Childhood Lead Levels Likely Under-Reported

Researchers at the Public Health Institute and Healthy Homes Collaboration have found that elevated blood lead levels (EBLL) in children 12 months to 5 years have been under-determined, missing one-third of children with EBLL nationwide and up to 80% in some regions (Pediatrics 2017;139:e201642d86). This means that nationwide cases reported to the Centers for Disease Control and Prevention (CDC) from blood lead level (BLL) tests are below actual EBLL prevalence, and that many more children than previously thought are at risk of complications from lead poisoning.

State-level reporting of EBLL via CDC’s Childhood Lead Poisoning Prevention Program (CLPPP) has been variable and inconsistent, and just four states recommend that schools require proof of testing for students to attend kindergarten or prekindergarten, according to the authors.

During the study period—1999 to 2010—39 states participated in CLPPP, but 18 did so only intermittently. The investigators sought to garner a better estimate of EBLL prevalence by applying new statistical methods to National Health and Nutrition Examination Survey data.

The researchers estimated that 1,200,000 children had BLL ≥10.0
µg/dL during the study period, yet just half that number of cases had been reported to CDC. When the investigators refined their analysis to include data only from states that had complete CLPPP reporting, they found that 36% of cases had not been documented.