- Why is CDC revising its guidance now?
CDC regularly updates its guidance about childhood lead poisoning
prevention, and the current revision is a timely addition to the series begun in 1975.
Subsequent editions appeared in 1978, 1985, and 1991.
Children in some places, especially large, urban inner cities, continue
to be exposed to lead and many of these children who need individual follow-up are not
being screened.
There is a decline in the average blood lead levels of children in the
United States as a whole.
The new guidance will reflect the need to screen
more
lead-exposed children and fewer children without lead exposure.
- When will
the new guidance be available?
The new guidance will be available for public
distribution in early November, 1997.
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What is the purpose of the guidance
document?
The new guidance contains
information to assist state and local health departments determine which
children in their jurisdictions are most likely to benefit from screening.
CDC will:
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Help health departments
organize the process of making decisions about screening
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Expand screening and
follow-up care among children who most need these services.
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Diminish screening of
children who are not exposed to lead.
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What will be new in this guidance?
-
The new guidance, entitled
Screening Young Children for Lead
Poisoning: Guidance for State and Local Public Health Officials will
not be a comprehensive overview of childhood lead poisoning prevention,
but instead will be focused on screening and follow-up of children with
elevated blood lead levels.
-
It will discuss universal
and targeted approaches to screening for childhood lead poisoning in order
to achieve the purposes outlined in question #3 above.
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What is the "universal approach" and the
"targeted approach" to screening?
Universal screening is the
blood lead testing of all children in a given area.
Targeted screening is blood
lead testing of some but not all children in a given area. Using such an
approach, children would be selected for screening on the basis of criteria
provided by the health department (either state or local). These criteria
are likely to include:
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Residence in a high-risk
zip-code or neighborhood.
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Membership in a population
that is at increased risk of lead exposure. National data show that poor
children, minority children, children who are exposed to lead-containing
home remedies, cosmetics, and ceramicware, and children of occupationally
exposed adults are at increased risk of lead exposure. Risk for these
children is compounded by residence in older housing.
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Answers to a personal-risk
questionnaire. Such a questionnaire should be developed by the health
department and be based on local risks of lead exposure.
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Who is the primary audience for the
proposed new guidance?
The primary audience for CDC's
updated screening recommendations is composed of state and local public
health officials. Secondary audiences include public health providers,
pediatricians and other child health care providers and health care
organizations, including managed care organizations.
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What population is covered by the proposed
new guidance?
The guidance will focus on the
screening of young children. It will include a discussion of anticipatory
guidance for pregnant women, as well as lead screening for older children
who are at risk.
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How was the document prepared?
The new guidance was prepared
by CDC staff with advice from CDC's Advisory Committee on Childhood Lead
Poisoning Prevention, a group of non-Federal experts on childhood lead
poisoning prevention. The guidance also reflects the comments of many other
persons involved in scientific and programmatic aspects of childhood lead
poisoning prevention and child health. The guidance takes into account new
scientific information and practical concerns about how best and most
efficiently to prevent and control childhood lead poisoning.
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What sort of assistance will CDC give to states and locales to help
in the implementation of the new guidance?
CDC will provide support for
development and communication of appropriate screening strategies. CDC will
also continue to conduct and promote research to improve screening.
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Will the new guidance replace the 1991
document?
The new guidance does not
contain information on all the subjects included in the 1991 guidelines.
Rather, it focuses on decision-making processes, screening and follow-up for
children with lead exposure. Sources of updated information on childhood
lead poisoning and its prevention include the following:
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Measuring Lead Exposure in Infants,
Children and Other Sensitive Populations. National Research Council.
Washington, D.C. National Academy Press. 1993. -- National Academy of
Sciences' review of the adverse health effects of lead exposure, and the
sources and pathways of lead exposure.
-
Treatment Guidelines for Lead Exposure in
Children. American Academy of Pediatrics Committee on Drugs.
Pediatrics 1995;96: 155-60.C American Academy of Pediatrics' review of
chelation therapy.
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Guidelines for the Evaluation and Control
of Lead-based Paint Hazards in Housing. U.S. Department of Housing
and Urban Development. 1995. -- U.S. Department of Housing and Urban
Development discusses the management of lead hazards in the child's home
environment.
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Putting the Pieces Together: Controlling
Lead Hazards in the Nation's Housing. Lead-Based Paint Hazard
Reduction and Financing Task Force. 1995.CLead-Based Paint Hazard
Reduction and Financing Task Force's review of their experience and
recommendations on reducing lead hazards in housing.
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the new guidance,
"Screening Young Children for Lead
Poisoning: Guidance for State and Local Public Health Officials."
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