Most children with elevated blood lead levels have no symptoms. Iowa recommends testing at ages 1 and 2.
When families hear the words “lead poisoning,” they may first think of old, peeling paint. There is good reason for that: lead-based paint and the dust it creates in older homes remain among the most common sources of childhood lead exposure.
In Iowa, the risk deserves particular attention. Iowa Health and Human Services warns that most homes in the state built before 1978 contain some lead-based paint, even if they have been renovated or repainted.
But paint is not the only potential source. Lead can also be found in soil, drinking water, cookware, toys and some everyday products. It can even be brought into the home on an adult’s clothing or belongings.
Young children face greater risk because they crawl, play on the floor and frequently put their hands, toys and other objects in their mouths. Here are seven potential sources of exposure parents and caregivers should know about.
1. Dust in older homes
Most Iowa homes built before 1978 contain some lead-based paint. Even when that paint is covered by several newer layers, it can still create contaminated dust.
The danger is not limited to peeling paint. Friction from opening and closing older doors or windows can release small particles. Sanding, cutting, demolishing or repairing painted surfaces can also create significant amounts of lead dust.
Children can accidentally swallow that dust after touching floors, window frames, toys or other contaminated objects and then putting their hands in their mouths.
Wet-cleaning floors and surfaces and frequently washing children’s hands and toys can help reduce exposure. Improper sweeping or vacuuming can stir settled dust back into the air.
Families planning renovations in homes built before 1978 should learn about the Environmental Protection Agency’s lead-safe renovation practices before work begins.
2. Soil around the home
Lead can also be found outside the home. Soil near older buildings may be contaminated by deteriorating exterior paint, historical emissions from leaded gasoline or industrial activity from years past.
When children play in areas with bare soil, contaminated particles can remain on their hands, clothes and toys. Adults can also track the soil indoors on their shoes.
Covering exposed soil in areas where children play with grass, mulch or another barrier can reduce contact. Taking shoes off at the door and washing children’s hands after outdoor play are other simple precautions.
Families growing fruits or vegetables near an older home, busy roadway or former industrial area can contact their local health department to ask about soil testing options.
3. Drinking water and plumbing materials
Lead can enter drinking water when pipes, service lines, solder, faucets and other plumbing components containing the metal corrode.
Service lines connect a home to the main water line. These lines and other older plumbing materials are more common in some cities and in homes built before 1986.
Water contaminated with lead does not necessarily look, smell or taste different. Testing is the only way to determine whether the water contains a harmful amount.
People concerned about their home’s plumbing or drinking water can contact their local water utility or public health agency to ask about available testing and recommended steps. The Environmental Protection Agency also provides information about lead in drinking water.
4. Toys, jewelry and vintage items
A toy passed down through generations or a colorful piece of children’s jewelry may deserve a closer look.
Lead has been found in some imported toys and jewelry, as well as antiques, furniture, collectibles and products manufactured before current safety standards took effect.
Objects that children frequently handle or put in their mouths require particular attention. An older item should not automatically be given to a child simply because it remains in good condition or has sentimental value.
The U.S. Consumer Product Safety Commission maintains an updated list of toys, jewelry and other products recalled because of lead and other hazards.
5. Dishes, pottery and cookware
Ceramics and traditional pottery are part of the culture and homes of many families. However, some glazes used on imported, handmade, antique, decorative or improperly manufactured pieces may contain lead.
When pottery contains a lead-based glaze, the metal can leach into food or drinks prepared, served or stored in the container. The risk may increase when the surface is cracked, damaged or worn.
This does not mean that all traditional, handmade or imported pottery is dangerous. Containers used for cooking, serving or storing food should be clearly identified as safe for food use.
Decorative, antique or unknown-origin pieces should not be used with food or beverages unless they have been confirmed as safe for that purpose.
6. Some foods, spices, cosmetics and traditional remedies
Lead has been found in some candies, spices, cosmetics, ceremonial powders and traditional remedies. Contamination can occur during manufacturing, grinding, coloring, storage or packaging.
The Centers for Disease Control and Prevention has documented lead in some remedies known as greta or azarcon, eye products such as kohl or surma, and certain imported foods, candies and spices.
It is not possible to tell whether a product contains lead by its appearance, smell or taste. Even the person selling it may not know that it is contaminated.
This also does not mean that all imported foods, products or traditional remedies contain lead. Choosing clearly labeled products, avoiding items with unknown ingredients or origins and checking health alerts can help reduce risk.
The CDC provides information about foods, cosmetics and remedies linked to lead exposure. If a family suspects that a child used or consumed a contaminated product, they should tell the child’s healthcare provider.
7. An adult’s job or hobby
In some homes, lead can be carried inside on the skin, hair, clothing, shoes, tools or vehicle of an adult who is exposed at work.
Jobs that may involve lead exposure include construction, renovation, painting, welding, manufacturing, automotive repair, battery or metal recycling and work involving ammunition.
Some hobbies may also involve lead, including stained-glass work, the use of fishing weights or lures, pottery making and ammunition reloading.
Workers should follow the safety procedures established at their workplace and avoid bringing contaminated clothing, shoes or equipment into areas where children live or play. When appropriate, work clothes should be changed before entering family living areas and kept separate from other clothing.
Iowa recommends lead testing at ages 1 and 2
Most children with elevated blood lead levels do not have obvious symptoms. A child can look and feel healthy and still have been exposed.
A blood test is the only way to determine a child’s blood lead level.
At a minimum, Iowa Health and Human Services recommends that all children in the state receive blood lead testing at ages 1 and 2. Children with additional risk factors may need annual testing through age 6.
A child’s risk can change as they grow, begin crawling, spend time in different places or come into contact with new products. For that reason, an earlier test does not rule out future exposure.
Iowa also requires children to have received at least one blood lead test before entering kindergarten. The state provides religious and very-low-risk exemptions for families who meet the applicable requirements.
Related: How to protect children from lead poisoning
How to get a lead test in Iowa
Families can ask their child’s healthcare provider whether a lead test is already recorded in the child’s medical record. If there is no record of one, they can request a blood lead test.
Some community agencies and local health departments also provide testing or can help families find a location where testing is available.
There are two main types of blood lead tests:
- Capillary test: uses a small blood sample taken from a finger or heel and is typically used as an initial screening test.
- Venous test: uses blood drawn from a vein and provides a more precise result. It is generally recommended to confirm an elevated capillary test result.
Most private insurance plans and public programs, including Medicaid and Hawki, cover the cost of blood lead testing. Families without insurance or another way to pay can contact their local health department.
The Iowa Childhood Lead Poisoning Prevention Program provides information about testing, results and available services. Families can also call 1-800-972-2026 for assistance.
Lead exposure is preventable. Identifying potential sources and completing recommended blood lead testing can help families take action before exposure goes unnoticed.
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