Wal Mart and Target

Abstract
Lead is a naturally occurring element that has been used by humankind for millennia, but a growing body of evidence confirms its serious toxicity for virtually all bodily systems. This paper reviews and discusses the relevant peer-reviewed and academic literature concerning lead exposure and poisoning and to determine their effects children’s academic performance. In addition, a discussion concerning the implications of the adverse effect of lead exposure and poisoning on children’s performance at school is followed by a summary of the research and important findings concerning these issues in the conclusion.
The Effect of Lead Poisoning on Children's Performance at School
Although it is a preventable disease, lead exposure in general and lead poisoning among children in particular remains a serious problem in the United States today. Lead poisoning is caused by the consumption of lead in some form including dust particles and lead-based paint chips (Lead poisoning still leads in environmental risk issues, 2009). Lead poisoning can affect individuals of any age from virtually any walk of life, but minority young people from lower socioeconomic families tend to suffer disproportionately in spite of aggressive efforts by the federal government to reduce the use of lead in occupational settings as well as in household paints and gasoline products (Lead poisoning, 2009) and even the lead solder used in household and commercial plumbing (Miranda & Anthopolos, 2011). In fact, current estimates indicate that at least 4 million young people in America live are at risk (Children and lead poisoning, 2017) and between a half million (McGill, 2013) and one million children in the U. S. already have dangerously high blood levels of lead above 5 micrograms per deciliter, the level at which the U.S. Centers for Disease Control recommends the commencement of public health actions (Lead poisoning, 2009). To determine the facts about this troubling this issue, this paper provides a review and discussion of the relevant literature to provide an overview of lead and lead poisoning and to determine the effect of lead poisoning on children’s performance at school. Finally, a discussion concerning the implications of lead poisoning’s adverse effect on children’s academic performance is followed by a summary of the research and important findings concerning the effect of lead poisoning on children’s academic performance are provided in the conclusion.
Overview of lead, lead exposure and lead poisoning
Although the element has a number of valuable commercial uses (Learn about lead, 2017), lead is enormously toxic to humans and there have been no safe blood lead levels for children identified in the research to date (Lead, 2017). In fact, lead poisoning is currently the most common environmental health problem affecting children in the United States (Endres & Montgomery, 2009). Although adults are also at risk, children are at greater risk of being harmed by lead exposure because the substance is more readily absorbed by them compared to adults, and their body tissues are especially sensitive to the harmful effects of lead (Currie, 2010). The high level of toxicity also means that exposure to lead can adversely impact almost all bodily systems (Lead, 2017).
Exposure to lead, however, may go unnoticed in children because there may not be any clearly discernible symptoms (Lead, 2017). Some of the more common symptoms and signs of lead poisoning in children include the following:
· Developmental delay;
· Learning difficulties;
· Irritability;
· Loss of appetite;
· Weight loss;
· Sluggishness and fatigue;
· Abdominal pain;
· Vomiting;
· Constipation;
· Hearing loss;
· Seizures; and,
· Pica (i.e., eating paint chips) (Overview of lead poisoning, 2017).
Moreover, these symptoms can persist well into adolescent and adulthood as well (Endres & Montgomery, 2009).
Although the majority of American homes constructed prior to 1960 contain paint with large concentrations of lead, the practice of using these durable paints persisted into the late 1970s (Overview of lead poisoning, 2017). Current estimates indicate that there are approximately 64 million housing units that contain lead paints in the United States today, and the overwhelming majority of these housing units are occupied by urban-dwelling, lower-income families (Overview of lead poisoning, 2017). As shown in Figure 1 below, American children who live in housing units that were constructed prior to 1978 are at far greater risk of experiencing lead exposure as a result of lead-based household paints (McGill, 2013).
Figure 1. Percentage of American homes likely to contain lead-based paint based on year built
Source: https://www.epa.gov/sites/production/files/lead/images/olderhomes.jpg
Likewise, schools and daycare facilities for children built prior to 1978 may also represent a source of lead poisoning (Overview of lead poisoning, 2017). Indeed, even soil, cookware, toys and playground equipment with lead-based paint can cause lead poisoning in children (Overview of lead poisoning, 2017). In addition, children living within 500 miles of airports where aircraft use leaded aviation gas suffer higher blood lead levels compared to other children (Miranda & Anthopolos, 2011). Indeed, Miranda and Anthopolos emphasize that, “Lead emitted from aircraft using leaded aviation gasoline (avgas) is currently the largest source of lead in air in the United States, constituting about 50% of lead emissions in the 2005 National Emissions Inventory” (p. 1514). Here again, because many lower-income residences are located in geographic proximity to airports, children from lower socioeconomic families are at higher risk of lead exposure and poisoning.
Despite these troubling issues, the good news is that blood lead concentrations in American have experienced significant and sustained decreases over the past 4 decades due to legislation and stricter standards for lead-based products as shown in Figure 2 below.
Figure 2. Timeline of lead poisoning prevention policies and blood lead levels in children aged 1–5 years, by year
Source: Prevention of childhood lead toxicity, 2017, p. 2
Notwithstanding this progress, though, the bad news is that hundreds of thousands and perhaps even millions of poor American young people are already suffering from elevated blood lead levels and many remain exposed to various sources of lead that are not typically shared by their more affluent counterparts. Many children from lower-income families continue to live in housing units with aging lead and corresponding elevated lead dust levels placing them at greater risk of lead exposure and poisoning and the corresponding academic deficits this can cause (Prevention of childhood lead toxicity, 2017). According to the American Academy of Pediatrics, “Evidence continues to accrue that commonly encountered blood lead concentrations, even those below 5 µg/d (50 ppb), impair cognition [and] there is no identified threshold or safe level of lead in blood” (p. 1). The most recent research shows that during the period from 2007 through 2010, more than half a million preschool students aged 1 to 5 years (about 2.6%) in the U.S. suffered from elevated blood level concentrations equal to or greater than 5 µg/d (Prevention of childhood lead toxicity, 2017).
As show in Figure 3 below, there are also a number of additional sources besides lead-based paints that place all American children at risk of lead exposure,
Figure 2. Respective contributions of lead exposure to children’s blood lead concentrations, Source: Prevention of childhood lead toxicity, 2017, p. 6
In most cases of lead poisoning, though, these sources of lead exposure have been shown to inordinately affect lower-income and minority children, but whenever housing units are renovated, the potential for exposure to lead becomes greater for families of all socioeconomic categories (Lead poisoning, 2009). Taken together, these trends indicate that a surprising number of American children are being slowly poisoned by their environments, but give the growing body of evidence concerning its harmful effects on a wide array of human systems, the adverse effects of lead exposure and poisoning on children should not be surprising as discussed further below.
Effect of lead poisoning on children's performance at school
There is a growing body of scientific evidence concerning the relationship between higher levels of blood lead developed during the early part of childhood and diminished academic performance, cognitive skills, motor skill development and intellectual levels (Endres & Montgomery, 2009). While some of the symptoms of elevated blood lead levels such as weight loss may not directly affect academic performance in substantive ways, lead poisoning has a direct effect. For instance, according to Currie (2009), “Health problems can affect a child's school readiness both directly and indirectly. Lead poisoning, for example, directly impairs a child's cognition and causes behavior problems” (p. 118).
Moreover, these findings are supported by a number of recent studies. For instance, a retrospective study by Evens (2015) involved 58,650 Chicago-born children from 1994 and 1998 who had been evaluated for blood lead concentration levels at some point from their birth and 2006 and who were enrolled in the third grade in Chicago public schools during the period 2003 through 2006. Drawing on the Chicago Blood Lead, the Registry Chicago birth registry and the Illinois Standard Achievement Tests (ISAT) scores for third grade pupils to identify the relationship between academic performance and blood lead concentrations (Evens, 2015). Even after controlling for race/ethnicity, income levels and gender as well as low birth weights and premature births, the findings that emerged from this retrospective analysis confirmed that early childhood exposure to lead in any form represented an accurate predictor of subsequent diminished academic performance among this third-grade cohort (Evens, 2015) as shown in Figure 3 below.
.

Figure 3. Adjusted and observed reading failure rates by blood lead level concentrations
Source: Evens, 2015, p. 7
As can be seen in Figure 3 above, elevated blood lead level concentrations in early childhood adversely affect math and reading performance together with substantially higher failure rates (Evens, 2015). These findings are also congruent with the results of several other studies that have identified a relationship between elevated blood lead level concentrations and academic performance as measured by standardized tests (Evens, 2015). Likewise, research by Miranda and her associates (2011) found that blood lead concentration levels as low as low as 2 microgram/deciliter (microg/dl) can have significant impacts on academic performance during early childhood as measured by end-of-grade test scores (Miranda & Antopolos, 2011). As a result, and as noted above, the U.S. Centers for Disease Control have concluded that there are no safe blood lead level concentrations for children (Miranda & Antopolos, 2011).
Although additional research is needed to identify the precise relationship between various blood lead level concentrations and its adverse effects on different academic areas, a study of third- and fourth-grade students in Massachusetts found that improved academic performance as measured by state tests was achieved following the implementation of initiatives designed to reduce the rate of lead exposure and poisoning (Zubrzycki, 2012). In this regard, Zubrzycki (2012) reports that, “Groups of children with higher levels of blood-lead exposure were likely to do worse on the tests, and as blood-lead levels dropped, student achievement improved” (p. 2). The results of these interventions provided an impressive 1% to 2% decrease in the number of students in the study cohort who scored unsatisfactorily on the Massachusetts state tests (Zubrzycki, 2012).
Likewise, a study by Chandramouli and Steer (2009) identified a direct relationship between diminished academic performance by children following lead exposure at lower levels than the 5 microg/dl standards than are currently used as indicators for clinical concern. In addition, lead poisoning in children can cause a number of other problems that can exacerbate their learning difficulties, including a reduction in their intelligence quotient, higher levels of antisocial and aggressive behaviors, physical and emotional developmental delays (Morse, 2006). Clearly, these negative outcomes have profound implications for American society in general and educators in particular, and these issues are discussed further below.
Implications for American society and educators
In this context, a "disability" in American society is addressed by the Americans with Disabilities Act of 1990 that includes physical or mental impairments that restrict one or more major life activities, but the nearest legal definition for a “chronic illness” is the one provided by the Individuals with Disabilities Education Act 1975 (reauthorized in 1997) which states that the term “other health impaired” means “... limited strength, vitality, or alertness due to chronic or acute health problems, such as . . . lead poisoning which adversely affects a child's educational performance” (as cited in Thies, 1999, p. 392).
The political wherewithal that is required to address the broad-based problem of lead in children’s environment at home and in the schools has been negatively influenced by the America public’s perception of the problem in terms of class and race (Richardson, 2005). In this regard, Richardson (2005) points out that, “Since most documented cases of childhood lead poisoning are poor African American children, behavioral disorders and learning difficulties have historically been linked exclusively to personal and familial deficits” (p. 7).
Besides ensuring their own school systems are safe, the vast majority of the sources of lead poisoning are uncontrollable by educators, though, but they are still faced with the need to address the specialized learning needs of children who have been poisoned by lead (Richardson, 2005). Although every young person’s learning needs are unique, the specialized services needed by young people with learning disorders attributable to lead poisoning cost between three and four times as much for regular students (Richardson, 2005). Moreover, Morse (2006) emphasizes that, “The cost of regular education has been steadily shrinking as the cost of federally mandated special education rises” (p. 40).
While the only proven method of ensuring that young people are completely protected against lead exposure and poisoning is to completely remove the substance or otherwise remediate sources such as soil and paint, most authorities, including the U.S. Centers for Disease Control, concede that given its ubiquity, these efforts are not economically feasible (Endres & Montgomery, 2009).. Therefore, there is an urgent need for cost-effective evidence-based initiatives that have proven efficacy in reducing children’s exposure to lead and educating parents concerning mitigation strategies in the home (Endres & Montgomery, 2009). To this end, a number of federal, state and local agencies have developed a variety of educational pamphlets and brochures designed to educate parents concerning the dangers related to lead exposure and poisoning and what steps they can take to address them (Endres & Montgomery, 2009). A systematic review of these pamphlets and brochures by Endres and Montgomery (2009), though, showed that that were consistently written at higher reading levels than the average reading levels of their targeted populations. Based on their analysis, Endres and Montgomery (2009) concluded that these educational materials would be more effective if they were written at the fourth- to sixth-grade reading level
Conclusion
Throughout history, lead has been a double-edged sword for humankind, providing a number of useful applications on the one hand but eventually poisoning anyone who consumes it over time on the other hand. Because many modern commercial applications such as plumbing and paint have included lead, the element continues to represent a significant public health threat that demands evidence-based solutions. While the primary sources of lead contamination have largely been mitigated through federal legislation and stricter standards, even renovation projects can still introduce new lead contaminants into the environment. As the efforts to remediate lead in the environment continue, school systems are faced with providing the best quality and therefore most expensive educational services for children with elevated blood lead concentrations. Some of the steps that were shown effective in addressing this problem included educating parents concerning strategies to reduce and eliminate lead contamination in the home and ensuring that these educational materials are geared towards the broadest segment of the targeted population.

References
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