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New guidelines: 200,000 more kids at risk of lead poisoning

4:14 PM, Jun 8, 2012   |    comments
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(USA Today) TAMPA BAY, Fla. -- About 200,000 more children across the country will be considered at risk of lead poisoning under new guidelines released Wednesday by the Centers for Disease Control and Prevention.

Last month, the 10 News Investigators - in partnership with USA Today - investigated leftover lead in a Tampa Bay neighborhood.

Last week, several U.S. Senators called for action following the stories.

Today's move from the CDC cuts in half the amount of lead that will lead to medical monitoring and other actions in children ages 1 to 5. Now, any child with more than 5 micrograms per deciliter of lead in their blood will be considered at risk.

The new guidelines increase the patient population nationwide from 250,000 to 450,000.

The new levels 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 6 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."

The 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 older standard of 10 micrograms per deciliter should be replaced. Almost all laboratories will say 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. "Any lead is too much lead," says Gottesfeld, executive director at Occupational Knowledge International, a California-based non-profit group.

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.

Because it's a moving target, it's likely to slowly fall as environmental levels of lead decrease, given lowered pollution and the fact that lead is no longer allowed in paint. The advisory panel suggested that the CDC reset the trigger level every four years, Gottesfeld says.

Tips to prevent lead exposure

Get tested: Pediatricians and local health departments can test children's blood to measure lead levels. Make sure to ask for the child's exact blood-lead level and don't accept a vague report that the level is "normal" or "negative." Health departments can provide advice on how to test homes, yards and gardens for lead.

Keep surfaces clean: Household dust can be a major source of lead exposure for children. It can come from deteriorating lead-based paint in older homes, but also from lead-contaminated soil that is tracked into homes or picked up on the wind and blown through windows. Leave shoes at the door to avoid tracking contaminated soil inside. Wet-mop floors and wet-wipe surfaces - especially window ledges - regularly, the Centers for Disease Control and Prevention advises.

Create a barrier: Avoid letting children play in bare soil, especially in a city. Laying down a thick layer of sod, mulch or even a blanket can reduce their exposure to lead dust in soil. Consider replacing contaminated soil with clean dirt. Keep children's play areas and vegetable gardens away from the "dripline" around the base of homes or garages, where soil is more likely to be contaminated from airborne lead particles and flaking paint.

Wash up: Children are exposed to lead dust by putting dirty hands or toys in their mouths. Wash hands and toys frequently.

Eat well: Good nutrition can protect children from the effects of lead exposure. Children who don't get enough calcium and iron absorb more lead.

Doctors and laboratories often focus on the CDC's official action level set by the agency and don't alert parents when blood-lead levels are below 10, USA TODAY reported last month as part of an investigation of the lead-poisoning risks to children living near forgotten factory sites called smelters. Those factories operated for decades before closing in the mid-1960s or 1970s, leaving behind lead particles in nearby neighborhoods.

Lead exposure is especially dangerous in children 6 years old and younger because their brains are developing. It can cause cognitive and behavioral problems, learning disabilities and at high levels seizures and even death.

Another major shift is that the CDC says the goal is no longer testing and treating, but instead making sure kids aren't exposed in the first place.

"There's no good treatment. Prevention is the only way to make sure kids are growing up to their fullest abilities, so they're not impaired from a neurological standpoint," Gottesfeld says.

Multiple studies have shown impairment at levels below 10. A report by the National Toxicology Program found that blood-lead levels lower than 5 can lead to "losses in IQ, cognitive and academic impairment as well as ADHD," Rosen says.

At these levels, there is no treatment beyond removing the child's exposure to lead. Chelation therapy, which involves giving chemicals that bind to lead so it can be excreted from the body, is reserved for children who have blood lead levels over 45, Rosen says.

Congress has gotten involved in the budget issues around lead. Monday, 26 members released a letter decrying the loss of funding for the Lead Poisoning Prevention Program in 34 states. The new funding levels proposed by Republicans "could potentially result in children with unsafe levels of lead being denied critical services and treatment," Rep. Ed Markey, D-Mass., said in a statement.

The new levels are important not just for children in the USA but internationally, because many nations use CDC benchmarks as their own. "Last time, the World Health Organization picked up the CDC standards, and it became the global standard," Gottesfeld says.

Elizabeth Weise and Alison Young, USA TODAY

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