Childhood Lead Poisoning Prevention: Getting the Job Done by 2010

By Brown, Mary Jean | Journal of Environmental Health, January-February 2008 | Go to article overview

Childhood Lead Poisoning Prevention: Getting the Job Done by 2010


Brown, Mary Jean, Journal of Environmental Health


Editor's note: NEHA strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we will feature a column from the Environmental Health Services Branch (EHSB) of the Centers for Disease Control and Prevention (CDC) in every issue of the Journal.

EHSB's objective is to strengthen the role of state, local, and national environmental health programs and professionals to anticipate, identify, and respond to adverse environmental exposures and the consequences of these exposures for human health. The services being developed through EHSB include access to topical, relevant, and scientific information; consultation; and assistance to environmental health specialists, sanitarians, and environmental health professionals and practitioners.

EHSB appreciates NEHA's invitation to provide monthly columns for the Journal. EHSB staff will be highlighting a variety of concerns, opportunities, challenges, and successes that we all share in environmental public health.

Lead is a potent, pervasive neurotoxi-cant that affects practically all systems in the human body (National Research Council, 1993). In children, increased lead exposure causes developmental delay, reduced IQ, and behavioral problems. Extensive use of lead, particularly during the most recent century, has caused widespread environmental lead contamination and human exposures.

In 1990, the Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) established the ambitious goal of eliminating elevated blood lead levels (BLLs) in children--BLLs [greater than or equal to]10 [micro]g/dL--by the year 2010, under the overarching goal of eliminating health disparities in the population (U.S. Department of Health and Human Services, 2000a, 2000b).

CDC's National Health and Nutrition Examination Surveys, conducted between 1976 and 2002, show a marked decrease in lead exposure of children in the United States. For example, the prevalence of BLLs [greater than or equal to]10 [micro]g/dL among children in the United States decreased from 8.6 percent in 1988-1991 to 1.6 percent in 1999-2002, an 81 percent decline. This decline, observed even in groups at high risk for lead poisoning, reflects the impact of strategies followed at the national, state, and local levels, including eliminating lead in gasoline, controlling lead paint hazards in housing, and improving screening of high-risk groups (CDC, 2005a). Disparities in lead exposure still exist, however, and areas of the U.S. population with significant lead exposure remain (CDC 2002; Dignam et al., 2004; Geltman et al., 2001). In many communities where the risk of lead poisoning is disproportionately high, the 2010 goal will not be achieved if we continue to conduct business as usual. CDC has identified five steps that provide a clear path to achieving the 2010 goal.

1. Continue the intensive efforts to identify and provide services to children with elevated BLLs, while also expanding program activities into the area of primary prevention (i.e., strategies that control or eliminate sources of lead before children are poisoned). A focus on primary prevention of lead exposure also is the most appropriate response both to recent research demonstrating adverse health effects for children at BLLs <10 [micro]g/dL and to the lack of science-based interventions that can decrease already elevated BLLs or reduce the intellectual deficits resulting from elevated levels. Primary prevention requires that lead programs initiate and maintain active, productive collaborations with traditional and non-traditional partners. State and local plans to eliminate childhood lead poisoning can be found at www.cdc.gov/nceh/lead.

2. Target efforts to clearly identifiable areas where risk for lead exposure is disproportionately high. In many urban areas, the prevalence of elevated BLLs is 10 to 15 times higher than the national average. …

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