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Targeted Screening for Elevated Blood Lead Levels: Populations at High Risk

Abbreviations: NHANES, National Health and Nutrition Examination Survey

Lead poisoning is a preventable environmental disease without borders, affecting children worldwide. Currently, the Centers for Disease Control and Prevention defines an elevated blood level to be 10 µg/dL or greater.¹ The most recent National Health and Nutrition Examination Survey (NHANES) 1999 data demonstrated that the geometric mean blood lead level in the United States has decreased to 2 µg/dL.² That report did not present prevalence data because of small numbers. Despite the lowering of blood lead levels nationally, complacency about lead poisoning is not indicated. An analysis of childhood blood lead data collected by state surveillance programs found that prevalence of elevated blood lead levels varied from state to state and county to county, indicating that lead poisoning is still a problem at the local level.²

Additionally, data suggests that there may be effects of lead on cognitive ability at levels lower than previously reported.³ Other data suggests that standard application of chelation therapy did not improve neuropsychological function in lead-poisoned children.⁴ These data point out the need for improved prevention efforts, specifically, a shift to primary prevention through improved housing paired with continued, vigilant blood lead screening among populations at risk.

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Helen J. Binns, MD, MPH

Chicago, IL

Dennis Kim, MD, MPH

Atlanta, GA

Carla Campbell, MD, MS

for the Advisory Committee on Childhood Lead Poisoning Prevention
Department of Health and Human Services
Philadelphia, PA

Address correspondence to Helen J. Binns, MD, MPH, Children’s Memorial Hospital, 2300 Children’s Plaza, #208, Chicago, IL 60614

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