Lead and children: clinical management for family physicians.
OBJECTIVE
To provide family physicians with a practical, evidence-based approach to screening for and preventing children's exposure to lead.


METHODS
MEDLINE was searched using terms relevant to lead exposure and poisoning. We reviewed English-language articles published in 2003 to 2008. Most cited studies provide level 2 or 3 evidence.


RESULTS
Lead is a developmental neurotoxin. Children are most commonly exposed and they are most vulnerable. Lead exposure has been associated with many cognitive and motor deficits, as well as distractibility and other characteristics of attention deficit hyperactivity disorder. Although children's blood lead levels have declined considerably over the past 3 decades with removal of lead from gasoline and paint, children can still be exposed to lead from lead paint in older homes, toys, and other sources. Because post-exposure treatment cannot reverse the cognitive effects of lead exposure, preventing lead exposure is essential.


CONCLUSIONS
Family physicians have an important role in screening for children at high risk of lead exposure, and in educating families to prevent the exposure of children to lead.
Abelsohn
Alan R
AR
Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto, Canada. alan.abelsohn@utoronto.ca
Sanborn
Margaret
M
D002170:Canada; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000517:prevention & control; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000379:methods* / Q000592:standards; D006801:Humans; D007854:Lead / Q000032:analysis / Q000633:toxicity; D007855:Lead Poisoning / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000517:prevention & control; D010150:Paint / Q000633:toxicity; D011314:Preventive Health Services / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D014481:United States; D014881:Water Supply / Q000032:analysis
D007854:Lead