November 16, 2011

The Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP)* voted today to recommend a significant change in how CDC selects the number at which a child's blood lead level should be considered elevated, and to renew its call for primary prevention. In a unanimous vote on the third day of its public meeting in Atlanta, the ACCLPP members passed the following resolution:

Low Level Lead Exposure Harms Children:  A Renewed Call for Primary Prevention

"Based on its conclusions that blood lead levels < 10 μg/dL harm children, the Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) recommends elimination of the use of the term 'blood lead level of concern.' It recommends the use of a reference value based on the 97.5th percentile of the NHANES-generated blood lead distribution in children age 1-5 years (currently 5 μg/dL) to identify children with elevated blood lead levels. These lower levels currently impact approximately 450,000 U.S. children. The absence of identified blood lead levels without deleterious effects underscores the critical importance of primary prevention. The ACCLPP document summarizing these recommendations will be finalized and voted upon in January 2012."

The document, slated to undergo revisions based on members' input in the coming weeks, was drafted by an ACCLPP work group that is co-chaired by Perry Gottesfeld, Executive Director of Occupational Knowledge International and Deborah Cory-Slechta, Professor at the University of Rochester School of Medicine. The document will provide specific recommendations for making progress in responding to children most affected by lead and stopping lead poisoning through housing-based primary prevention and other efforts.  It's up to the Department of Health and Human Services and CDC to accept the recommendations, determine how the federal government might implement them, issue appropriate guidance for providers, government agencies, and others, and take other action.

This is certainly a step forward in the fight to reduce children's lead exposure. NCHH will offer a question-and-answer webinar once the final ACCLPP document is released in January. More details will be provided when possible.

*The charter of the Advisory Committee on Childhood Lead Poisoning Prevention states that this federal advisory  committee "shall provide advice and guidance to the Secretary, Department of Health and Human Services (HHS); the Assistant Secretary for Health; and the Director, Centers for Disease Control and Prevention (CDC), regarding new scientific knowledge and technological developments and their practical implications for childhood lead poisoning prevention efforts," and "shall also review and report regularly on childhood lead poisoning prevention practices and recommend improvements in national childhood lead poisoning prevention efforts."

Jane Malone, Director of Policy
National Center for Healthy Housing

ATLANTA, June 15, 2009            SOURCE Council of State and Territorial Epidemiologists

Citing evidence that even a very low level of blood lead is a significant health risk at any age, the Council of State and Territorial Epidemiologists (CSTE) is recommending a change in the case definition of elevated blood lead levels in adults. In a vote at the CSTE annual conference in Buffalo, NY, State Epidemiologists approved a proposal to consider blood levels of 10 ug/dl or more in adults as "elevated" -- the same standard as currently exists for children.

Studies show that blood lead levels as low as 10 ug/dl contribute to an elevation in blood pressure and attendant health risks, including stroke. Low blood levels also are associated with an increase in mortality from heart disease, decreased kidney function and changes in cognition.

The risk of lead poisoning is especially pronounced among workers in certain industries, including lead refining and smelting; construction work involving paint removal; manufacture of bronze and brass products such as plumbing fixtures; demolition and maintenance of outdoor metal structures such as bridges and water towers; and battery manufacturing and recycling.

CSTE is a professional association of more than 1,050 public health epidemiologists working in states, local health agencies, and territories. CSTE works to establish more effective relationships among state and other health agencies, especially through its partnership with the Centers for Disease Control and Prevention. It also provides technical advice and assistance to partner organizations, such as the Association of State and Territorial Health Officials (ASTHO), the Association of Public Health Laboratories, and the National Association of County and City Health Officials. CSTE members have surveillance and epidemiology expertise in a broad range of areas including occupational health, infectious diseases, immunization, environmental health, chronic diseases, injury control, and maternal and child health. CSTE's work is an important step in ensuring a well prepared and competent public health workforce.