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Tables
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Table 1-1. Interpretation of blood lead test results and follow-up activities: class of
child based on blood lead concentration
| Class |
Blood
lead concentration (µg/dl) |
Comment |
| I |
<=
9 |
A child
in Class I is not considered to be lead-poisoned. |
| IIA |
10
- 14 |
Many
children (or a large proportion of children) with blood lead levels
in this range should trigger communitywide child- hood lead
poisoning prevention activities (Chapter 9). Children in this range
may need to be re-screened more frequently. |
| IIB |
15
- 19 |
A child
in Class IIB should receive nutritional and educational
interventions and more frequent screening. If the blood lead level
persists in this range, environmental investigation and intervention
should be done (Chapter 8). |
| III |
20
- 44 |
A child
in Class III should receive environmental evaluation and remediation
(Chapter 8) and a medical evaluation (Chapter 7). Such a child may
need pharmacological treatment of lead poisoning (Chapter 7). |
| IV |
45
- 69 |
A child
in Class IV will need both medical and environmental interventions,
including chelation therapy (Chapter 7 and
Chapter 8). |
| V |
>=
70 |
A child
with Class V lead poisoning is a medical emergency. Medical and
environmental management must begin immediately (Chapter 7 and
Chapter 8). |
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Table
3-1. Industries identified by surveillance for elevated blood lead levels,
California and New York, 1991
| Industry
Description |
Standard
Industrial Classification Number |
| Secondary smelting and refining of nonferrous metals |
3341 |
| Storage batteries (lead batteries) |
3691 |
| Valve and pipe fittings (except plumber's brass goods) |
3494 |
| Plumbing fixture fittings and trim (brass goods) |
3432 |
| Brass/copper foundry |
3362 |
| Glass products, made of purchased glass |
3231 |
| Motor vehicle parts and accessories |
3714 |
| Firing range workers |
7997,9221 |
| Pottery, nec |
3269 |
| Chemical and chemical preparations |
2899 |
| Bridge, tunnel, and elevated highway construction |
1622 |
| Automotive repair shops |
7539 |
| Industrial machinery and equipment |
5084 |
| Inorganic pigments |
2816 |
| Primary batteries, dry and wet |
3692 |
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Sources: Baser and Marion,
1990; Maizlish et al., 1990.
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Table
6-1. Priority group for screening
| Children, ages 6 to 72 months, who live in or are
frequent visitors to deteriorated housing built before 1960.
Children, ages 6 to 72 months, who live in housing built before
1960 with recent, ongoing, or planned renovation or
remodeling.
Children, ages 6 to 72 months, who are siblings, house mates, or
playmates of children with known lead poisoning.
Children, ages 6 to 72 months, whose parents or other household
members participate in a lead-related occupation or hobby.
Children, ages 6 to 72 months, who live near active lead
smelters, battery recycling plants, or other industries likely to
result in atmospheric lead release. |
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Table
6-2. Assessing the risk of high-dose exposure to lead -- sample
questionnaire
| Does
your child -
1. Live in or
regularly visit a house with peeling or chipping paint built before
1960? This could include a day care center, preschool, the home of a
babysitter or a relative, etc.
2. Live in or
regularly visit a house built before 1960 with recent, ongoing, or
planned renovation or remodeling?
3. Have a brother
or sister, housemaid, or playmate being followed or treated for lead
poisoning (that is, blood lead greater than or equal to 15 µg/dL)?
4. Live with an
adult whose job or hobby involves exposure to lead (see
Chapter
3)?
5. Live near an
active lead smelter, battery recycling plant, or other industry
likely to release lead?
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Table 6-3. Class of child and recommended action
according to blood lead measurement
| Class |
Blood
Lead Concentration (µg/dL) |
Action |
| I |
<=9 |
Low risk
for high-dose exposure: rescreen as described in text. |
| |
|
High
risk for high-dose exposure: rescreen as described in text. |
| IIA |
10-14 |
Rescreen
as described in text. If many children in the community have blood
lead levels >=10, community interventions (primary prevention
activities) should be considered by appropriate agencies (see
Chapter 9). |
| IIB |
15-19 |
Rescreen
as described in text. Take a history to assess possible high-dose
sources of lead. Educate parents about diet, cleaning, etc. Test for
iron deficiency. Consider environmental investigation and lead hazard abatement if levels persist. |
| III |
20-44
* |
Conduct
a complete medical evaluation. Identify and eliminate
environmental lead sources. |
| IV |
45-69
* |
Begin
medical treatment and environmental assessment and remediation
within 48 hours. |
| V |
>=70
* |
Begin
medical treatment and environmental assessment and remediation
IMMEDIATELY. |
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*Based on confirmatory blood
lead level.
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Table
6-4. Suggested timetable for confirming capillary blood lead results
with a venous blood lead measurement
| Blood
Lead Level (µg/dL) |
Time
Within Which Blood Lead Level Should Be Obtained |
| <
10 |
Not
applicable
|
| 10-14 |
Not
applicable |
| 15-19 |
Within
1 month |
| 20-44 |
Within
1 week |
| 45-69 |
Within
48 hours |
| >=
70 |
Immediately |
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Table 7-1. Chelating Agents Used In Treating Children With
Lead Poisoning
| Product
Name |
Generic
Name |
Chemical
Name |
Abbreviation |
| Calcium
Disodium Versenate |
Edetate
disodium calcium |
Calcium
disodium ethylenediamine tetraacetate |
CaNa2
EDTA |
| BAL
in Oil |
Dimercaprol |
2,3-dimercapto-l-propanol |
BAL |
| Cuprimine |
D-penicillamine |
3-mercapto-D-valine |
D-penicillamine |
| Chemet |
Succimer |
Meso
2,3-dimercaptosuccinic acid |
DMSA |
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