XII. Environmental and Occupational Health

FY 2000 Performance Plan - Revised Final FY 1999 Performance Plan

Lead Poisoning

Childhood lead poisoning, a major preventable environmental health problem in the U.S., is estimated to cost society billions of dollars. Exposure to lead is a well-recognized cause of serious cognitive, learning, and behavioral problems in children. Progress continues to be made in reducing childhood lead poisoning, but many children nationwide, especially those who live in large central cities in older housing, continue to be heavily exposed to lead from lead-based paint, dust, and soil. The burden of lead poisoning is not equally distributed among children in the U.S. The prevalence of elevated blood lead levels (BLL) in African American children living in large inner cities is around 36 percent, and the prevalence among white, suburban children who are not poor is around 4 percent. Screening and other lead poisoning prevention approaches are being intensified among children in high-risk populations. In order to more effectively focus screening and follow up efforts on high-risk children, CDC has updated its screening guidelines, based on new scientific and practical information. This will result in better targeting of prevention efforts and enable prevention programs to use their limited resources more cost-effectively. CDC staff are expanding technical assistance, consultation, and training to support state and local health officials and their prevention programs.

The goal of the CDC program in childhood lead poisoning prevention is to eliminate childhood lead poisoning as a major public health problem within the next two decades. The challenge is to select a mix of appropriate and complementary strategies for eliminating childhood lead poisoning in populations with different lead poisoning problems, while strengthening childhood lead poisoning prevention efforts in populations that are at highest risk.

Performance Goals and Measures

Performance Goal: By 2011, there will be virtually no children with blood lead levels that exceed 10 micrograms per deciliter, which is the level at which children's health may be damaged (baseline data from 1991-1994 NHANES III for the period 1991-1994 indicates that there were 890,000 children with blood lead levels greater than 10 micrograms per deciliter).

Performance Measures:

This long-term objective is supported by outcome-based performance measures that capture the essence of the childhood lead poisoning prevention program, which seeks to eliminate childhood lead poisoning by the year 2011. We believe that an annual 5% decline in childhood blood lead levels is achievable. However, as we get closer to meeting our goal of eliminating this public health problem, we may encounter greater challenges that will result in slower declines. We are currently engaged in efforts to anticipate and address these challenges through a greater emphasis on primary prevention and targeted screening approaches. However, the National Health and Nutrition Examination Survey (NHANES) which provides the data to measure our progress, is a periodic survey that is dependent on continued congressional appropriations. The next NHANES is planned such that results will be available to assess progress on this objective by 2002 or 2003; however, sufficient appropriations to accomplish this survey are not assured. There are no data sources that allow for annual tracking of this measure, although CDC's National Center for Environmental Health (NCEH) is working with its state grantees to increase the availability of state-specific data on blood lead levels.

Verification/Validation of Performance Measures: Data for these measures will be available from grantee progress reports, and children's blood lead levels will be monitored using NHANES data.

Links to DHHS Strategic Plan

This performance objective is related to DHHS Goal 1: Reduce major threats to the health and productivity of all Americans.

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