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Experts Endorse Lower Lead-Poisoning Threshold
Date:1/6/2012

By Steven Reinberg
HealthDay Reporter

THURSDAY, Jan. 5 (HealthDay News) -- Pediatric health experts are applauding a U.S. advisory panel's recommendation to lower the threshold for toxic lead exposure in children.

Lead, a metal once common in gasoline and house paint, can permanently damage developing brains.

On Wednesday, the Advisory Committee on Childhood Lead Poisoning Prevention voted to recommend that the federal government change the standard for lead poisoning from 10 micrograms of lead per deciliter of blood to 5 micrograms. This was the first time in two decades that the panel recommended lowering the levels.

"We are delighted that we have finally moved forward," said Ruth Ann Norton, executive director of the Coalition to End Childhood Lead Poisoning. "It's long overdue. This is science that's been out there."

Existing guidelines have given parents and doctors a false sense of security that children are safe from harm, Norton said.

If the U.S. Centers for Disease Control and Prevention adopts the panel's recommendation, as many as 1 million children could be diagnosed with lead poisoning, up from the current 250,000, according to Dr. John Rosen, a professor of pediatrics and head of the division of environmental sciences at the Children's Hospital at Montefiore Medical Center in New York City.

"It's about time for CDC to move from its definition of childhood lead poisoning of 10 [micrograms per deciliter of blood] to 5," Rosen said. "Ten was established 20 years ago and there are at least 20 articles which demonstrate unequivocally that there are adverse effects of lead on IQ and intellectual and cognitive development at blood levels between 5 and 9."

Although banned from house paints in 1978, lead-based paint in deteriorating housing remains the major source of childhood lead poisoning today, Rosen said.

Lead is also found in some art supplies and imported toys, old painted toys, household pipes and faucets, certain hobby equipment and miniature lead figures. The metal can enter children's bodies if they touch these items and put their fingers in their mouths, or swallow the items.

Damage from lead exposure is irreversible. "It affects memory, learning, being able to sit, listen and learn in school, abstract thinking, planning, organization, communication skills and fine motor skills," Rosen said.

Dr. Vikas Kapil, chief medical officer of the CDC's National Center for Environmental Health, said it will be several months before the CDC decides to accept or reject the committee's recommendation.

"We have been looking at the issue of lead levels in kids for some time," Kapil said. In 2005, the CDC asked the committee to see if a change was needed, but at that time there wasn't sufficient evidence to recommend a change, he said.

"We asked the committee to look again at the evidence in late 2010, and this most recent recommendation is the outcome," he added. "There is a growing body of evidence about blood lead levels below 10 that are associated with adverse health impacts in kids. We don't want clinicians to see 10 as a safe level."

The U.S. National Institutes of Health recently endorsed similar recommendations about blood lead levels, Kapil said.

If adopted by the CDC, the new standard would push health departments and housing departments around the country to improve code enforcement and focus on the only cure for lead poisoning, which is primary prevention, Norton said. "There is no drug, no treatment that reverses the impact of lead poisoning," she added.

The problem with lead paint has lingered for decades, these experts said.

"There will not be an end until there is a federal mandate to totally de-lead all pre-1960 housing," Rosen said. He emphasized that de-leading of a home should only be done by a licensed lead-removal contractor, as is required by law.

The current strategy for protecting children from leaded paint is ineffective, Rosen said. "At present, the approach is to paint over lead-based paint and modify the home so there are no obvious paint chips or lead paint in household dust," he explained. "I refer to this as a Band-Aid approach."

More information

For more information on lead poisoning, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: John F. Rosen, M.D., professor of pediatrics, and division head, environmental sciences, Children's Hospital at Montefiore Medical Center, New York City; Ruth Ann Norton, executive director, Coalition to End Childhood Lead Poisoning, Baltimore; Vikas Kapil, D.O., M.P.H., chief medical officer, U.S. National Center for Environmental Health


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