Interagency Taskforce to Prevent Childhood Lead Poisoning from Non-paint Related Sources Mary Jean Brown, ScD, RN Chief, Childhood Lead Poisoning Prevention Branch Centers for Disease Control and Prevention

Figure. Blood Lead Levels Associated with Adverse Health Effects Children Lead Concentration in Blood (  g/dL) Adults Death Encephalopathy Nephropathy Frank Anemia Colic Nephropathy Frank Anemia Male Reproductive Effects Hemoglobin Synthesis and Female Reproductive Effects Nerve Conduction Velocity Hemoglobin Synthesis Vitamin D Metabolism Nerve Conduction Velocity Erythrocyte Protoporphyrin Vitamin D Metabolism(?) Developmental Toxicity IQ, Hearing, Growth Transplacental Transfer Elevated Blood Pressure Erythrocyte Protoporphyrin (men) Erythrocyte Protoporphyrin (women) Note: = increased function and = decreased function. Source: ATSDR, 1992

Year 1972 Blood Lead Levels (µ/dL) Impact of Lead Poisoning Prevention Policy on Reducing Children’s Blood Lead Levels Lead Gasoline Phase-out (1973) Lead-based Paint Poisoning Prevention Act (1971) Residential Lead Paint Ban (1978) Lead Title X (1992) Housing units with lead based paint hazards reduced by 40% since 1990 Lead Contamination Control Act (1988) Virtual Elimination of Lead in Gasoline Ban on lead solder in food cans (1995) 2.7 % 2.2 % Lead in Plumbing banned (1986) %

The lead (Pb) story Regulatory action has removed Pb from gasoline, tin cans, paint and reduced it in food, products, drinking water systems, and workplace. Pb-dust from paint still an issue. Analysis of city level data indicates that ~ 35% of children > 10 ug/dL Pb in blood lived in a home with earlier cases of Pb exposure. As prevalence declines – the attributable fraction of Pb exposures from other sources increases.

Primary Prevention- Non-Paint Lead Sources Intervention before the children’s blood lead becomes elevated  Identify communities where cultural practices and traditional medicines put families at risk.  Incorporate lead poisoning prevention activities into health and community services that reach families at high risk for exposure  Control or eliminate current and new non- essential uses of lead particularly in toys, food implements and cosmetics.

Interagency Taskforce to Prevent Childhood Lead Poisoning from Non-paint Related Sources Various foods, consumer products, environmental conditions continue to cause Pb- poisoning. Regulate Exposures: EPA, OSHA, FDA, and CPSC. Control, Treat, Remediate, and Enforce: CDC, Commerce, Customs, HUD, and DHHS.

Interagency Taskforce to Prevent Childhood Lead Poisoning from Non-paint Related Sources Objective: Develop a comprehensive strategy to control non-paint lead sources through interagency collaboration and cooperation. Membership: EPA, FDA, CPSC, Commerce, Customs and OSTP Next Steps:  To work at the staff level  To develop data collection tools and real time communication to respond to cases, and  To research each agency’s control mechanisms.

Prioritizing Identification and Elimination/Control of Sources 1. Consumption-Look at the overall lead consumption and rank the non-paint sources of lead poisoning that represent the largest percentages of total lead consumed. One problem is that this could end up focused on sources that do not threaten children in their unmodified form and accepted use. 2. Harm Presented-Identify the children harmed by non-paint sources of lead and rank the sources by the severity of their harm and frequency of exposure. 4. Multi-Track-Identify the non-paint sources of lead poisoning that cause harm, and aggressively follow them to recognize trends and provide assistance and information to the federal agency that addresses the particular source. 3. Other considerations-A reasonable alternative exists and using lead in the product is unnecessary

Lead poisoning is a problem we can fix. For More Information: Dr. Mary Jean Brown Chief, Lead Branch CDC ,