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This document is the fourth revision of a statement by the Centers for Disease Control. Introductory and background chapters present data that indicate significant adverse effects of lead levels in children's blood that were previously believed to be safe. Other chapters discuss: (1) sources of lead exposure, including paint, soil and dust, and drinking water; (2) the role of the pediatric health care provider, including interpreting blood lead levels and educating parents about reducing lead levels in the blood; (3) the role of state and local public health, housing, and environmental agencies; (4) screening, including schedules and measurement techniques; (5) diagnostic evaluation and medical management of affected children, including symptoms of lead poisoning and chelation procedures; (6) management of local hazards in the child's environment, including testing for lead-based paint; and (7) management of local hazards in the community, including surveillance of blood levels and environmental factors, prevention planning, and hazard abatement. At the end of most chapters, a list of references relevant to the chapter's topic is provided. Appendixes include a description of the protocol for testing blood lead levels through capillary sampling and a summary of the document for the benefit of pediatric health care providers. (BC)

This document is the fourth revision of a statement by the Centers for Disease Control. Introductory and background chapters present data that indicate significant adverse effects of lead levels in children's blood that were previously believed to be safe. Other chapters discuss: (1) sources of lead exposure, including paint, soil and dust, and drinking water; (2) the role of the pediatric health care provider, including interpreting blood lead levels and educating parents about reducing lead levels in the blood; (3) the role of state and local public health, housing, and environmental agencies; (4) screening, including schedules and measurement techniques; (5) diagnostic evaluation and medical management of affected children, including symptoms of lead poisoning and chelation procedures; (6) management of local hazards in the child's environment, including testing for lead-based paint; and (7) management of local hazards in the community, including surveillance of blood levels and environmental factors, prevention planning, and hazard abatement. At the end of most chapters, a list of references relevant to the chapter's topic is provided. Appendixes include a description of the protocol for testing blood lead levels through capillary sampling and a summary of the document for the benefit of pediatric health care providers. (BC)

The purpose of this statement by the Center for Disease Control is to reflect new data available from clinical, epidemiological and experimental studies by making revised recommendations regarding the screening, diagnosis, treatment, and followup of children with undue lead absorption and lead poisoning. The ultimate preventive goal is identification and removal of lead in the environment before it is absorbed by the child. Until this occurs, screening, diagnosis, treatment, and environmental management will continue to be necessary public health activities. Topics discussed in the statement are: (1) the background of past experience with lead screening and the nature of the effects of lead on health; (2) aspects of screening procedures, including the goal, target population, schedule, methods, and interpretation of results; (3) the types of procedures to be followed and tests available for diagnostic evaluation of the patient's lead absorption status; (4) suggestions for clinical management of children diagnosed at various risk determinations (urgent risk, high risk, moderate and low risk); (5) environmental investigation and intervention, including common methods for reducing lead-based paint hazards; and (6) health education. The statement also includes a list of references and reprints of two papers published by members of the Center for Disease Control: "Exposure to Lead: Sources and Effects," by Dr. Herbert Needleman, and "Treatment of Lead Poisoning," by Dr. Julian Chisolm. (Author/SS)