Publications

Childhood Lead Poisoning Publications

Note: Most of these documents refer to a blood-lead level of 10 micrograms per deciliter (μg/dL) as the CDC level of concern for adverse health outcomes in children. This terminology is outdated and readers are referred to the ACCLPP recommendations of 2012. However, the 2012 document does not recommend changes to the guidelines for the evaluation and treatment of children requiring chelation (BLLs ≥ 45 μg/dL) published here.

Data and Surveillance Reports:

• NEW! Raymond J, Brown MJ. Childhood Blood Lead Levels in Children Aged <5 Years — United States, 2007–2014. MMWR. January 20, 2017 / 66; 1-10.
• Raymond J, Brown MJ. Blood Lead Levels in Children Aged <5 Years. MMWR. October 24, 2016 / 63;66-72.
• Kennedy C, Yard E, Dignam T, Buchanan S, Condon S, Brown MJ, et al. Blood Lead Levels Among Children Aged <6 Years — Flint, Michigan, 2013–2016. . MMWR. July 1, 2016 / 65(25);650-4.
• Raymond J, Brown MJ. Childhood Blood Lead Levels — United States, 2007–2012. MMWR. October 23, 2015 / 62(54);76-80.
• Raymond J, Wheeler W, Brown MJ. Lead screening and prevalence of blood lead levels in children aged 1–2 years—Child Blood Lead Surveillance System, United States, 2002–2010 and National Health and Nutrition Examination Survey, United States, 1999–2010 and National Health and Nutrition Examination Survey, United States, 1999–2010. . MMWR. 2014;63(Suppl 2).
• CDC. Blood Lead Levels in Children Aged 1–5 Years — United States, 1999–2010. MMWR. April 5, 2013 / 62(13);245-248.
• CDC. Infant Lead Poisoning Associated with Use of Tiro, an Eye Cosmetic from Nigeria - Boston, Massachusetts, 2011. MMWR. August 3, 2012 / 61(30);574-576.
• CDC. CDC Health Disparities and Inequalities Report - United States, 2011 [PDF - 3.01 MB]. MMWR 2011;60(Suppl):1-116.
• Iqbal S, Blumenthal W, Kennedy C, Yip FY, Pickard S, Flanders WD, Loringer K, Kruger K, Caldwell KL, Jean Brown M. Hunting with lead: association between blood lead levels and wild game consumption. Environ Res. 2009 Nov;109(8):952-9.
• CDC. Blood Lead Levels---United States, 1999--2002. MMWR. May 27, 2005; 54(20):513-516.
• Using GIS to Assess and Direct Childhood Lead Poisoning Prevention: Guidance for State and Local Childhood Lead Poisoning Prevention Programs [PDF - 1.85 MB] (2004) - These guidelines were prepared to help new lead epidemiologists quickly learn how to use geographic information systems (GIS) mapping technology to assess and direct childhood lead poisoning elimination efforts.
• CDC. Surveillance for Elevated Blood Lead Levels Among Children - United States, 1997--2001. MMWR. September 12, 2003; 52(SS-10):1-21. [PDF - 333 KB]
• CDC. Trends in blood lead levels among children---Boston, Massachusetts, 1994--1999. MMWR. May 4, 2001 50(17):337-339.
• CDC. Blood Lead Levels in Young Children---United States and Selected States, 1996--1999. MMWR. December 22, 2000; 49(50):1133-1137.
• CDC. Update: Blood Lead Levels---United States, 1991--1994. MMWR. February 21, 1997; 46(7):141.
  Erratum: Vol. 46, No. 7 MMWR. July 4, 1997; 46(26):607

Health Care Systems/Insurance Guidelines:

• A Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage (2006) - This is an important resource on preventive services, including elevated blood lead level screening. The guide translates clinical guidelines and medical evidence, providing large employers with the information they need to select, define, and implement preventive medical benefits. The section on elevated blood lead level screening starts on page 164 of the guide, under the Evidence Statement for Child Health Promotion. The guide was developed by CDC, the Agency for Healthcare Research and Quality, and the National Business Group on Health.
• Overcoming Barriers to Data-Sharing Related to the HIPAA Privacy Rule: A Guide for State and Local Childhood Lead Poisoning Prevention Programs [PDF - 586 KB]
  This guide reviews HIPAA requirements and exceptions, focusing on those for public health agencies, and describes permissible uses of lead-related data under the HIPAA Privacy Rule. [PDF - 586 KB].
• HIPAA Privacy Rule and Public Health Source: MMWR (Morbidity and Mortality Weekly Report) 2003 (Vol. 52(S-1); 1-12.

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International Response:

• Kaufman JA, Brown MJ, Umar-Tsafe NT, Adbullah MB, Getso KI, Kaita IM, et al. Prevalence and risk factors of elevated blood lead in children in gold ore processing communities, Zamfara, Nigeria, 2012 . J Health Pollut. 2016;6(11):2-8.
• Basir M, Umar-Tsafe N, Getso K, Kaita IM, Nasidi A, Sani-Gwarzo N, et al. Assessment of blood lead levels among children aged ≤5 Years — Zamfara State, Nigeria, June–July 2012. Morbid Mortal Wkly Rep. 2014;63(15):325-7. [Brown MJ].
• Thurtle N, Greig J, Cooney L, Amitai Y, Ariti C, Brown MJ, et al. Description of 3,180 courses of chelation with dimercaptosuccinic acid in children ≤5 y with severe lead poisoning in Zamfara, Northern Nigeria: A retrospective analysis of programme data. PLoS Med. 2014;11(10): e1001739.
• Dooyema CA, Neri  A, Lo Y-C, Durant J, Dargan PI, Swarthout T, et al. Outbreak of fatal childhood lead poisoning related to artisanal gold mining in northwestern Nigeria, 2010 . Environ Health Perspect. 2012; 120:601-607.
• Lo Y-C, Dooyema CA, Neri A, Durant J, Jefferies T, Medina-Marino A, et al. Childhood lead poisoning associated with gold ore processing: a village-level investigation—Zamfara State, Nigeria, October–November 2010 . Environ Health Perspect. 2012; 120:1450-1455.
• Evaluation and Recommendations for Preventing Lead Poisoning among the Internally Displaced Roma Population in Kosovo from the Centers for Disease Control and Prevention (2011) [PDF - 88 KB]
  This is a report of the status of identification and clinical care of the children who are less than 6 years old and have been relocated. The report contains recommendations for next steps to be taken in addressing the needs of these children.
• U.S. Geological Survey. Helping to Understand a Lead Poisoning Outbreak in Nigeria. GeoHealth Newsletter. Winter 2010/2011; 8(2).
• CDC. Notes from the Field: Outbreak of Acute Lead Poisoning Among Children Aged <5 Years --- Zamfara, Nigeria, 2010. MMWR. July 16, 2010; 59(27):846.
• Recommendations for Preventing Lead Poisoning among the Internally Displaced Roma Population in Kosovo from the Centers for Disease Control and Prevention [PDF - 629 KB](2007) - Lead exposure is a continuing urgent health problem for Roma in Kosovo. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the United Nations International Children’s’ Emergency Fund (UNICEF) have collaborated in blood lead surveillance of the Roma children living in refugee camps in Kosovo. This document includes recommendations.

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Lead Exposure Case Studies:

• CDC. Blood Lead Levels in Children Aged 1–5 Years — United States, 1999–2010. MMWR. April 5, 2013 / 62(13);245-248.
• CDC. Take-Home Lead Exposure Among Children with Relatives Employed at a Battery Recycling Facility — Puerto Rico, 2011. MMWR. November 30, 2012 / 61(47);967-970.
• CDC. Infant Lead Poisoning Associated with Use of Tiro, an Eye Cosmetic from Nigeria - Boston, Massachusetts, 2011. MMWR. August 3, 2012 / 61(30);574-576.
• CDC. Lead Poisoning in Pregnant Women Who Used Ayurvedic Medications from India — New York City, 2011–2012. MMWR. August 24, 2012; 61(33):641-646.
• CDC. Lead Poisoning of a Child Associated with Use of a Cambodian Amulet --- New York City, 2009. MMWR. January 28, 2011; 60(03):69-71.
• CDC. Children with Elevated Blood Lead Levels Related to Home Renovation, Repair, and Painting Activities --- New York State, 2006--2007. MMWR. January 30, 2009; 58(03):55-58.
• CDC. Death of a Child After Ingestion of a Metallic Charm---Minnesota, 2006. MMWR. March 31, 2006; 55(12):340-341.
• CDC. Lead Exposure from Indoor Firing Ranges Among Students on Shooting Teams --- Alaska, 2002--2004. MMWR. June 17, 2005; 54(23):577-579.
• CDC. Lead Poisoning Associated with Use of Litargirio---Rhode Island, 2003. MMWR. March 11, 2005; 54(9):227-229.
• CDC. Elevated Blood Lead Levels in Refugee Children---New Hampshire, 2003--2004. MMWR. January 21, 2005; 54(2):42-46.
  Erratum: Vol. 54, No. 2 MMWR. January 28, 2005; 54(3):76.
• CDC. Childhood Lead Poisoning from Commercially Manufactured French Ceramic Dinnerware---New York City, 2003. MMWR. July 9, 2004; 53(26):584-586.
• CDC. Lead Poisoning Associated with Ayurvedic Medications---Five States, 2000--2003. MMWR. July 9, 2004; 53(26):582-584.
• CDC. Brief Report: Lead Poisoning from Ingestion of a Toy Necklace---Oregon, 2003. MMWR. June 18, 2004; 53(23):509-511.
• CDC. Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water---District of Columbia, 2004. MMWR. April 2, 2004; 53(12):268-270.

  Addendum: Following the release of the MMWR, "Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water -- District of Columbia, 2004", some reports have suggested erroneously that the Centers for Disease Control and Prevention has determined that lead in residential tap water at concentrations as high as 300 parts per billion is ‘safe’. CDC would like to reiterate the key message from the 2004 article that because no threshold for adverse health effects in young children has been demonstrated (no safe blood level has been identified), all sources of lead exposure for children should be controlled or eliminated. Lead concentrations in drinking water should be below the U. S. Environmental Protection Agency’s action level of 15 parts per billion.

  Read more about Lead in Drinking Water

• CDC. Childhood Lead Poisoning Associated with Tamarind Candy and Folk Remedies---California, 1999--2000 . MMWR. August 9, 2002; 51(31):684-686.
• CDC. Fatal Pediatric Lead Poisoning---New Hampshire, 2000. MMWR. June 8, 2001 50(22):457-459.
• CDC. Occupational and Take-Home Lead Poisoning Associated With Restoring Chemically Stripped Furniture---California, 1998. MMWR. April 6, 2001; 50(13):246-248.
• CDC. Lead Poisoning Associated with Imported Candy and Powdered Food Coloring---California and Michigan. MMWR. December 11, 1998; 47(48):1041-1043.
• CDC. Children with Elevated Blood Lead Levels Attributed to Home Renovation and Remodeling Activities--New York, 1993-1994. MMWR. January 3, 1997; 45(51&52):1120-1123.
• CDC. Blood Lead Levels Among Children---Rhode Island, 1993--1995. MMWR. October 27, 1995; 44(42):788-791.
• CDC. Blood Lead Levels Among Children in a Managed-Care Organization---California, October 1992--March 1993 MMWR. September 1, 1995; 44(34):627-629, 635.
• CDC. Lead Poisoning Associated with Use of Traditional Ethnic Remedies---United States. MMWR. July 16, 1993; 42(27):521-524.

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Lead Policy Statements:

Note: These documents refer to a blood-lead level of 10 μg/dL as the CDC level of concern for adverse health outcomes in children. This terminology is outdated and readers are referred to the ACCLPP recommendations of 2012. However, the 2012 document does not recommend changes to the guidelines for the evaluation and treatment of children requiring chelation (BLLs ≥ 45 μg/dL) published here.

• Preventing Lead Poisoning in Young Children [PDF - 2.59 MB](2005) - This is the fifth revision of the statement on Preventing Lead Poisoning in Young Children by the Centers for Disease Control and Prevention. This revision accompanies a companion document, developed by the Advisory Committee on Childhood Lead Poisoning Prevention which reviews the scientific evidence for adverse effects in children at blood lead levels below 10 µg/dL.
• Preventing Lead Poisoning in Young Children (1991)** - The fourth revision of the statement on Preventing Lead Poisoning in Young Children by the Centers for Disease Control.
• Preventing Lead Poisoning in Young Children [PDF - 3.59 MB] (1985) ** - The second revision of the statement on Preventing Lead Poisoning in Young Children by the Centers for Disease Control and Prevention.
• Preventing Lead Poisoning in Young Children [PDF - 2.83 MB] (1978) ** - The first revision of the statement on Increased Lead Absorption and Lead Poisoning in Young Children by the Centers for Disease Control and Prevention.
• Increase Lead Absorption and Lead Poisoning in Young Children [PDF - 1.49 MB] (1975) ** - A statement on Lead Poisoning in Young Children by the Centers for Disease Control and Prevention.

** These documents are being kept on this website for historical purposes and are no longer in print.

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Lead Toxicology Reports:

• Interaction Profile for Lead, Manganese, Zinc, and Copper - The ATSDR Interaction Profile succinctly characterizes the toxicologic and adverse health effects information for mixtures of hazardous substances.
• Public Health Statement for Lead - This Public Health Statement is the summary chapter from the Toxicological Profile for lead.
• ToxFAQs™ for Lead - This fact sheet answers the most frequently asked health questions about lead.
• Toxicological Profile for Lead - This ATSDR toxicological profile succinctly characterizes the toxicologic and adverse health effects information for lead.

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Primary Prevention Guidelines:

Note: These documents refer to a blood-lead level of 10 μg/dL as the CDC level of concern for adverse health outcomes in children. This terminology is outdated and readers are referred to the ACCLPP recommendations of 2012. However, the 2012 document does not recommend changes to the guidelines for the evaluation and treatment of children requiring chelation (BLLs ≥ 45 μg/dL) published here.

• Building Blocks for Primary Prevention: Protecting Children from Lead-Based Paint Hazards [PDF - 930 KB] (2005) - This publication offers a comprehensive collection of 70 "building blocks," which are primary prevention strategies to reduce exposure to hazards in housing. To use a searchable version of this CDC publication click here. Source: Alliance for Healthy Homes
• Preventing Lead Exposure in Young Children: A Housing-Based Approach to Primary Prevention of Lead Poisoning [PDF - 858 KB] (2004) - This document presents recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Childhood Lead Poisoning Prevention for a housing-based approach to primary prevention of childhood lead poisoning to accelerate progress towards the elimination of elevated blood lead levels in children.

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Screening and Case Management Guidelines:

Educational Services for Children Affected by Lead Expert Panel. Educational interventions for children affected by lead [PDF - 1.51 MB]. (2015)

Note: These documents refer to a blood-lead level of 10 μg/dL as the CDC level of concern for adverse health outcomes in children. This terminology is outdated and readers are referred to the ACCLPP recommendations of 2012. However, the 2012 document does not recommend changes to the guidelines for the evaluation and treatment of children requiring chelation (BLLs ≥ 45 μg/dL) published here.

• CDC. Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women [PDF - 4.24 MB] (2010)
  These guidelines are based on scientific data and practical considerations regarding preventing lead exposure during pregnancy, assessment and blood lead testing during pregnancy, medical and environmental management to reduce fetal exposure, breastfeeding, and follow up of infants and children exposed to lead in utero.

• CDC. Recommendations for Blood Lead Screening of Medicaid-Eligible Children Aged 1--5 Years: an Updated Approach to Targeting a Group at High Risk. MMWR. August 7, 2009; 58(RR09);1-11.

• CDC. Interpreting and Managing Blood Lead Levels <10 µg/dL in Children and Reducing Childhood Exposures to Lead: Recommendations of CDC's Advisory Committee on Childhood Lead Poisoning Prevention. MMWR. November 2, 2007; 56(RR08):1-14;16.
  Erratum: Vol. 56, No. RR-8 MMWR. November 30, 2007; 56(47):1241-1242.

• CDC. Deaths Associated with Hypocalcemia from Chelation Therapy---Texas, Pennsylvania, and Oregon, 2003--2005. MMWR. March 3, 2006; 55(8):204-207.

• Managing Elevated Blood Lead Levels Among Young Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention (2002) - This report from the Advisory Committee on Childhood Lead Poisoning Prevention is intended to facilitate the management of children with elevated blood lead levels by providing case managers with information and guidance.

• CDC. Recommendations for Blood Lead Screening of Young Children Enrolled in Medicaid: Targeting a Group at High Risk---United States. MMWR. December 8, 2000; 49(RR-14):1-13. [PDF - 146 KB]

• CDC. Elevated Blood Lead Levels Among Internationally Adopted Children---United States, 1998. MMWR. February 11, 2000; 49(5):97-100.

• Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials, Centers for Disease Control and Prevention (1997) - The policy outlined in the document has two main purposes: to increase screening and follow-up care of children who most need these services, and to help communities pursue the most appropriate approach to the prevention of childhood lead poisoning.

• CDC. Targeted Screening for Childhood Lead Exposure in a Low Prevalence Area---Salt Lake County, Utah, 1995--1996. MMWR. March 14, 1997; 46(10):213-217.

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Small Area Surveillance:

Technical Guide, Small Area Surveillance to Estimate Prevalence of Childhood Blood and Environmental Lead Levels (2016) [PDF - 2.35 MB].

• Conducting Blood Lead Prevalence Studies Training Module [PDF - 1.43 MB]
• Conducting Environmental Sampling Training Module [PDF - 513 KB]

 Top of Page Children’s Activity and Coloring Books:

• Ethan’s House Gets Healthier with A Visit from the Lead Poisoning Prevention Team [PDF - 2.83 MB]
• Is There Lead in the Water? [PDF - 1.14 MB]

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Healthy Homes Publications

• The Economic Burden of Exposure to Secondhand Smoke for Child and Adult Never Smokers Residing in U.S. Public Housing (2015).
• Advancing Healthy Housing – A Strategy for Action [PDF - 1.18 MB] (2013).
• Using Health Data to Highlight Milestones: A Cookbook for Non-profit Program Managers [PDF - 1.75 MB] (2012).
• Safety and Health in Manufactured Structures [PDF - 2.92 MB] (2011).
• Healthy Homes Manual: Smoke-Free Policies in Multiunit Housing [PDF - 7.35 MB] (2011).
• Developing a Healthy Homes Program [PDF - 1.8 MB] (2010).
• A Healthy Home for Everyone: The Guide for Families and Individuals [PDF - 2.56 MB] (2010).
• The Surgeon General’s Call to Action to Promote Healthy Homes (2009).
• Healthy Housing Inspection Manual (2008).
• Healthy Housing Reference Manual (2006).
• Integrated Pest Management: Conducting Urban Rodent Surveys [PDF - 1.4 MB] (2006).

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