‘Unfinished agenda’ in preventing lead poisoning

Over the years, the Centers for Disease Control (CDC) and its partners have made major progress towards reducing lead exposure in the United States. But more work remains in preventing lead poisoning in US children and adults, according to a special supplement to the Journal of Public Health Management and Practice.

While US population blood lead levels continue to decline, researchers, public health officials, and policymakers still face challenges in reaching national goals in the fight against lead poisoning, according to an introductory editorial by Adrienne S. Ettinger, ScD, MPH, Perri Z. Ruckart, MPH, and Timothy A. Dignam, Ph.D., MPH, of the CDC’s Childhood Lead Poisoning Prevention Program. Published online today, the CDC-sponsored supplement collects new practice reports and perspectives on the continued challenges of preventing lead exposure in the US population.

Need for Further Advances in the National ‘War on Lead’

The special issue of JPHMP  “marks a turning point in the nation’s ‘war on lead’ that has spanned over a century and highlights the accomplishments of the CDC and its state and local partners in preventing and controlling lead poisoning,” Dr. Ettinger and coauthors write. Mainly due to policies aimed at controlling lead exposure in gasoline, paint, and consumer products, the percentage of American children with elevated blood levels has declined sharply over the past four decades.

Yet, as illustrated by the water contamination crisis in Flint, Michigan, lead exposure continues to be a major public health problem in the US. Recent estimates indicate that at least 500,000 one- to five-year-old children nationwide—2.5 percent of children in that age range—still have elevated blood lead levels. “There is no known safe level of lead in children, and exposure to even low levels of lead can affect a child’s growth and development,” according to the authors.

The supplement presents 18 original practice reports and commentaries addressing the continued challenges of lead poisoning prevention. Topics include:

• The Flint water crisis response and recovery efforts, including the CDC-funded Flint Lead Exposure Registry.
• Legislative and policy efforts to control lead sources in the US—including the historic importance and current status of the CDC’s Childhood Lead Poisoning Prevention Program.
• Ongoing efforts to improve blood lead surveillance, laboratory testing, and appropriate interventions for lead-exposed children.
• State and local initiatives to strengthen blood lead testing in high-risk areas across the US. “Lead exposure is a local problem with local solutions,” Dr. Ettinger and coauthors write.
• “Non-traditional” sources of lead exposure, such as foods, folk remedies, spices, toys, and cosmetics.
• The special challenges facing groups of children with characteristics placing them at high risk of lead exposure, including race/ethnicity, poverty, and living in older housing.

“The key to reaching the Healthy People 2020 goals for childhood lead poisoning prevention remains in sustained efforts by CDC and its partners to strengthen blood lead testing, surveillance, population-based interventions, and processes to identify lead-exposed children and link them to services with a focus on high-risk children and early interventions,” Dr. Ettinger and coauthors conclude. “From this issue, it is clear that significant progress continues to be made in these areas and innovative ways to use data and resources are being developed and deployed.”

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