FAQs

Lead is a heavy metal (with the elemental symbol Pb) found in small amounts in the earth’s crust. As lead has been added to a number of products, it can be toxic for the health of people, animals, and our broader environment. 

Lead is commonly found in soil and dust, paint in homes built before 1978 (that have not been remediated), old water systems, certain industrial jobs (e.g., working on cars, working with batteries, construction/demolition, electronic waste recycling, factories that process metals), and some consumer products. 

With lead commonly found in our environments, there are several ways for people to become exposed to lead, including eating or breathing in lead found in water, soil, and household dust with leaded paint. 

Children are more vulnerable to lead exposure because their developing bodies absorb lead more easily than adults and may come into close contact with materials that are likely to have lead (e.g., soil, dust). In addition, the health effects of exposure are more harmful to children because their bodies are still developing and growing rapidly.

Lead is a heavy metal that biologically has no beneficial but only hazardous effects to the body. If absorbed or ingested, lead can affect the development of the brain and nervous system leading to damage to the brain and nervous system, slowed growth and development, learning and behavior problems, and hearing and speech problems. Lead exposure has also been associated with lower intelligence quotient (IQ), decreased ability to pay attention, and underperformance in school. Lead exposure in children is often difficult to see. Most children have no obvious immediate symptoms.

For adults, lead exposures have been linked with increased risk of high blood pressure, cardiovascular problems, and kidney damage. Exposure of pregnant women to high levels of lead can cause miscarriage, stillbirth, premature birth and low birth weight.

There is no known safe blood lead concentration; even blood lead concentrations as low as 3.5 µg/dL may be associated with decreased intelligence in children, behavioral difficulties and learning problems. It is important to note that every child’s exposure to lead and the effects of lead on their well-being may vary as a number of factors may influence children’s exposures to lead, the absorption of lead to the body, and the effects of lead to the body. These include age of the child, their behaviors and nutritional status, where they live, age of the house, drinking water sources etc.

Test your child for lead 

• Children on Medi-Cal who are younger than 6 years of age are required to get tested for lead exposures. Additionally, private health insurance companies are required to cover the costs of blood lead testing for children. 

Minimize lead exposures at home and in the community: Minimize your direct exposure

• Plant bushes next to and outside older homes
• Plant grass or ground cover in soil that is likely contaminated with lead
• During windy days, keep windows closed to keep contaminated dust from entering the house
• If working with lead, change clothes before coming home
• If children play outside or in a dusty area, thoroughly wash their hands afterwards
• Recycle old electronic devices (e.g., phones) or batteries at electronic stores (e.g., Best Buy)
• Recycle old car batteries at auto stores (e.g., Auto Zone)

Use the power of certain foods to reduce the health effects of lead in the body

·      Eat healthy diet rich in calcium, iron, and Vitamin C, for example: 

The following farms and stores sell foods that are rich in calcium and iron and include some organic foods: 

CAL-FRESH Nutrition Assistance Resources (Through Orange County Social Services)

Additional Resources that May be Useful

The Inequities in Childhood Life-Course Lead Exposure and Academic and Neurobehavioral Outcomes (I-CLEAN) Study was developed by public health researchers at UC Irvine, Getting Residents Engaged in Exercise and Nutrition – Madison Park Neighborhood Association (GREEN-MPNA), and Orange County Environmental Justice (OCEJ) to understand the impact of low-level lead exposure on children’s academic performance and neurobehavioral outcomes in the city of Santa Ana in response to resident concerns about lead in the soil. 

The overarching goal of this 5-year (2023-2028) study is to associate life course and current Pb exposures with children’s academic performance and neurobehavioral outcomes, identify risk factors of current Pb exposure, and develop and implement a Public Health Equity Action Plan (PHEAP), with particular attention to health equity and environmental justice. The clinical portion of the study is currently underway, and we are actively recruiting families living in Santa Ana with children ages 7-10 to participate (see information about who is eligible to participate below). The process to develop a Public Health Equity Action Plan will take place over the coming months and years. If you are interested in participating in either part of the study now or in the future, please contact us by phone at 949-345-1711 or by email at icleanstudy@hs.uci.edu.

• You can reach the I-CLEAN Study team
  • By phone: 949-345-1711
  • By email: icleanstudy@hs.uci.edu
  • If you would like to speak to one of our team members in person, please call or email us to schedule an appointment

Blood samples can help us to understand your child’s recent lead exposures, as blood samples are generally indicative of lead exposures over the last 30 days. 

For most participating children, we will collect only one blood sample shortly after caregivers and children agree to participate in the study. 

It will take a few months to receive the findings from the blood sample. If the lab analysis of the blood sample indicates that there are high levels of lead in your child’s blood, we will ask you if we can collect another sample to see if your child’s blood lead levels are still high. We will also share with you resources and strategies that may be helpful for addressing lead exposures.

We will collect a very small amount of blood (250-500 µL – microliters) from your child using TASSO+ device, which is used one time to collect a sample. 

The Tasso+ is a sterile, disposable blood lancing device. When collecting a sample, the device is held onto the skin by a mild adhesive. A sterile blade will make a small cut on your child’s upper arm with a press of the button. At the same time, this creates a vacuum that helps to collect the blood into a tube using suction. After a few minutes, or when the tube is full, our team will peel the device off the skin. Our team will cover the collection site on your child’s arm with a bandaid. Our team will then prepare the blood sample to be stored and taken to the lab. 

This device is designed to lessen discomfort for the child. The process may not leave a mark, or may leave a very small (less than ¼ inch) long cut that will scab and heal within a few days.

After your child provides a blood sample, the sample will be stored at a research lab at the University of California, Irvine. Periodically (once we have many blood samples), we will send the blood samples to a research lab for analysis of the levels of lead and other heavy metals. 

With your permission, we will keep any remaining blood that was not used in the analysis in case we need to do further analyses to improve our understanding of how exposure to lead and other heavy metals affects children’s health.

Lead can be stored in the bones of our bodies. Our teeth are bones, and children shed their baby teeth, providing a non-invasive way to understand children’s exposures to lead from when they were in utero (in pregnancy) until the tooth was shed. By non-invasive, we mean that using teeth that children naturally lose as part of their maturation process allows us to study the lead levels in their bones without having to do a medical procedure, for example.

We are asking that you provide us with 2-3 baby teeth that your participating child naturally lost or shed so that we can understand their exposures to lead throughout their lifetime. 

We will give you a “tooth fairy kit” with all the items you need to safely store your child’s baby teeth when they fall out or if you already have them. The kit will include: clear instructions, labeled tubes in a ziploc bag to place the teeth in, and a tooth collection form for you to fill out. Once you have some teeth to provide for the study, please let our team know at 949-345-1711 or icleanstudy@hs.uci.edu so that we can schedule a time to pick these items up from you.

We will ask you to provide us with 2-3 baby teeth that your participating child naturally loses or sheds. Periodically, we will send baby teeth from participating children to a lab for analysis. The lab will identify which of the teeth that you provided would be best for the analysis. During the analysis, the lab will use a laser to slice the tooth open so that we can understand the timepoints when children were exposed to lead. 

Unfortunately, we cannot return the tooth that was analyzed back to you. However, once the lab analysis is complete, if you would like we can return any unused baby teeth to you.

For caregivers who donate more than one tooth, if you would like, we can return the unused tooth to you after the lab analysis of metal exposure is completed. Because we will be sending tooth samples to the lab in batches, please note that this will likely take several months.

I-CLEAN is a five-year funded National Institutes of Health (NIH) study which includes 5 years of academic performance and 3 years of behavior outcomes.

We are grateful for your participation in the I-CLEAN Study, which will help us to learn about children’s exposures to lead and other heavy metals, and how these exposures may affect children’s health and academic outcomes. If you decide to participate, we will provide a cash incentive as a token of our appreciation for your participation in the study. The total available compensation for participation is $90 per participant (family).

• Compensation will be distributed in cash:
  • $20 – Shedded baby teeth
  • $15 – Per blood sample (1-2 samples)
  • $10 – Baseline surveys
  • $15 – Behavioral & stress surveys (asked to complete at 3 time points)

All of the information we collect is kept confidential. It will be securely stored and separated from personal information (e.g., tooth samples, survey responses). We use a three-level locking system to protect your data. For physical data, like tooth samples, blood samples, and paper surveys, this means they will be stored in a locked storage cabinet, in a locked office or laboratory, in a locked building. For electronic data, this means that they will be stored on protected servers with multi-factor authentication, only accessible on protected computers, by trained and authorized study team members. 

To help us protect your privacy, the project has a Certificate of Confidentiality from the National Institutes of Health. This means that we protect the privacy of research participants by prohibiting disclosure of identifiable, sensitive research information to anyone not connected to the research.

REDCap is a secure web-based application for data collection and storage. It is a system designed to protect study participants’ data, and will be used by the I-CLEAN Study team to capture your demographic information and survey responses. 

Our research team who uses REDCap have to have permission to access the system. They are also trained and can only access the system with multi-factor authentication.

Once blood samples are analyzed, we will share findings with participating caregivers. At that time, we will share how the lead levels found in the blood compare to recommendations from the Centers for Disease Control and Prevention (CDC), the country’s leading public health agency. 

At that time, we will share with you suggestions for what you can share with your child’s doctor, as well as some resources and strategies that can help you and your family to prevent and address any lead exposures. 

We will also invite you to have your child provide a second blood sample so that we can understand if they still have high levels of lead exposure.

• The results of your child’s blood and tooth samples will be shared with you when they become available to us. Because the laboratories we work with receive samples in batches, results will likely take several months. We will reach out to you to schedule a time to discuss your study results once they are available, and please do not hesitate to reach out to us in the meantime with any questions or concerns. 
• Our study team will stay in touch and provide information about the study in the years to come. Results from the study will emerge as we combine the data across the study timeline. Once we have analyzed our study results, we will hold events to share information with study participants and the community at large.

• The I-CLEAN results (e.g. exposures to lead and other metals through blood and tooth samples, questionnaire survey results, and association of lead exposure and children’s neurodevelopmental outcomes and school performance) will be shared with participants in a timely manner. Children’s blood lead level results will be used to determine whether the participants should reach out to their pediatric care and/or to local lead mitigation resources.
• The results will support the implementation of community-driven solutions to the local experience of childhood lead exposures.
• De-identified I-CLEAN results will be presented at conferences and reported in publications so that these results can inform the broader scientific community on 1) the key risk factors of lead exposures in early childhood in a disadvantaged community; 2) how low-level life course lead exposure affects children’s school performance and behavioral outcomes; 3) recommendations for an equity-oriented multi-level action strategy for reducing children’s lead exposures.
• The results will inform future intervention strategies applicable to Santa Ana and many other places across the U.S. and worldwide where legacy lead sources still contribute to children’s lead exposure.

We are recruiting families (one caregiver and one child) to participate in the clinical portion of the I-CLEAN Study. You and your child may be eligible to participate in the study if: 

• You live in Santa Ana (Zip Codes: 92701, 92703, 92704, 92705, 92706, or 92707)
• At least one child in your family who is: 7-10 years old and your child:
  • Attends a school in the Santa Ana Unified School District (SAUSD)
  • Does not attend special education programs full-time
  • Is in their age-matched grade
    • A general guideline for age-matched grades would be, a 4-5 yr old would be in kindergarten, 5-7 yr old in 1st, 6-8 yr old in 2nd, 7-9 yr old in 3rd grade, etc. Then each level goes up one year from there.
• Have 1 adult parent or guardian who is fluent in Spanish, English, or Vietnamese & consents or agrees to the following:
  • 1) participate in the study over a two-year period
  • 2) donate 1-2 baby teeth that your participating child shed or lost naturally
  • 3) have your child tested for blood lead
  • 4) fill out surveys at three time points (during the initial visit, and at one year and two years after the initial visit)
  • 5) agree to have the study team access your child’s SAUSD school records from kindergarten through 8th grade

Anyone is eligible to participate in the Public Health Equity Action Plan (PHEAP) process. Please reach out to our study team for more details.

Right now, we are looking to recruit one child per family. If you have another child who may be eligible, we can follow-up with you in about 1 year to let you know if we are able to include more than 1 child per family. 

If there are multiple families who live in your home, other children (from other nuclear families) who live in your home are eligible to participate in this study.

This is an important question. Because we’re relying on school records and standardized test scores are a part of our analysis in this study, we unfortunately do not have the capacity at this time to account for all of the different aspects of special education and gifted education programs.

We want this study to be as helpful as possible, and one of those factors is the school environment and assessment tools that are used with readily available scores that can be associated with children’s exposure to lead. When students are not in their age-matched grade, i.e. they are younger or older than most of their classmates, this can also have an impact on their academic results, which we are unable to control for in this study.

We hope in future studies to be able to include all children in school environments, regardless of their participation in special education or gifted education programs and regardless of whether or not they are in their age-matched grade.

As long as your child’s school is part of the SAUSD school district, they should be eligible to participate in the study. We will verify eligibility on a case-by-case basis.

• Please inform the I-CLEAN Study team of your change in address by calling 949-345-1711, sending an email to icleanstudy@hs.uci.edu, or speaking with one of our team members.
• We will connect with you if you move so that we can deliver your results.