PEDIATRICS Vol. 89 No. 4 April 1992, pp. 740-742
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Prevalence of Radiographic Evidence of Paint Chip Ingestion Among Children with Moderate to Severe Lead Poisoning, St Louis, Missouri, 1989 Through 1990

Michael D. McElvaine DVM, MPH1, Thomas D. Matté MD, MPH1, Sue Binder MD1, Estilita G. DeUngria MD2, and Charles G. Copley MA2

1 From the Division of Environmetal Hazards and Health Effects, National Center for Environmental Health and Injury Control, Centers for Disease Control, Atlata, GA
2 City of St Louis, Departmet of Health and Hospitals, Division of Health, St Louis, MO.

Although experts once believed that ingesting chips of lead-based paint was the major cause of lead poisoning among children, conventional wisdom now holds that lead-contaminated dust and soil are the major routes of exposure. Data from a Childhood lead-poisoning treatment clinic were examined to assess the frequency with which children ingest paint chips. For this study, the reports on abdominal radiographs of 90 children with moderate to severe lead poisoning who had received their first chelation treatment during 1989 or 1990 were reviewed. According to a radiologist's evaluation, 13 of 90 abdominal radiographs (14%; 95% confidence interval [CI] 7% to 22%) showed evidence of paint chip ingestion. Of 46 children with blood lead levels ge 55 µg/dL, 12 (26%) had radiographs that showed paint chips, whereas only 1 (2%) of 44 children with blood lead levels <55 µg/dL had such radiographs (prevalence ratio = 11.5; 95% CI 1.6 to 84.6). The actual proportion of children with moderate to severe lead poisoning who have consumed leaded-paint chips is likely to be higher than this estimate based on radiographic evidence. While lead-contaminated dust is a major source of lead exposure, ingestion of leaded-paint chips clearly remains an important source of exposure among children with moderate to severe lead poisoning.

Key Words: lead poisoning • lead paint • radiograph

Submitted on August 23, 1991
Accepted on October 21, 1991