(Chris Johnson)

New Year’s Day marks the start of  year 18 working with lead poisoning prevention and as I think about this milestone, it puts me in mind of the French saying that goes something to the effect that the more things change, the more they stay the same. There have been a lot of changes in the field over the past 17 years to be sure. When I started, the Centers for Disease Control and Prevention (CDC) had just recently lowered the blood lead action level for children from 25 to 10 µg/dl, the level still in effect today. Lead poisoning was front and center in the national consciousness. Congress had just passed the “Lead Based Paint Hazard Reduction Act” (1992) or Title X as it is more commonly known. As a result of these and other acts, the numbers of children with levels of 10 µg/dl and above have decreased dramatically from the numbers in 1993.

Today, however, evidence continues to mount that significant damage occurs at levels below 10 µg/dl and there have been strong suggestions that the national action level be lowered from 10 µg/dl to at least 5 µg/dl. Some local governments have reduced or are considering reducing their action levels to 5 µg/dl, and they are to be commended for that. At the national level, however, the level remains at 10.

We know lead is toxic at levels below 10 µg/dl, but the action level remains at 10 µg/dl. The military has a term collateral damage, a euphemism used whenever they kill or wound non-combatant civilians in a military campaign. If we don’t lower the action level, do children with levels between 5 and 10 µg/dl then become collateral damage, an unfortunate but acceptable outcome of the current campaign? I sincerely hope not.  

Yes, there have been a lot of positive outcomes for children since 1993. However, we’ve yet to eliminate lead poisoning and 2010 is just months away. There are still a significant number of children with elevated blood lead levels and if the level is lowered to 5 µg/dl, there will be tens, perhaps hundreds of thousands more. If we don’t lower the federal action level, what will happen to those children? Has the time now come to consider lowering the current standard? We know that the evidence mounts as to how toxic lead is at levels below 10 µg/dl? I believe the science says yes.