Backgrounder: CDC Releases New Guidance on Lead Screening

More Localized Screening Benefits Children at Risk of Lead Poisoning

November 3, 1997

• Although there have been dramatic improvements in reducing lead in the environment, there are still nearly one million U.S. children with elevated blood lead levels. This statistic underscores the need for the new lead screening guidance recently released by the Centers for Disease Control and Prevention (CDC). The guidance focuses on helping state and local health care professionals identify children who are still at risk for lead exposure and who may need follow-up services.
• Through continuing analysis, CDC has improved its lead screening policies. New information about lead has shown that lead exposure occurs in predictable patterns throughout the United States. The new guidance will reflect this latest knowledge, and is designed to assist state and local health officials to determine which children in their jurisdictions will benefit from screening. However, in the absence of a statewide plan or other formal guidance from health officials, universal screening for virtually all young children, as called for in the 1991 CDC guidelines, should continue to be carried out.
• The guidance discusses the need for state health officials to examine local conditions that can contribute to lead hazards, and design a data-driven screening recommendation based upon findings. Several steps are outlined as to how to undertake this process, and include such activities as forming a professionally diverse advisory committee and assessing existing lead exposure and screening capacity.
• As a result, it is expected that more children who are actually exposed to lead will be screened, while children with low risk for lead exposure will not receive unnecessary screening, increasing the efficiency and benefits of screening efforts. In particular, the guidance recommends that state and local health officials determine appropriate screening policies by targeting their efforts at children who live in older homes and children from low-income families, two variables highly associated with lead exposure.

"Working through state and local public health officials is the most effective means of providing lead screening and follow-up care for children," said Dr. Richard Jackson, director of CDC’s National Center for Environmental Health (NCEH). "CDC’s position on the adverse health effects caused by lead has not changed, our goal is to expand screening and follow-up care for those children who are at risk. This new guidance will provide criteria for state and local public health officials to identify these children so that they can receive the appropriate care if they are exposed to lead."

• Lead exposure in young children is of particular concern because children absorb lead more readily than adults and children’s developing nervous systems are particularly vulnerable to adverse effects of lead. All children can be susceptible to lead poisoning if lead is accessible.

Dr. Jackson also emphasized that "the declines in blood lead levels can be attributed to the continued public health commitment demonstrated by CDC, the U. S. Environmental Protection Agency, the U.S. Department of Housing and Urban Development and the many efforts of state and local governments in support of increased screening and identification of children with elevated blood lead levels."

• The guidance document, Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials can be obtained by calling the toll free number: 1-800-CDC-INFO, or can be accessed through the Internet at http://www.cdc.gov/nceh/lead/. CDC is part of the U.S. Department of Health and Human Services.

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