The prevalence of childhood lead poisoning (CLP) in the US has declined as evidenced by NHANES. Removing lead from gasoline, paint and food cans has been credited. CLP however, remains at epidemic levels in cities with prevalence rates six times the national average. Primary prevention of CLP necessitates making pre-1978 housing lead-safe. Present efforts rely on secondary prevention; the identification of lead exposed children through blood lead screening. Several surveys have documented very low screening rates, especially in at risk children. Evidence supporting the effectiveness of secondary prevention is lacking and surveillance data was used to examine its effectiveness in St. Louis. The surveillance period covered was 1993-98. Of those initially found with an elevated blood lead level (EBL) between 10-19 µg/dl, 46% were retested. Of those retested, 14.5% had a decrease in blood level, 79.5% had no change and 6.0% increased. Of 4,097 children with EBLs of 20 µg/dl or higher, 1555 (38%) remained at this level for two or more years, 676 (16%) for three or more years and 240 (5.9%) for four or more years. Secondary prevention does not prevent childhood lead poisoning. It depends on blood screening which is inadequate. An EBL signifies that exposure has already occurred. The physiology of lead, particularly its storage in bone, ensures that many exposed children have excessive lead burdens at the time of diagnosis. The shortage of lead-safe housing hampers efforts to stop further lead exposure. Primary prevention of CLP is a public health imperative.
Learning Objectives: At the conclusion of the session, the particiapnt will be able to: 1) Explain the difference between primary and secondary prevention of childhood lead poisoning. 2) Descibe the extent of the childhood lead poisoning problem in inner cities. 3) List the shortcomings of secondary prevention of childhood lead poisoning
Keywords: Lead, Prevention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.