Examining Trends in Early Childhood Lead Exposure Using the National Poison Data System: 2007-2024

Lead is an important public health problem in the U.S., as blood lead concentrations have been linked to decreases in IQ in otherwise asymptomatic children. The role of poison centers (PCs) in childhood lead exposures has yet to be described. We sought to characterize lead exposures reported to U.S. poison centers for infants, toddlers, and preschool-age children (≤ 5 years) from 2007 to 2024.

Retrospective data collection and descriptive analyses were performed for childhood lead exposures occurring in the United States reported to the National Poison Data System (NPDS) between 2007 and 2024 among children aged 0-5 years. Descriptive analyses were performed to examine demographic characteristics, exposure characteristics, treatments, and medical outcomes associated with lead exposures.

There were a total of 20,009 lead exposure cases reported in NPDS between 2007 and 2024. Lead exposures decreased from 1,798 cases reported in 2007 to 914 in 2020. Since 2020, lead exposures increased to 1,390 cases reported in 2024. Specific substances or sources of lead were not identified or described in most cases (17,846, 89.2%). In cases where specific sources of concern were identified (2,163, 10.8%), common sources reported include fishing sinkers (577, 26.7%), lead pellets (547, 25.3%), magazine print (533, 24.6%), and aquarium thermometers (324, 15.0%). Among patients followed to a known medical outcome, few experienced moderate (516, 2.6%), or major (57, 0.3%) effects, and there were no recorded deaths.

Lead exposure cases reported to NPDS in early childhood declined overall from 2007 to 2020 but have been increasing since 2020. In most cases, no specific substance of concern was identified. Additionally, few cases reported to poison centers experienced severe outcomes. Children aged 1-2 years accounted for the majority of cases in the National Poison Data System. Reasons may include increased mobility and exploration, hand-to-mouth behaviors, and efficient lead absorption in this age range. Other factors such as mandated lead testing at ages 12 and 24 months for children enrolled in Medicaid might also contribute to the observed age distribution.