Lead poisoning guidelines revised; more considered at risk

Up to 365,000 more children across the USA will be considered at risk of lead poisoning under new guidelines released today by the Centers for Disease Control and Prevention.

In an important shift, the CDC cut in half the amount of lead that will lead to medical monitoring and other actions in children ages 1 to 5.It's the first time in more than 20 years that the CDC has revised its action level on lead poisoning.

Now any child with more than 5 micrograms per deciliter of lead in their blood will be considered at risk. This afternoon, the CDC said the new guidelines increase the patient population nationwide to about 442,000 from about 77,000 using the latest available data. (The CDC had previously said about 250,000 were affected under the current standard.)

The new levels mark the first change to the standard in 20 years and come with a huge caveat. The CDC doesn't "have the funding, staff or control over the means to implement" them, it said in a statement. "A commitment to implement actions cannot be made due to our lack of control over available resources."

The CDC's funding for lead-poisoning prevention was slashed 94% this year by Congress, from $29 million in fiscal year 2011 to $2 million. The CDC is reducing staff in its Lead Poisoning Prevention Program from 26 to six full-time employees.

Still, the new guidelines are necessary. "It's about time," says John Rosen, a professor of pediatrics at Children's Hospital at Montefiore in New York City. Pediatricians will be on alert about the "enormous impact that a blood lead level of 5 can have, forever, on a child's life and future academic success."

Children can be exposed to lead from a variety of sources. While lead-based paint is the best-known source, a USA TODAY investigation last month revealed the danger posed by lead-contaminated soil around forgotten factory sites that spewed lead particles into neighborhoods for decades before closing in the 1960s or 1970s. Other sources of exposure include soil contaminated from years of leaded gasoline emissions.

The new guidelines are based on recommendations made by the CDC's Advisory Committee on Childhood Lead Poisoning Prevention work group. The group suggested, and the CDC agreed, that the old standard of 10 micrograms per deciliter should be replaced. Until now, almost all laboratories would have told parents that if a child's blood-lead levels are less than 10, they're fine, says Perry Gottesfeld, who co-chaired the CDC advisers' work group.

That's simply wrong, according to Gottesfeld, executive director at Occupational Knowledge International, a California-based non-profit group. "Any lead is too much lead," he says.

Instead, the CDC is moving toward what's known as a reference value approach, says Rebecca Morley, national director of the National Center for Healthy Housing in Columbia, Md. The value is based on levels found in the 2.5% children nationally with the most lead in their blood, which is at 5, according to data from the National Health and Nutrition Examination Survey or NHANES.