Questions and Answers

Managing Elevated Blood Lead Levels Among Young Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention

1. How is the new CDC guidance on case management different from other guidance documents?

   CDC printed three revisions of the statement on Preventing Lead Poisoning in Young Children in 1978, 1985, and 1991. In 1997, CDC provided recommendations on screening. This document provides current information on the scientific basis for interventions to reduce exposure to lead among identified cases.

2. What is the purpose of the new guidance document?

   The new guidance is intended to improve the quality of the management of children with elevated blood lead levels (EBLLs). Current case management practices of children with elevated blood lead levels vary markedly among states, cities, and jurisdictions. This document provides case managers with up-to-date information on assessment and interventions in five key areas:

   • Environmental Exposure
   • Medicine
   • Nutrition
   • Child Development
   • Caregiver Education

3. What is new in this guidance document?

   The new guidance is not a comprehensive overview of childhood lead poisoning prevention, but instead focuses on follow-up care of children with EBLLs.

   It discusses approaches to case management for children with EBLLs to achieve the purpose outlined in question #2 above.

4. Who is the primary audience for the proposed new guidance document?

   The primary audience for CDC’s case management recommendations is case managers of children with EBLLs. However, other individuals or groups---primary care providers (PCPs), public health agencies, nutritionists, managed care organizations, and environmental inspectors---will find guidance in assessments and interventions related to children with EBLLs.

5. What population is covered by the new guidance document?

   The guidance focuses on the case management of children with EBLLs who are less than 6 years of age. However, it is especially important to direct interventions to children less than 2 years of age because lead exposure during time when the brain is still developing is more likely to result in permanent damage.

6. How was this document prepared?

   The new guidance was prepared by the Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP), CDC staff, and national experts in each subject area. Recommendations in each chapter are based on the results of evidence-based studies wherever possible. In the absence of sufficient study data, the opinions of respected authorities were considered in the formulation of these recommendations. In their final form, the recommendations in this document represent the consensus of the ACCLPP.

7. What sort of assistance will CDC give to state and local childhood lead poisoning prevention programs to help with the implementation of the new guidance?

   CDC will continue to provide technical assistance for the development and implementation of case management protocols in each program. In addition, CDC will continue to conduct and promote research into the most effective practices of case management in children with EBLLs.

8. Will the new guidance replace the 1991 document?

   The new guidance does not contain information on all the subjects in the 1991 guidelines. Rather, it focuses on the follow-up care for children with EBLLs.