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Blood Lead Level of Concern Workgroup Charge

The current charter of the Advisory Committee on Childhood Lead Poisoning Prevention expired on October 31, 2013. The ACCLPP has provided CDC and the Department of Health and Human Services with extremely valuable scientific and technical advice related to the prevention of childhood lead poisoning.

CDC is committed to childhood lead poisoning prevention; to address this important public health concern, CDC established the Lead Poisoning Prevention Subcommittee of the NCEH/ATSDR Board of Scientific Counselors in March 2015. The subcommittee was established to provide expertise on public health policies and practices relevant to lead poisoning prevention and to conduct preparatory research, analysis, and other developmental activities involving more detailed work that cannot be practically accomplished by the full Board of Scientific Counselors.

The Centers for Disease Control and Prevention’s Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) convened a workgroup to recommend a new approach, terminology, and strategy for elevated blood lead levels among children. This working group will include two focal areas.

One focal area will involve re-evaluating levels of lead in blood that are related to adverse effects, based on the current scientific literature. The workgroup’s charge includes:

  • Recommend how to best replace the ‘level of concern’ in relation to accumulating scientific evidence of adverse effects of <10 ug/dl blood lead in children and adults.
    • Potential approaches that can be considered include defining elevated levels as those exceeding normative reference values, undertaking a standard risk assessment based on reported adverse effect levels, or utilize an existing risk assessment prepared by others.
  • Factor in laboratory quantification for lead in blood as a possible limitation in establishing new guidance.

The second focal area will prepare recommendations to CDC to communicate corresponding advisories to groups who will be impacted by the recommended changes from focal area one deliberations. Such groups would include state and local health departments, health professionals, housing agencies, and the general public. New advisories will include the following areas of focus:

  • Interpretation of blood lead levels across the spectrum of levels;
  • Interpretation of increases in blood lead levels over time;
  • Screening and re-screening intervals, blood lead test result notification procedures and other interventions;
  • Recognizing that most intervention strategies were designed to address blood lead levels above the current “level of concern,” outline actions that parents/guardians can take to reduce (further) lead exposure for which there is evidence of effectiveness; and
  • Identify potential interventions that although they may not have been demonstrated to reduce blood lead concentrations at these levels but which seem promising.

The focal areas will then integrate recommendations and jointly develop a final document to include recommendations for future research to examine the efficacy of prevention and intervention strategies.

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