LEAD INTOXICATION occurs most frequently in children between 1 and 3 years of age. (In the various series of cases reported in the literature approximately 85% of the cases were first diagnosed in the children in this age range.) For reasons not completely understood approximately 80% of symptomatic cases occur during the summer months. With rare exceptions children exhibiting clinical lead intoxication reside in the older sections of urban areas where they may have ready access to crumbling, peeling or easily chipped paint. Lead pigment paints were widely used for indoor painting until approximately 25 years ago. Lead pigments are still found in exterior paints, particularly those specified as mildew suppressants. Since the absorption of lead from the intestine proceeds slowly a child must nibble upon these flakes for several months before a quantity of lead sufficient to produce toxic manifestations is absorbed into the body. The child need ingest only a few chips each week; but if he continues this practice for longer than 3 to 6 months the clinical manifestations of lead intoxication to be described may occur thereafter, especially during the summer months. Although a history of pica may be a valuable question to ask in public health surveys, one must not overlook the possibility of pica even when it is denied. It is important for the clinician to realize that mothers may or may not observe their children eating a paint chip now and then. Even when they do see it they may not attribute much importance to the ingestion of the paint. If the clinician strongly suspects the possibility of lead poisoning he should proceed with the necessary laboratory diagnostic steps.
- Copyright © 1961 by the American Academy of Pediatrics