Low level lead exposure harms children : a renewed call for primary prevention : report of the Advisory Committee on Childhood Lead Poisoning Prevention of the Centers for Disease Control and Prevention
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Low level lead exposure harms children : a renewed call for primary prevention : report of the Advisory Committee on Childhood Lead Poisoning Prevention of the Centers for Disease Control and Prevention

  • 12/01/2021

Filetype[PDF-888.89 KB]


  • Description:
    This document was solely produced by the Advisory Committee for Childhood Lead Poisoning Prevention. The posting of this document to our website in no way authorizes approval or adoption of the recommendations by CDC. Following the committee vote on January 4, 2012 to approve these recommendations, HHS and CDC will begin an internal review process to determine whether to accept all or some of the recommendations and how to implement any accepted recommendations.

    Based on a growing body of studies concluding that blood lead levels (BLLs) <10 μg/dL harm children, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) recommends elimination of the use of the term “blood lead level of concern”. This recommendation is based on the weight of evidence that includes studies with a large number and diverse group of children with low BLLs and associated IQ deficits. Effects at BLLs < 10 μg/dL are also reported for other behavioral domains, particularly attention-related behaviors and academic achievement. New findings suggest that the adverse health effects of BLLs less than 10 μg/dL in children extend beyond cognitive function to include cardiovascular, immunological, and endocrine effects. Additionally, such effects do not appear to be confined to lower socioeconomic status populations. Therefore, the absence of an identified BLL without deleterious effects combined with the evidence that these effects, in the absence of other interventions, appear to be irreversible, underscores the critical importance of primary prevention.

    Primary prevention is a strategy that emphasizes the prevention of lead exposure, rather than a response to exposure after it has taken place. Primary prevention is necessary because the effects of lead appear to be irreversible. In the U.S., this strategy will largely require that children not live in older housing with lead-based paint hazards. Screening children for elevated BLLs and dealing with their housing only when their BLL is already elevated should no longer be acceptable practice.

    The purpose of this report is to recommend to the CDC how to shift priorities to implement primary prevention strategies and how to best provide guidance to respond to children with BLLs <10 μg/dL. This report also makes recommendations to other local, state and federal agencies, and the ACCLPP recommends that CDC work cooperatively with these other stakeholders to provide advice and guidance on the suggested actions.

    This report recommends that a reference value based on the 97.5th percentile of the NHANES- generated BLL distribution in children 1-5 years old (currently 5 μg/dL) be used to identify children with elevated BLL. There are approximately 450,000 U.S. children with BLLs above this cut-off value that should trigger lead education, environmental investigations, and additional medical monitoring.

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