Preventing Lead Poisoning in Young Children: Tables
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- Table of Contents
- Chapter 1. Introduction
- Chapter 2. Background
- Chapter 3. Sources and Pathways of Lead Exposure
- Chapter 4. The Role of the Pediatric Health-Care Provider
- Chapter 5. The Role of State and Local Public Agencies
- Chapter 6. Screening
- Chapter 7. Diagnostic Evaluation and Medical Management of Children with Blood Lead Levels > or = to 20 µg/dL
- Chapter 8. Management of Lead Hazards in the Environment of the Individual Child
- Chapter 9. Management of Lead Hazards in the Community
- Appendix I. Capillary Sampling Protocol
- Appendix II. Summary for the Pediatric Health-Care Provider
- Tables
- Table 1-1. Interpretation of Blood Lead Test Results and Follow-up Activities: Class of Child Based on Blood Lead Concentration
- Table 3-1. Industries Identified by Surveillance for Elevated Blood Lead Levels, California and New York, 1991
- Table 6-1. Priority Groups for Screening
- Table 6-2. Assessing the Risk of High-Dose Exposure to Lead—Sample Questionnaire
- Table 6-3. Class of Child and Recommended Action According to Blood Lead Measurement
- Table 6-4. Suggested Timetable for Confirming Capillary Blood Lead Results with a Venous Blood Lead Measurement
- Table 7-1. Chelating Agents Used in Treating Children with Lead Poisoning
- Figures
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Table 1-1. Interpretation of Blood Lead Test Results and Followup Activities: Class of Child Based on Blood Lead Concentration
| Class | Blood lead concentration (µg/dL) | Comment |
|---|---|---|
| I | < or = to 9 | A child in Class I is not considered to be lead-poisoned. |
| IIA | 10-14 | Many children (or a large proportion of children) with blood lead levels in this range should trigger communitywide childhood lead poisoning prevention activities (Chapter 9). Children in this range may need to be rescreened more frequently. |
| IIB | 15-19 | A child in Class IIB should receive nutritional and educational interventions and more frequent screening. If the blood lead level persists in this range, environmental investigation and intervention should be done (Chapter 8). |
| III | 20-44 | A child in Class III should receive environmental evaluation and remediation (Chapter 8) and a medical evaluation (Chapter 7). Such a child may need pharmacologic treatment of lead poisoning (Chapter 7). |
| IV | 45-69 | A child in Class IV will need both medical and environmental interventions, including chelation therapy (Chapter 7 and Chapter 8). |
| V | > or = to 70 | A child with Class V lead poisoning is a medical emergency. Medical and environmental management must begin immediately (Chapter 7 and Chapter 8). |
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Table 3-1. Industries Identified by Surveillance for Elevated Blood Lead Levels, California and New York, 1991
| Industry Description | Standard Industrial Classification Number |
|---|---|
| Secondary smelting and refining of nonferrous metals | 3341 |
| Storage batteries (lead batteries) | 3691 |
| Valve and pipe fittings (except plumber's brass goods) | 3494 |
| Plumbing fixture fittings and trim (brass goods) | 3432 |
| Brass/copper foundry | 3362 |
| Glass products, made of purchased glass | 3231 |
| Motor vehicle parts and accessories | 3714 |
| Firing range workers | 7997,9221 |
| Pottery, nec | 3269 |
| Chemical and chemical preparations | 2899 |
| Bridge, tunnel, and elevated highway construction | 1622 |
| Automotive repair shops | 7539 |
| Industrial machinery and equipment | 5084 |
| Inorganic pigments | 2816 |
| Primary batteries, dry and wet | 3692 |
Sources: Baser and Marion, 1990; Maizlish et al., 1990.
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Table 6-1. Priority Groups for Screening
Children, ages 6 to 72 months, who live in or are frequent visitors to deteriorated housing built before 1960.
Children, ages 6 to 72 months, who live in housing built before 1960 with recent, ongoing, or planned renovation or remodeling.
Children, ages 6 to 72 months, who are siblings, housemates, or playmates of children with known lead poisoning.
Children, ages 6 to 72 months, whose parents or other household members participate in a lead-related occupation or hobby.
Children, ages 6 to 72 months, who live near active lead smelters, battery recycling plants, or other industries likely to result in atmospheric lead release.
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Table 6-2. Assessing the Risk of High-Dose Exposure to Lead—Sample Questionnaire
Does your child—
1. Live in or regularly visit a house with peeling or chipping paint built before 1960? This could include a day care center, preschool, the home of a babysitter or a relative, etc.
2. Live in or regularly visit a house built before 1960 with recent, ongoing, or planned renovation or remodeling?
3. Have a brother or sister, housemate, or playmate being followed or treated for lead poisoning (that is, blood lead > or = to 15 µg/dL)?
4. Live with an adult whose job or hobby involves exposure to lead (see Chapter 3)?
5. Live near an active lead smelter, battery recycling plant, or other industry likely to release lead?
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Table 6-3. Class of Child and Recommended Action According to Blood Lead Measurement
| Class | Blood Lead Concentration (µg/dL) | Action |
|---|---|---|
| I | < or = to 9 | Low risk for high-dose exposure: rescreen as described in text. High risk for high-dose exposure: rescreen as described in text. |
| IIA | 10-14 | Rescreen as described in text. If many children in the community have blood lead levels > or = to 10, community interventions (primary prevention activities) should be considered by appropriate agencies (see Chapter 9). |
| IIB | 15-19 | Rescreen as described in text. Take a history to assess possible high-dose sources of lead. Educate parents about diet, cleaning, etc. Test for iron deficiency. Consider environmental investigation and lead hazard abatement if levels persist. |
| III | 20-44* | Conduct a complete medical evaluation. Identify and eliminate environmental lead sources. |
| IV | 45-69* | Begin medical treatment and environmental assessment and remediation within 48 hours. |
| V | > or = to 70* | Begin medical treatment and environmental assessment and remediation IMMEDIATELY. |
*Based on confirmatory blood lead level.
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Table 6-4. Suggested Timetable for Confirming Capillary Blood Lead Results with a Venous Blood Lead Measurement
| Blood Lead Level (µg/dL) | Time Within Which Blood Lead Level Should Be Obtained |
|---|---|
| <10 | |
| 10-14 | Not applicable |
| 15-19 | Within 1 month |
| 20-44 | Within 1 week |
| 45-69 | Within 48 hours |
| > or = to 70 | Immediately |
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Table 7-1. Chelating Agents Used in Treating Children with Lead Poisoning
| Product Name | Generic Name | Chemical Name | Abbreviation |
|---|---|---|---|
| Calcium Disodium Versenate | Edetate disodium calcium | Calcium disodium ethylenediamine tetraacetate | CaNa2EDTA |
| BAL in Oil | Dimercaprol | 2,3-dimercapto-1-propanol | BAL |
| Cuprimine | D-penicillamine | 3-mercapto-D-valine | D-penicillamine |
| Chemet | Succimer | Meso 2,3-dimercaptosuccinic acid | DMSA |
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- Page last reviewed: October 1, 1991
- Page last updated: October 1, 1991
- Content source:
National Center for Environmental Health, Division of Emergency and Environmental Health Services