What do the new CDC recommendations mean?

The blood lead reference value represents the highest 2.5% of blood lead concentrations in children ages 1 to 5. Lead levels above the reference value may prompt follow-up investigation or testing. In October 2021, the CDC announced that the blood lead reference value would be reduced from 5 micrograms per deciliter to 3.5 micrograms per deciliter, the first change in nearly 10 years. Lowering the value means that more children will be identified as having exposure to the potentially negative effects of lead. It also lets public health and environmental officials focus lead reduction efforts on the highest-risk communities.

If my child has been exposed to lead, what should I do?

Children with exposure to lead may need follow-up measures, depending on how elevated the blood lead level is. Your doctor may recommend a more detailed assessment of potential sources of lead in the home and environment, repeat testing, and nutritional counseling to improve calcium and iron in the diet. Treatment to remove lead from the body may be required for children with the highest blood lead levels.

Local health departments, childhood lead prevention programs, and regional pediatric environmental health specialty units can be additional resources for families at the greatest risk for lead exposure.

When should my child be tested?

The Massachusetts Department of Health recommends that all children be tested for lead at 9 to 12 months, 2 years, 3 years, and at 4 years if a child lives in a high-risk community (as defined by the local department of health). Blood lead testing may be indicated in additional settings, such as if a sibling has an elevated blood lead level, children with persistent oral exploratory behaviors, unexplained anemia, and other risk factors.

How can I make my home lead-safe?

Lead exposure is ubiquitous in our environments and remediation is costly. If not done safely, renovations can worsen pediatric lead exposure by generating lead-laden dust. Families with concerns for lead exposure should have their homes evaluated by a certified lead inspector. Based on these findings, the lead-hazard remediation work should be conducted by a lead-certified contractor, or by those that have received training to conduct deleading.

In the interim, temporary mitigation measures can be helpful to reduce lead exposure. These include minimizing ongoing exposure (such as by covering chipping interior paint using contact paper or duct/masking tape), frequent hand washing, frequent dusting/wet mopping of the home (several times per week), leaving shoes at the door, and eating an iron- and calcium-rich diet.

The bottom line

While exposure to lead has decreased significantly in recent years, it remains an important public health problem. You should speak with your pediatrician about routine testing for your child, and the ways to minimize lead hazards and prevent long-term health effects. More funding is needed to help families and property owners mitigate lead-based paint and other hazards in their homes. These steps, along with the work of the public health and medical community, can help make the lead poisoning epidemic a thing of the past.

(Marissa Hauptman, M.D., MPH, is a contributor and Ryan Brewster, M.D., is a guest contributor to Harvard Health Publications.)

©2022 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC.