摘要：The US Centers for Disease Control and Prevention (CDC) in 1991 chose 10 μg/dL as an initial screening level for lead in children’s blood. Current data on health risks and intervention options do not support generally lowering that level, but federal lead poisoning prevention efforts can be improved by revising the follow-up testing schedule for infants aged 1 year or less with blood lead levels of 5 μg/dL or higher; universal education about lead exposure risks; universal administration of improved, locally validated risk-screening questionnaires; enhanced compliance with targeted screening recommendations and federal health program requirements; and development by regulatory agencies of primary prevention criteria that do not use the CDC’s intervention level as a target “safe” lead exposure. The US Centers for Disease Control and Prevention (CDC) has since 1970 set tiered screening and intervention levels for childhood lead poisoning. The purpose of these levels is to guide federal, state, and local health departments and individual pediatricians in identifying and responding appropriately to lead-exposed children. 1 No law requires development of the intervention levels, and criteria for setting and changing them are not well defined. They are set forth in CDC guidance documents that are implemented through conditions on funding to government and individual providers. The initial, or threshold, intervention level (referred to here as “the intervention level”), which was originally set at 40 μg/dL, was most recently lowered from 25 μg/dL to 10 μg/dL in 1991. 1 Some researchers (e.g., Landrigan 2 and Lanphear and colleagues 3 ) have suggested that the intervention level should be reexamined and possibly further lowered, and this issue is currently under consideration by the CDC’s Advisory Committee on Childhood Lead Poisoning Prevention (M. A. McGeehin, oral communication, August 27, 2002). In other work, I conducted a statistical analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III) to identify the prevalence of childhood blood lead levels (BLLs) of 5 μg/dL or higher and the socioeconomic and demographic characteristics of 1- to 5-year-old children with BLLs of at least 5 μg/dL but less than 10 μg/dL. 4 In this article, I investigate whether data or policy considerations support lowering the childhood blood lead screening level.
