Interpreting and Managing Blood Lead Levels of Less Than 10 µg/dL in Children and Reducing Childhood Exposure to Lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention

Authors

Helen J. Binns, Northwestern University
Carla Campbell, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Mary Jean Brown, Division of Environmental and Emergency Health Services, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Center for Disease Control and Prevention, Atlanta, GeorgiaFollow

Date of this Version

2007

Citation

PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275)

Comments

U.S. Government Work

Abstract

Lead is a common environmental contaminant. Lead exposure is a preventable

risk that exists in all areas of the United States. In children, lead is associated with

impaired cognitive, motor, behavioral, and physical abilities. In 1991, the Centers

for Disease Control and Prevention defined the blood lead level that should

prompt public health actions as 10 µg/dL. Concurrently, the Centers for Disease

Control and Prevention also recognized that a blood lead level of 10 µg/dL did not

define a threshold for the harmful effects of lead. Research conducted since 1991

has strengthened the evidence that children’s physical and mental development

can be affected at blood lead levels of <10 µg/dL. In this report we provide

information to help clinicians understand blood lead levels <10 µg/dL, identify

gaps in knowledge concerning lead levels in this range, and outline strategies to

reduce childhood exposures to lead. We also summarize scientific data relevant to

counseling, blood lead screening, and lead-exposure risk assessment. To aid in the

interpretation of blood lead levels, clinicians should understand the laboratory

error range for blood lead values and, if possible, select a laboratory that achieves

routine performance within ±2 µg/dL. Clinicians should obtain an environmental

history on all children they examine, provide families with lead-prevention counseling,

and follow blood lead screening recommendations established for their

areas. As circumstances permit, clinicians should consider referral to developmental

programs for children at high risk for exposure to lead and more frequent

rescreening of children with blood lead levels approaching 10 µg/dL. In addition,

clinicians should direct parents to agencies and sources of information that will

help them establish a lead-safe environment for their children. For these preventive

strategies to succeed, partnerships between health care providers, families,

and local public health and housing programs should be strengthened.