We recently connected with Dr, Olushola Fapo, a pediatrician at University Hospitals, who serves as a co‑clinical lead for the Lead Safe Screening & Testing Program. This program is part of the broader work of the Lead Safe Cleveland Coalition.
Dr. Fapo shared thoughtful insights about risk assessment and screening as well as nutrition and lifestyle guidance. Her full responses offer a deeper look at the work happening in our community to protect children and families.
Risk Assessment & Screening
At what ages do you recommend routine lead screening for children?
It is important to note that screening is a risk assessment for lead poisoning administered by a questionnaire, while testing is performed via a blood test. Blood testing should be performed for all children living in the city of Cleveland at ages 1 and 2, and at least once between ages 3 and 6 if never tested. All children should be screened at 6, 9, 12, 18, 24 months, and 3, 4, 5, 6 years of age.
Which children are considered high-risk and should be screened more frequently?
Children are at increased risk for lead poisoning if they have a sibling with confirmed lead poisoning, if they live in a house, attend school or receive childcare in a building constructed before 1978. Risk is also elevated for children exposed to renovation, repair, or repainting activities in buildings built before 1978, as well as for those who have regular contact with an adult who is exposed to lead in the workplace. Additionally, immigrant children may face a higher risk of lead exposure. It is important to note that, regardless of identified risk factors, all children in Cleveland should be tested for lead exposure at ages 1 and 2, and at least once between ages 3 and 6 if never tested. Many children who are at risk are still not being tested, making universal testing at these ages essential for early detection and intervention.
How do you assess environmental risk factors in homes built before 1978?
Any home constructed before 1978 should be considered at potential risk for lead exposure. A lead risk assessment evaluates the presence of lead hazards, including deteriorating paint and lead-contaminated dust. This assessment should be conducted by a certified lead inspector or risk assessor to ensure accurate identification and appropriate recommendations.
Nutrition & Lifestyle Guidance
What dietary habits help reduce a child’s absorption of lead?
Iron deficiency can increase the body’s absorption of lead. However, a diet rich in iron, calcium, and vitamin C can help reduce lead absorption and support overall health. Children should consume at least three balanced, nutritious meals and two to three healthy snacks each day.
Are there specific foods or nutrients (iron, calcium, vitamin C) you recommend regularly for children in higher-risk environments?
A wide variety of foods provide essential nutrients such as iron, calcium, and vitamin C that help reduce the absorption of lead in the body. Examples include fresh leafy green vegetables, fruits, beans and legumes, lean meats, eggs, seafood, iron-fortified cereals, milk and other dairy products, nuts and seeds.
REFERENCES
https://www.pehsu.net/lib_facts/pehsu_fact_sheet_lead_management_for_health_professionals.pdf
https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le9742.pdf
Blood Lead Testing Requirements For Ohio Children Less Than 6 Years of Age