Lead in water is probably not the main cause of elevated lead levels in children, medical expert says

Although the number of children living in Illinois ZIP codes where they are required to receive lead exposure testing has grown, a medical expert thinks well-known sources of exposure are still the main culprits.

Dr. Susan Buchanan, a clinical associate professor and the associate director of the occupational and environmental medicine residency program at the University of Illinois Chicago School of Public Health, said lead found in paint used inside older homes remains the primary source of lead exposure for children.

“The primary source is in old buildings,” Buchanan said.

She also said lead found in public water systems isn’t the main driver of elevated lead levels in children.

“There is lead in a lot of the plumbing, especially in our urban areas, but water is not a major source of lead because the actual levels in water are such that a child would have to drink exorbitant amounts of water to raise their lead levels,” Buchanan said.

In 2021, Illinois legislators sought to mitigate the public’s exposure to lead through the Lead Service Line Replacement and Notification Act. That piece of legislation requires municipal water systems in Illinois to replace lead service lines by 2034, according to the Illinois Environmental Protection Agency.

Regardless of the source of exposure, lead can have harmful and adverse effects on a child’s health, including damage to the brain and nervous system and slowed growth and development, according to the U.S. Centers for Disease Control and Prevention.

Learning, behavioral, hearing, and speech problems are all associated with lead exposure, according to the CDC.

Dr. Chukwunonye Ogbuji, an OSF Healthcare pediatrician, said lead exposure can cause learning difficulties and disabilities that impact the rest of a child’s life.

“Some of the damages are irreversible, like the behavioral problems, attention problems, hyperactivity,” Ogbuji said. “You may see kids who have no history or family history of ADHD, you know, presenting with symptoms like that or presenting with autistic symptoms, it could be as a result of lead exposure.”

That’s not theoretical, Ogbuji said he’s seen the consequences of lead exposure in Streater and Ottawa.

“Unfortunately, we do see some children with high lead levels here,” Ogbuji said. “We do see a good number of children with high lead levels. Streater, unfortunately, has some houses that might be a little old ... so children who live in those houses, they usually get exposed to lead.”

Ogbuji and Buchanan said structures built or painted before 1978 are where many children with elevated lead levels are exposed to the toxic metal.

“If they live in an old house or they see kids putting like paint chips in their mouth, [parents or guardians] should be, they should be very, you know, concerned about that, that those kids might be exposing themselves to lead at that point,” Ogbuji said.

Buchanan said children often ingest lead paint dust when they put their hands in their mouths after playing in areas contaminated with lead. Those areas aren’t confined to old buildings, however. She said lead-contaminated soil is also a chronic culprit.

Parents and guardians who seek to mitigate their child’s risk of lead exposure are also encouraged to wash their child’s hands after playing in outdoor areas near old roadways. That’s because lead gasoline, which has been completely banned in the U.S. since 1996, can still be found in the soil near roads that once saw vehicles that ran on lead gasoline.

“Lead is a metal, and so it doesn’t break down. So once it’s in the soil, it’s not going away,” Buchanan said. “The soil in all old urban areas is contaminated with lead. The other important issue is that it takes very little lead-contaminated dust to raise a child’s lead level, unlike water.”

Changes in state policy mean more children will be tested for lead exposure

In June, the Illinois Department of Public Health added 180 new ZIP codes to its list of areas where children are required to receive lead exposure testing. Cook, DeKalb, DuPage, Kane, Kankakee, Kendall, Lake, La Salle, McHenry, and Will counties were among the 47 counties containing ZIP codes added to the testing list. Every ZIP code in Illinois is expected to be put on that list in 2026, according to IDPH.

Those policy changes stem from the Lead Poisoning Prevention Act, which requires children living in high-risk ZIP codes in Illinois to be tested for lead exposure when they turn one and two years old.

Ogbuji said the parents of children over that age are often given a questionnaire used as a screening tool to determine a child’s risk of elevated lead levels in their blood, but stressed the importance of blood testing one and two-year-olds.

“I think it is important that parents make sure their kids go to those appointments at those ages and get their lead levels checked,” Ogbuji said.

Buchanan said the 180 ZIP codes that were put on the lead exposure testing list were added because state legislators lessened the amount of lead that can be found in blood before public intervention is required.

If the blood tests indicate lead levels of more than 3.5 micrograms per deciliter, public intervention is required. The threshold for public intervention was 5 micrograms per deciliter until Jan. 1, 2025, according to the Lead Poisoning Prevention Act.

Buchanan said she supports the state’s new lower threshold.

“Our science is advancing, in our ability to detect subtle neurocognitive abnormalities in young kids,” Buchanan said. “What our science has shown is that even very low levels of blood lead affect neurocognitive abilities.”

Of the 206,016 children who were given lead exposure blood tests in 2023, 3,217 children were found to have blood levels over the public intervention threshold, according to the Illinois Lead Program 2023 annual surveillance report.

Public interventions include a home inspection to determine the source of lead exposure and what removal options can be used. Additionally, a public health nurse visits the family to identify ways to protect the children from lead exposure.

Ogbuji said children with elevated blood lead levels are retested one or three months after the elevated lead levels were discovered.

In the Rockford region – Jo Daviess, Stephenson, Winnebago, Boone, Carroll, Ogle, DeKalb, Whiteside and Lee counties – nearly 11,000 children were given blood, lead exposure tests in 2023. Of those children, 214 had blood lead levels at or above the old public intervention threshold, and 361 were above the new limit.

The number of elevated blood lead levels cases was not uniformly distributed between races. While Black children were 20% of the children tested for elevated blood lead levels, 29% of all children with elevated results are Black, according to the surveillance report.

Of the children tested, 19.5% were Medicaid recipients, and 2% of those children had elevated blood lead levels. Of the 80.5% of children who weren’t on Medicaid at the time of the tests, 1.5% had results requiring public intervention.

Buchanan said children from families with higher incomes are often more able to mitigate exposures to lead than those with less capital available to them.

“The best solution is the really expensive one, which is turning over this old housing stock and remediating all the lead paint indoors,” Buchanan said. ”It’s basically too expensive. So what people can do on an individual level is make sure kids wash their hands a lot."

Here are the ZIP codes that now require lead exposure testing in Shaw markets

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