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1991.10.07 :  Blood Lead Levels

Contact:  CDC Press Office (404) 639-3286
October 7, 1991

       HHS Secretary Louis W. Sullivan, M.D., today announced a
new and lower "threshold of concern" for lead levels in
children's blood.  The new "threshold" represents lead levels in
blood which should trigger various responses, or "levels of
action,"
ranging from individual treatment or case-management to community
prevention activities.  The "threshold" also represents a new low
blood lead level goal toward which the nation should now move for
all children, especially through concerted community prevention
activities, Secretary Sullivan said.
       "New data have shown that blood lead levels which were
previously believed to be safe are in fact associated with
significant adverse effects," Secretary Sullivan said.  "We have
made considerable progress in lowering blood lead levels.  But
with these new findings, we owe it to our children to work
together toward further improvement.  We need to identify and
treat youngsters with high blood lead levels, and we need to keep
working in our communities to control childhood lead exposure."
       The new threshold, included in a statement issued by the
U.S. Centers for Disease Control, is placed at 10 micrograms per
deciliter of whole blood (ug/dL) -- less than half the level of
25 identified by CDC in 1985. 
       According to the CDC statement, "Preventing Lead Poisoning
in Young Children," blood lead levels as low as 10 ug/dL can
result in subtle effects such as developmental delays and reduced
stature.
       Secretary Sullivan said publication of the statement is
"an important step in the implementation of our long-range
strategy on lead exposure."  The HHS Strategic Plan to Eliminate
Childhood Lead Poisoning, describing public and private sector
efforts, was released by the Secretary in February.  It outlines
the first five years of a projected 20-year effort.
       Today's CDC statement provides guidelines on preventing
and treating childhood lead poisoning for action by diverse
groups, including public health officials, pediatricians,
government agencies and private citizens.  
       It replaces the single, all-purpose definition of lead
poisoning with "levels of action" at which different
interventions should be triggered by specific levels of lead in
the blood of exposed children, with highest priority given to
children with the highest blood lead levels:
       --      Children with blood lead levels of 20 micrograms
               or more should be medically evaluated and the
               source of lead exposure located and removed;

       --      Children with blood levels of 15-19 micrograms
               should receive individual case management,
               including nutritional and educational
               interventions and more frequent screening.  If the
               levels persist, environmental investigation
               (including a home inspection) is recommended,
               depending on availability of resources.

       --      When many children in a community have levels of
               10 or above, CDC recommends community-wide primary
               prevention activities. 
       No interventions directed toward the individual child are
recommended for those with levels of 10-14, due to imprecision of
laboratory measurements for levels this low, as well as lack of
proven effective interventions in this range.
       In addition to the threshold "triggers," the CDC statement
recommends greater emphasis on preventing lead poisoning before
it occurs.  It also recommends that universal screening of young
children be phased-in, except in communities where large numbers
or percentages of children have been screened and found not to
have lead poisoning.
       However, the statement says, full implementation of
universal screening cannot be accomplished immediately, since it
"will require the ability to measure blood lead levels on
capillary samples and the availability of cheaper and easier-to-
use methods of blood lead measurement."  Efforts are underway to
develop "inexpensive, easy-to-use portable methods for measuring
blood lead levels," the statement says.
       "The CDC has presented our best understanding of the
danger of lead exposure for children, and today's statement makes
clear what our common goal must be," Secretary Sullivan said. 
"Now it is up to all of us to work together -- to treat children
who are affected, and to reduce and prevent lead poisoning in the
future.
       "This statement will help all of us focus on that goal --
physicians, parents, and community leaders, as well as public
officials at the state and federal level," Dr. Sullivan said.
       Speaking for the Public Health Service, HHS Assistant
Secretary for Health James O. Mason, M.D., said, "Lead poisoning
is one of the most common pediatric health problems in the United
States today, and it is entirely preventable.  Three to four     
million children under age 6 in the United States have blood
levels greater than 15 micrograms per deciliter.  This is far
greater than the number of children affected by other common
childhood illnesses."
       William L. Roper, M.D., director of the CDC, stressed that
"the symptoms of lead poisoning are silent and largely invisible
at first, leaving most cases undiagnosed and untreated.  Yet this
is a childhood health problem that can affect the physical and
mental health of an individual for life."  Without appropriate
interventions, exposure to lead can cause learning disabilities,
IQ deficits and neurobehavioral problems.

       Efforts to prevent childhood lead poisoning have already
"resulted in substantial progress in reducing blood lead levels
in the entire U.S. population," the statement says.  Efforts have
included elimination of lead from gasoline, elimination of leaded 
solder in cans of food by most manufacturers, and elimination of
lead additives to paints.

       "Childhood lead poisoning prevention programs have had a
tremendous impact on reducing the occurrence of lead poisoning. 
Because of these programs, deaths from lead poisoning and lead
encephalopathy are now rare," the statement says.  However, it
adds, "Screening and medical treatment of poisoned children will
remain critically important until the environmental sources most
likely to poison children are eliminated."

       Copies of the statement, "Preventing Lead Poisoning in
Young Children," are available from Publication Activities,
Office of the Director, National Center for Environmental Health
and Injury Control, CDC, MS-F29, 1600 Clifton Road, Atlanta, Ga.
30333.

     CDC is an agency of the U.S. Public Health Service, within
the Department of Health and Human Services.


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