Guidance

Lead: information for the public

Published 8 October 2024

If you think your child has lead poisoning

Effects of lead poisoning in children

Children are particularly sensitive to the effects of lead on the nervous system as their brains are still developing. Children exposed to lead during the first few years of life may have a lower IQ, behavioural problems or nerve damage.

Eating food or drink or breathing in air contaminated with lead or lead compounds for a short period usually does not cause any ill effects. Additionally, in the UK lead levels are under stringent control and exposures to lead in water, air and food are reduced to the lowest practical level to minimise possible risks to health.

Low levels of exposure may not cause obvious health effects. Exposure to high levels of lead in a short time can result in stomach upset, mood changes, poor attention span, headaches, and damage to the brain and kidneys in severe (high dose) cases.

Potential sources of exposure

As lead is controlled in the UK, most exposure to lead is from historic sources such as houses built near lead smelters and busy roads where leaded petrol as exhaust or dust, has been deposited in gardens. In the home, lead pipes, red lead paint on metal work, leaded paint on windowsills, bannisters, door frames and doors can still exist. Lead paint was common before the 1970s and although lead paint has not been used after 1992, prior to this UK paint may have contained up to 50% lead by weight (500,000 mg/kg), which is potentially capable of causing lead poisoning in a small child if they eat just a single flake. Leaded paint at these concentrations may still be found in non-remediated Victorian properties, often below newer non-leaded paint.

Many babies and infants put non-food items in their mouths; this oral sensory seeking behaviour, or mouthing items, is a normal behaviour in babies and infants. They use sucking to help to calm themselves and self soothe. However, older children may develop an eating disorder known as pica where they eat items that are not typically thought of as food such as hair, dirt, and paint chips.

If your child has pica and picks at loose paint flakes or chews wooden painted items then your child may need a blood test. Vitamin and mineral supplements may decrease pica behaviour. Taking your child’s mind away from it can also work. Paediatric occupational therapists can provide advice (see support and charities section).

If you have any health concerns regarding exposure to lead seek guidance from your GP or contact NHS 111.

Pregnancy and the unborn child

How to protect yourself from lead exposure

It is recommended that pregnant women avoid activities with a risk of high levels of lead exposure. If they cannot (for example at work), then use of personal protective equipment to limit the exposure is advised. The use of traditional medicines and cosmetics where the ingredients are unknown or the products may be unregulated (such as unbranded items bought on the internet), are not recommended during pregnancy.

If you think you may have been exposed to a high level of lead, you are advised to speak to your doctor. The local public health team can offer advice, including on how to avoid further lead exposure and any treatment.

Antenatal care

As part of your routine antenatal care you will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth. If blood tests have shown high levels of lead during pregnancy, additional monitoring to check that the baby is growing as expected is likely to be offered, as well as further blood tests to ensure that lead levels are returning to normal.

If your partner has been exposed to high levels of lead

There is some evidence that miscarriage and reduced growth of the baby in the womb may be more likely in pregnancies where the father had high blood lead levels around the time of conception. However, more research is required to confirm this finding. For more information please go to Bumps: best use of medicines in pregnancy. The ‘Leaflet A to Z’ tab provides advice for a number of conditions and exposures and lead is listed here.

If you have any health concerns regarding exposure to lead seek guidance from your GP or contact NHS 111.

Vulnerable groups

Pregnant women, infants and young children are particularly sensitive to the harmful effects of lead.

Lead and cancer

The International Agency for Research on Cancer (IARC) evaluated the available evidence regarding the ability of inorganic lead compounds (such as those in lead paint) to cause cancer. IARC concluded that there was sufficient evidence in experimental animals, but only limited evidence in humans from occupational studies in workers exposed to lead for several years. As a result inorganic lead compounds were classified as probably able to cause cancer in humans.

Advice from UKHSA and local authorities

If either your child or you (when pregnant), have a blood lead concentration above our intervention concentration we will get involved with your clinician (such as your paediatrician or GP) to try and identify the source of the lead and help you prevent or decrease your exposure to it. 

As part of our work in trying to identify the source of the lead we may ask lots of questions about your home and about you to help us make sure you and your child are not harmed by it. Some of these questions may appear personal, however they may highlight the source of lead.

You may be asked about:

• your ethnicity, because certain traditional medicines or imported products can contain lead, and recent migrants, or families that have spent several weeks abroad, may have elevated lead levels due to lead in water and food in the place they visited – many countries do not have such stringent regulations for levels of lead in food and water as the UK and EU

• drugs, because some drugs, such as illegal cigarettes or opium, are known to contain lead

This information will only be used by ourselves for identifying potential sources of lead. The information will not be shared with other agencies except for health purposes or if we think we might have identified the source of lead and decide to sample it to confirm. Either UKHSA or the local authority environmental health officer will take samples, and results will take approximately 2 weeks from a laboratory that does lead analysis.

If we think the source could cause lead poisoning in other members of the family (particularly other children) we will ask for them to be tested for lead (a blood test) as well.

Once we find the source of lead, we will work with you and the local authority to find a way to prevent exposure. This might be a temporary mitigation such as running your main tap to remove standing water if there is lead in your drinking water pipes, to covering paint or preventing a child from accessing certain rooms. For more mitigation please see below.

Mitigation of lead in your water supply

If the suspected lead source is your drinking water, your water supply company (or the owner of a private water supply) should test the water. If your home was built before 1970 it may have lead pipes; since 1999 it has been illegal to use lead solder or brass fittings in water supplies (although it can still be used for central heating systems).

Routine sampling by a water company can identify lead and determine whether the levels exceed the prescribed drinking water concentration value of 10 μg/L. They will tell you as the customer or UKHSA or both if the water is considered unsafe to drink. Where lead has been determined, lead concentrations should drop below 10 μg/L after the drinking water pipes are flushed by running the taps (see below).

There is information available on your local supplier’s website and on the Drinking Water Inspectorate’s (DWI) website under Learn more about your water where there is an information leaflet on lead and how to identify it in your home. 

If you are planning on replacing your pipework, we recommend that you employ a qualified plumber to carry out any plumbing work, for example one who is accredited through the WaterSafe scheme. The DWI’s website also provides an advice leaflet for finding a plumber.

For drinking and cooking, run the main tap (generally the kitchen tap) to clear any water that has been standing in the pipework for a while, for example, overnight. A washing up bowl full is normally enough to clear the pipe of standing water, although if you have a long service pipe you may need to run the tap for longer; generally 2 to 3 minutes is enough. Check to see if you notice the temperature of the water drop as the mains water comes through (run the tap over your fingers and you should notice the change of temperature as fresh mains water arrives). You can then use the kitchen tap as normal.

Mitigation of lead in soil

Soil in post-industrial or urban areas

Soil within gardens may be contaminated with lead if you live in an area that was industrial in the past or if you live near a busy road. Lead can also be found in soil naturally if you live in an area that was mined previously for metal, such as the Mendips or Northern Pennines. Soil in most urban areas contains chemicals such as lead, but generally not in concentrations that can affect your normal enjoyment of the garden or growing flowers and vegetables.

We have published guidance on the safe use of potentially contaminated residential land, gardens and allotments.

Soil and young children

Most toddlers will eat or pick at soil at some point. However if your child has pica, (defined by USEPA as the recurrent ingestion of unusually high amounts of soil, in the order of 1-5g per day (1)), then you should discuss this with your GP who may recommend blood tests. If your child has pica and has already been tested for blood lead concentrations and the levels are high, then as part of the investigation to determine the source of lead exposure, UKHSA and the local authority environmental health department can discuss the likely presence of lead via databases of previous industries and land use in your area, and then arrange soil sampling if required.

Interpreting the results can be challenging and samples from urban settings often have lead concentrations close to or exceeding screening levels for land contamination.

To prevent the child eating soil, remediation measures may include supervision of the child in the garden and laying a barrier of some kind (wooden decking for example) over sections of the garden to prevent the child’s access to the soil.

Mitigation of lead in paint

Most cases of lead poisoning in children are caused by the consumption of paint containing lead; generally due to compulsive eating of non-food items known as pica. Paint may flake due to damp or wear, or the child may chew wood or metal painted surfaces. 

An indication of the presence of paint containing lead includes multiple coats of paint in properties built before 1970, although in some properties leaded paint can be found from the very early 1990s. If the paint is in good condition or the property has been redecorated, then the lead should be sealed in and there should not be an exposure pathway unless your child has pica. Exposure is only likely if the paint is deliberately removed or sanded during redecoration. 

Sampling of the paintwork can be carried out with test kits sold on the internet but these are not accurate and may give a false answer, although can be useful if you are about to start renovation to see if lead paint exists. If your child is identified as having lead in their blood, and the source is likely to be lead paint, the local authority (environmental health or housing department) or housing association may be able to undertake sampling. This will be from areas where a child is known to have eaten paint flakes, or in areas where paint is noticeably flaking or has visible signs of biting or picking.  The best short term mitigation methods are to prevent access to the room, block the paint area with furniture or cover it with Perspex or plastic. 

Children with elevated blood lead levels may have inhaled dust and fumes via old paint removal during redecoration of older properties. A public information leaflet produced by Defra provides advice on how to limit exposure using protective equipment, and children should not be present during this work until all dust is removed, and the area ventilated.

Other potential sources of exposure and mitigation

Kitchen items

Lead can be found in certain kitchen items such as ceramics glazed with lead, lead crystal glass and pewter items. Leaching is more likely to occur with acidic items such as fruit. Lead was previously used as solder for canned produce but cannot be sold in the UK. If bought in the UK or EU, most cookware must be suitable for use so it does not contaminate food, however utensils and cookware from outside of the EU may not conform to this standard. Mitigation measures are to only use cookware sold in the UK or EU from a known reputable supplier.

Lead residue on clothing

Lead can be brought into the home through parental or carer hobbies such as jewellery making, stained glass, enamelling or pottery. Clothing used at work for parents or carers involved in foundry work, welding, roofing, the waste industry, or the construction, demolition or renovation of properties, may bring lead as dust into the home. Mitigation measures are wearing any protective gear you have been given by your employer, changing clothes at your workplace or immediately on getting home, and avoiding sitting on furniture and in the car with lead dust potentially on you. Food preparation or eating or smoking should not occur until hands, forearms and face have been washed.

Traditional medicines, herbs, spices and cosmetics

The most common source of lead after paint, is from imported herbs, spices and traditional medicines and tonics.

Whilst spices brought from a UK supermarket are legislated under food standards, when brought abroad they can be adulterated by lead (2). Lead chromate can be added to turmeric to brighten its golden colour and lead oxide to chilli powders to enhance their red colouring. Other spices or spice mixes can also contain lead (3).

One study in the USA, which looked specifically at Ayurvedic medicines, found that around 20% were contaminated with lead, and traditional medicines from many other areas of the world may also contain lead (for example, China, West Africa, South America, and Australasia).  If a lead contaminated herbal remedy was purchased in UK, we will liaise with the local Trading Standards team to ensure that there is no further opportunity for the medicine to be used by other members of the public. However, these medicines and tonics are often purchased abroad.

Traditional eye cosmetics known as kohl, kajal, al-Kahal, surma, tiro, tozali, and kwalli often contain high levels of lead. For example, lead, usually in the form of lead sulfide, sometimes accounts for more than half the weight of kohl products. These may be commonly imported from Africa and the Middle East.

Calabash chalk (also known as Argile, La Craie, Mabele, Nzu or Shiley) is sometimes eaten during pregnancy in the Asian and African subcontinent where it is believed to act as an antidote to morning sickness or nutritional supplement, and often these may contain elevated lead levels (4).

Support for children with pica

If your child has pica an option to help you manage this for your child is occupational therapy. Occupational therapy is available through the NHS or social services depending on your situation. You can ask your GP or paediatrician for a referral. Occupational therapists work with people of all ages and can look at all aspects of daily life in your home, school or workplace and can find ways to help reduce pica or provide a distraction for the child so they do not chew on items that can harm them.

Some children with pica have other learning and development challenges. If they are diagnosed with autism there is support for everyday things, to make it easier for you and your child. The NHS provides links to charities and organisations that can provide support.

This not only includes physical support, but emotional support and help, such as arranging for children at nursery or school to discuss help from special educational needs (SENCO) staff.

The National Autistic Society provides tools, tips and suggestions to support children and adults with needs on the autistic disorder spectrum.

If your child is diagnosed with a learning disability (a reduced intellectual ability and difficulty with everyday activities), there is an explanation at Learning disabilities.

You may also find MENCAPs site for advice and support useful.

However, if your child’s behaviour can be defined as ‘challenging’ (if it puts them or those around them (such as their carer) at risk, or leads to a poorer quality of life), there is also specialised support and the charity the Challenging Behaviour Foundation who provide advice for parents and professionals.

More information

For more information on lead, the LEAPP Alliance (Lead Exposure and Poisoning Prevention Alliance) is a joint initiative of the Lead Containing Materials Association and Lead Safe World UK is a charitable organisation that campaigns for lead removal in the UK.

The World Health Organization runs a web area for lead. It notes that recent reductions in the use of lead in petrol, paint, plumbing and solder have resulted in substantial reductions in population-level mean blood-lead concentrations. However, significant sources of lead exposure still remain. The site provides leaflets on how to reduce your lead exposure.

References

1.USEPA. Child-Specific Exposure Factors 2008

2. Public Health England. Chemical Hazards and Poisons Report 2016, issue 26

3. Saini S and Porte SM. Ayurvedic Aspect of Lead and its Chronic Toxicity International Journal of Research in Ayurveda and Pharmacy 2014: volume 5, issue 1

4. Public Health England. Alert issued to pregnant women in London following reports of toxic ‘antidote’ to morning sickness