe enough to hospitalize. The figure cited in the base
    note sounds okay for the finger stick method. If not, your child would
    have been called back for an actual Pb test from drawn blood. If the Pb
    test was above 25, public health officials would  notify you and
    require that you delead your house.
    
    In Massachusetts it is illegal for a child 6 or under to occupy a house
    that does not meet the lead laws -- this does not mean lead-free, but
    that no "mouthable edges" to a height of five feet contain lead, and
    that all paint, lead or not, is intact. In practice, this becomes an 
    issue only when a child is poisoned, or when a property owner wants to
    avoid the potential for lawsuits renting to families with children 6 or
    under. In fact, although Massachusetts has among the strictest lead
    laws in the country, much of the pressure these days is coming from
    insurance companies unwilling to write liability policies on houses
    without certification that they have been deleaded. This is confined
    mostly to multi-family houses, but singles can't be far behind.
    
     
    Kit

    
    Juli's lead test was the "finger test".  Pedi said if the test
    results are 35 or greater, they do the "full blood test".
    
    Juli was tested at her 1-year checkup and again (this week) at
    her 2-year checkup.
    
    Dottie
    

    My son Alexander was tested for lead at 21 months.  It was done at the
    hospital so that the insurance co. would pay for it.  They did a full
    blood test and sent the result to our pedi. and he sent a copy to me
    expalining the percentage rate, etc.  Alex's level was 20 which is
    normal.  this is how it reads onthe sheet thtat the pedi sent me from
    the hospital.
    
     0-25 ug/dl   = normal
    26-35 ug/dl   = equivical
                    specimen sent to state lab.
      35+ ug/dl   = high
                    specimen sent to state lab.
    
    So you might want to ask your pedi about her level, just to ease your
    mind.
    
    
    Liz

    
    Pedi told me that the results were "fine" for a finger test.
    No need to worry or pursue.
    
    Thanks!
    
    Dottie
    

    re: .6
    
    > Alex's level was 20 which is normal.
    
  Actually, no lead is "normal".  It's one of the weird things about lead.
    It should not occur in our bodies at all. Until recently, lead levels
    of 25 did not trigger treatment, deleading etc. But, I believe the 
    recommended trigger-level has dropped to around 20 in Massachusetts,
    and national experts are sending up worry flags on anything over 14 or
    15, based on some recent results from long-term studies.
    
    For levels of 20, doctors usually at least recommend supplemental iron,
    which binds with the lead to allow it to be excreted. I'd check his
    progress carefully, and make sure the level goes down.
    
    Kit

    There was a several-page-long article in Newsweek over the summer
    about lead and de-leading.  
    
    One of the things it mentioned was that deleading a house can stir
    up more lead than was there in the first place.  
    
    It also had some stuff about treatments, etc. 
    
    I didn't save it but people who are worried about lead might want
    to look it up in the library or something.  I think it was the
    cover article, and it was in connection with learning disability
    and poor children.
    
    --bonnie

    There is NO acceptable blood lead level that has ever been determined
    for anyone.
    
    It IS known that blood lead levels as low as 7 cause learning
    disabilities.
    
    For PRACTICAL reasons, the laws in various states have traditionally
    used 20 to 25 as levels at which corrective actions need to be taken.
    This only menas that the medical community did not know what to do with
    itself if the lead levels were lower (there would be so many cases
    to report), and that exsisting - easy to use tests - are imprecise below 
    the 20 level.
    
    The "EP" reading goes along with the lead reading (It stands for a word
    starting with "erythrop-------") and, for larger lead readings (i.e.
    above 20) combines with the lead reading to give the doctor an
    indication of how bad the lead poisoning might be.
    
    The problem parents and children have is that there seems to be no easy
    way to get accurate blood lead readings below 20, especially with the
    EP type testing, which is the testing usually used.
    
    Many pediatricians seem, themselves, to be confused between the legal
    definition for lead poisoning, which is usually above 25 (at which 
    they MUST act) and the clinical, epidimeological evidence of lead 
    poisoning of 7 and worse.
    
    In fact, I just read a major pediatric guide, published in 1988, that
    said blood lead readings of "up to 25" were considered normal, which
    conflicted with a 1988 EPA report to Congress that said lead levels "as
    low as 7" had been determined to cause learning disabilities.
    
    Part of the problem may be that there are two types of lead poisoning,
    "acute" and "chronic".  With "acute" you're so sick people recognize there's
    something wrong with you and rush you to the hospital.  With "chronic"
    you just slowly develop subtle problems - which can often, with
    children, be looked at as maturational delays.  (So, Johnny can't read
    as well as Suzy - he'll catch up.)
    
    Another part of the problem is that not all people are equally
    affected.  Massachusetts Department of Environmental Quality guidelines
    recognize a 10:1 variance in individuals susceptibility to
    environmental poisons like lead.
    
    

    re: .9
    
   > One of the things it mentioned was that deleading a house can stir
   > up more lead than was there in the first place.  
    
    True. Pretty intuitive, acutally. And this is why states like
    Massachusetts now have extremely strict regulation of deleading.
    Technically, you are not even allowed to remodel an old house in such a
    way that old paint would be disturbed, without meeting the deleading
    regulations. It's also why some types of deleading are recommended over
    others (i.e., replacement rather than dry scraping, even though the
    former is more expensive, or may be architectually inappropriate.)
    
    Deleading can be done only by a state-certified deleading contractor --
    all workers must be trained. The house or apartment must be vacated,
    and essentially sealed. Special vacuums are required to suck up the
    residue without spewing particles into the air. Special cleaning
    procedures must be followed. Finally, before the place is reoccupied,
    the inspector who has been overseeing the process (on behalf of the
    local health authorities) must take a series of "wipes" that are
    analyzed at a state lab to ensure that lead dust levels are below
    specified concentrations.
    
    Your mileage may vary, especially in places like "live free or die" New
    Hampshire!
    
    Kit
     

    re: .11
    
    Actually it was mostly California they were picking on . . .
    pretty strict lead regulations but no regulation on contractors.  
    
    --bonnie
    

    On October 7th the federal government announced that they were
    officially recognizing blood lead readings of 10 as being a cause for
    alarm - rather than the 25 now used nationwide.  The Globe article on
    this discussed the Massachusett's need for a new method for determing
    blood lead levels.  The "EP' method is an indirect measurement
    technique that only yields valid relationship to the very high blood
    lead readings of 25 or more.  High, and dangerous, blood lead levels of
    10 to 25 can not be accurately determined with the EP model and require
    direct testing of the actual blood lead levels, as is done with atomic
    absorption testing techniques.  This October th announced action by the
    federal government is a major step in getting the public to recognize
    that the "old" limits of 25 never were "safe" limits, but only the
    limits based on the practical capabilities of the EP test.
    

    Yet another facet to this is the difficulty of treating people with
    levels as low as 10 -- apparently there is no effective method of
    removing blood at that level, other than removal from the environment
    of lead.
    
    Which of course leads back to deleading -- an incredibly expensive,
    extremely disruptive process which falls disproportionately on those
    least able to bear it, based on the areas in which it is most likely
    found. We're playing musical chairs in houses that constitute a
    vast and ancient toxic waste dump.  When the music stops you pay to
    clean it up.
    
    Kit  

    After the doctor's office closed today we found a
    message on our answering machine saying that our
    two yr old's lead test came out a "little high".
    (I hate it when they leave these messages!)
    
    I've searched for keywords and can't seem to find
    any other notes about lead tests.  I will call
    first thing in the morning.  Just wondered what
    your experience has been.  
    
    Yes, we live in a 70 yr old house and have been
    rennovating forever, while taking precautions with
    old wallpaper removal etc.  Our 6 1/2 yr old (tested regularly)
    has never had "high results".  So, I'm worried.
    
    Have you received results that were a "little high"
    and found out that later results were alright????
    
    Julia
    

    I had the same phone message on my answering machine one day.  Yes, I
    was scared.  Yes, I called the doctor as soon as I could to find out
    what to do next.  She said the numbers weren't  critical and that we would
    have to have the test redone - either the same finger prick test (which is
    not very accurate) or blood taken from the vein.  I decided (with much
    coaxing and convincing from the nurse) to have the blood drawn for a
    more accurate test.  (I was really apprehensive on this because my 2
    year old screams bloody murder when the doctor looked in her ears,
    never mind having a needle in her arm.)  She did great and the
    
       Second Test Came Out Normal!!!!!
    
    Hang in there!  Lead poisoning is nothing to kid with, but the initial
    finger-prick tests can show up high because of traces of stuff on the
    child's finger.  Don't start to worry unless a blood test shows high
    lead levels.  And, even if it does, it is treatable.  MA has recently
    lowered  it acceptable lead levels, so I suspect a good number of the
    finger-prick tests will come back for retesting.  Let us know how
    things go.
    
    					Mair
    

    Thanks -- I needed that!
    
    We're going in for another test (drawn from the arm, oh fun)
    and then the 10-14 day wait.  I read through the notes here
    with the scale, which also really helped.  I guess her first
    test came out at 30...so we'll see.
    
    What a helpless feeling!
    Julia

    re:  1140.16 ... to Mair
    
    The test results just came in and all is well!
    Yippee!
    
    Thanks for the support....Julia

    I'm glad to hear the test results are fine.  I know how relieved I was
    to hear about Stephanie's normal tests. Whew!
    
    					Mair