The CDC blood lead reference value for children: time for a change

Environmental Health : a Global Access Science Source
Jerome A Paulson, Mary Jean Brown

Abstract

The purpose of this article is to consider alternate uses of the blood lead reference value for children. There are two possible approaches. Historically the reference value has been used to guide clinical and public interventions for individual children. As the distribution of blood lead levels in the population has been lowered over time, the blood lead level at which interventions are recommended has also been reduced. The use of a reference value of 3.5 μg/dL, based on the 98 percentile of blood lead levels for children in 2011-2014 National Health and Nutrition Examination Survey is under review. For several reasons, adopting the new reference value to guide clinical and public health management puts practitioners in an untenable position. First, the changes in the brain caused by lead are significant and persistent. However, these adverse impacts are subtle and although clearly identified at the population level, not predictive for individual children. In addition, the recommended interventions have not been shown to reduce blood lead levels once they are elevated. Finally, clinical laboratory and office-based blood lead testing devices are not required to quantify blood lead levels < 4 μg/dL and in many cases cannot reli...Continue Reading

Citations

Aug 29, 2020·Environmental Science and Pollution Research International·Zailin ChenQiulian Yu
Jul 30, 2020·Pediatric Research·Joseph M BraunBruce P Lanphear
Jun 20, 2019·International Journal of Environmental Research and Public Health·Howard W MielkeEric T Powell
Oct 16, 2019·Proceedings of the National Academy of Sciences of the United States of America·Howard W MielkeSara Perl Egendorf
Jun 4, 2020·Biological Trace Element Research·Liliana Carranza-LopezJesus Olivero-Verbel
Jun 24, 2021·BMC Public Health·Reem JalladAbdur Rahman
Jul 6, 2021·Journal of the Chinese Medical Association : JCMA·Tai-Jay ChangDe-Ming Yang
Jan 19, 2022·Journal of Racial and Ethnic Health Disparities·Jerel M EzellElizabeth C Chase

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