Tuesday, May 22, 2012

Childhood lead poisoning prevention

US CDC has issued its response to their Advisory Committee on Childhood Lead Poisoning Prevention’s recommendations presented in its report:  Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention (http://go.usa.gov/prD).

The most notable response is that for the first time in 20 years, US CDC will revise the blood lead level considered to be elevated.  The Advisory Committee recommended adopting a new reference value of 5 micrograms per deciliter (5 ug/dL) for identifying children with an elevated blood lead level, and US CDC has announced that it concurs with the use of this value.   The new reference value replaces the value of 10 ug/dL, which has been used as the benchmark for identifying children having an elevated blood lead level since 1991.

This change was motivated by a growing body of studies concluding that blood lead levels (BLLs) <10 μg/dL harm children, resulted in decreased IQ and other behavioral deficits such as attention-related behaviors and academic achievement.  Since no safe blood level in children has been identified, the Advisory Committee recommended the reference level be set at a value that represents a high level of exposure in the U.S. population – a level present in no more than 2.5 percent of young children.

Maine has tracked the number of children with a blood lead level of 10 ug/dL and higher for years, with the number of children above this benchmark dropping from over 200 in 2003 to about 100 children in 2010.   Maine estimates that there about 400 children under age 6 years were identified as having a blood lead level above 5 ug/dL in 2010.

Since no safe blood level in children has been identified, US CDC also concurred in principle with the Advisory Committee’s  recommendation  for an increased focus on primary prevention.  Fortunately for Maine children, a shift to primary prevention has already occurred because of action by the Maine Legislature to establish the Lead Poisoning Prevention Fund to support primary prevention efforts.  Maine CDC’s Childhood Lead Prevention Program already mails primary prevention information to all families in Maine with a 1- or 2-year-old.  In addition, the program will soon be offering free lead dust test kits to all families with a child with a blood lead level of 5 ug/dL lead or more.

US CDC also concurred with the Advisory Committee’s recommendation that clinicians should monitor children with a confirmed BLL ≥ 5 μg/dL for subsequent changes in blood lead levels until all recommended environmental investigations and mitigation strategies have been completed. US CDC plans to assist with provider training and develop guidance for implementing this recommendation. 

For more information about childhood lead poisoning, visit http://go.usa.gov/prK