It’s hard to sort through all the information swirling about lead contamination in the public drinking water in Flint, Mich., and how it has affected and will continue to affect the people who unknowingly drank the water.

Dr. Sharon Swindell, a pediatrician and assistant professor of pediatrics from the University of Michigan, and Dr. Kanta J. Bhambhani, director of the Lead Poisoning Clinic at Children’s Hospital of Michigan and co-director of its neuro-oncology program, offered insight into the short- and long-term effects of lead poisoning in children, how to tell whether your child has been exposed and how parents can help limit the damage in their children.

One important thing to know is that even kids outside of Flint have been exposed to lead, not through the drinking water, but from other sources.

“The biggest source of lead exposure is paint or dust from paint in older houses,” Bhambhani said, referring to any home built before 1978, when lead in paint was banned. “But, obviously, water is on a lot of people’s minds, and there are good tests for both,” Bhambhani said. “It’s possible to test the paint, and it’s possible to test the water. And so if families have concerns, they should have their home tested. They should have the water tested, and they should bring their concerns to the child’s pediatrician and if we have any concern that a child has risk for exposure, we do a test of the child’s blood-lead level.”

Lead also can be found in the soil of former industrial sites or where older homes have been demolished. Other sources of lead exposure include batteries, solder, pipes, pottery, roofing materials and some cosmetics.

If you’re doing renovations to your home or refinishing old furniture, consider lead paint as a possibility.

In 2013 the Michigan Department of Health and Human Services reported 5,702 children under the age of 6 with blood-lead levels of at least 5 ug/dl, and 653 with blood-lead levels of at least 10 ug/dl. No level of lead in the bloodstream is considered safe. And yet, 142,153 Michigan children under the age of 6 tested positive for small amounts up to 5 ug/dl.

“Older homes are among the biggest sources,” Swindell said. “If you’re living in poor-quality, older housing sources, and the paint isn’t in good repair, that has always been the biggest source of lead exposure for kids.”

Q&A

What you need to know about lead poisoning

Question: How do you know whether your child has been lead-poisoned?

Answer: Ask your doctor to have your child’s blood-lead level tested.

A simple blood test will show lead exposure within the last 20 to 30 days but will not show earlier exposure because lead settles into a person’s bones, like calcium.

All children enrolled in Medicaid are tested at ages 1 and 2, and kids who live in high-risk ZIP codes also should be tested at ages 1 and 2, as well as any child in a home built prior to 1978 with chipping paint, or in any older home where renovations have recently taken place.

And if any parent is concerned about the possibility of lead exposure, the recommendation is to talk to a doctor about testing.

Q: Why is everyone so concerned about kids being lead-poisoned?

A: Children, but especially kids under the age of 6, are more vulnerable to the effects of lead poisoning because they are still growing and developing. They also are so small that their bodies ingest more of the toxin. Lead poisoning cannot be reversed or undone. The damage is permanent.

“After age 6 the effect on the brain is not as severe,” Bhambhani said. “Not only that, young children will absorb about 50 percent of the lead they’re exposed to — compared to older children, which is about 5 to 10 percent. And it’s even less for an adult. The absorption of lead is much, much higher in young children. And of course the effects are also greater in younger children. The risk is greatest at less than 6 years of age, and the younger the child, the greater the risk.”

Q: Are there symptoms of lead poisoning in children?

A: Every child is different. Young children with lead poisoning might fail to meet developmental milestones or lose the ability to do things they once were able to do. Other children might have a delayed response and show lead exposure through behavioral problems or attention deficit disorder as they get older. Other kids might have an entirely different response.

“There’s not a set milestone in very young children that we’re looking for to say lead is the problem, because there are so many things that are affecting a child’s development at that age,” Swindell said.

According to the Mayo Clinic, other symptoms in children include:

>> Learning difficulties.

>> Irritability.

>> Loss of appetite.

>> Weight loss.

>> Sluggishness and fatigue.

>> Abdominal pain.

>> Vomiting.

>> Constipation.

>> Hearing loss.

In cases of very high exposure, it can cause seizures, coma and death.

Q: Are even small amounts of lead exposure OK?

A: No. There is no safe level of lead in the body.

“Lead is a neurotoxin and affects the growing brain,” Bhambhani said. “That is why it is so critical that these children are tested for lead levels and if the lead levels are high, then appropriate interventions are in place as soon as possible.”

Q: What can I do if my child’s blood test shows he or she has been exposed to lead?

A: “First and foremost,” Bhambhani said, “is to remove the source of lead.”

“Everything we know about the effects of lead in children is that prevention is, by far, our No. 1 goal because once the damage has been done, there’s not been research to show you can undo it,” Swindell said. “Then, our next step is to halt any additional exposure and progression of any effects. And then, the third thing is to buffer those effects as much as we can by optimizing the child’s development in every other way, making sure they have good access to health care and access to good nutrition.”

Q: How should I know when to take my child to the doctor about potential lead exposure?

A: “Don’t wait. If you have a concern, or if there is a possibility of lead exposure in the environment, talk to your doctor about it,” Swindell said.

“I think one of the most important things from the standpoint of a pediatrician is access to regular health care because we do regular checkups on children not just to give them immunizations, but one of our tasks at every one of their well-child visits is to monitor their development,” Swindell said.

Q: What if I live in an old house with chipping paint?

A: Any house built before 1978 likely has some lead paint on walls, even if they’ve been repainted and recovered, Bhambhani said.

“The lead-based paint in older homes is oil-based, and the paint they sell now is water-based, so they aren’t really compatible,” Bhambhani said. “It’s really like a Band-Aid if you put the new paint on the old paint. If the underlying problem isn’t taken care of, it’s going to peel and chip again and be available to the child.”

In any older home that isn’t well maintained or where there is chipping paint, children are at risk.

“Get rid of peeling and chipping paint, and generally that is done with the help of the Health Department or with their direction using licensed contractors, and also, there are some nonprofit organizations … that have helped families try to get rid of environmental lead from old lead-based paint.

“We also talk to the families about windows that go up and down. With the friction of opening and closing the windows, paint in the window wells can chip and collect at the base of the window. If the child is standing and the window is sort of low and the child is standing over there, the child can have access to the paint that’s collected in the window wells.”