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Department of Health and Human Services (HHS) Secretary Tommy G. Thompson and Environmental Protection Agency (EPA) Administrator Christie Whitman co-chair the President's Task Force on Environmental Health Risks and Safety Risks to Children, which in 2000 released a government-wide strategy for eliminating the causes of paint-related lead poisoning among children. The strategy integrates the activities of HHS, EPA, the Department of Housing and Urban Development (HUD), and the Department of Justice. HHS' budget for fiscal year 2002 includes $43 million in funding for the Centers for Disease Control and Prevention (CDC), which carries out programs for efforts such as screening and public education about childhood lead poisoning. The federal-state Medicaid program provides screening for children from low-income families. Other HHS agencies are also involved in screening, research and other activities to prevent childhood lead poisoning.

Background: Lead poisoning is a serious, yet preventable, condition that is particularly damaging to young children. Lead poisoning can affect a child's brain, kidneys, bone marrow and other body systems. There can be adverse health effects even at low blood lead levels.

Great strides have been made in reducing lead exposure during the past two decades. Lead is no longer present in gasoline, new supplies of house paint, food and beverage cans. Lead also has been reduced in industrial emissions, drinking water, hazardous waste and consumer goods. As a result, there has been a decline of more than 80 percent in children's blood lead levels since the mid-1970s. In 1978, approximately 14.8 million children in the United States suffered from lead poisoning. By the early 1990s, that number had declined to 890,000 children, according to CDC statistics.

Today, many children remain at risk for lead poisoning due primarily to deteriorated lead paint in older housing as well as house dust, drinking water and soil contaminated by lead paint. Although a 1978 ban prohibits the use of lead in new paint, children who live in older housing are still at risk, with low-income and minority children experiencing the greatest risk. For example, the CDC estimates that 16 percent of children living in older housing are poisoned, compared to 4.4 percent of all children.

Reducing lead exposure not only benefits children's health and development but also yields economic benefits from avoiding health care and special education costs, from preventing reductions in children's intelligence, academic achievement and future productivity, and from improvements to housing associated with controlling lead hazards.

NATIONAL STRATEGY TO ELIMINATE CHILDHOOD LEAD POISONING

HHS plays an integral role in the government-wide strategy to eliminate childhood lead poisoning in America within the next 10 years. Developed by the President's Task Force on Environmental Health Risks and Safety Risks to Children, the strategy calls for making 2.3 million children's homes lead-safe by controlling lead paint hazards. The strategy also calls for promoting public education programs, strictly enforcing lead-paint regulations, and encouraging early interventions for at-risk children. The report estimates that by preventing adverse effects of lead on children's health and development, the economic benefits will exceed the cost of the effort by $8.9 billion. Copies of the strategy are available from the National Lead Information Center at 1-800-424-LEAD. The strategy is also available on the Internet at www.epa.gov/children/whatwe/tf_proj.htm.

HHS ROLE IN COMBATING LEAD POISONING

HHS agencies are actively involved in the government-wide efforts to combat childhood lead poisoning:

Centers for Disease Control and Prevention: CDC's fiscal year 2002 budget includes $42 million to fund various programs to prevent lead poisoning in children. CDC administers the Childhood Lead Poisoning Prevention Grant Program, which provides grants to state and local health departments to support childhood lead poisoning prevention programs designed to identify and screen at-risk children. CDC also works with other federal agencies in the effort to screen all high-risk children, especially Medicaid-enrolled children. In addition to encouraging screening and follow-up of affected children, the grants support education and outreach efforts.

CDC is researching ways to improve the quality of blood lead measurements and to develop new technology to provide faster, lower-cost blood analyzers. Under the Blood Lead Laboratory Reference System, CDC sends blood lead specimens for quarterly analysis to more than 275 laboratories worldwide. CDC also administers the National Health and Nutrition Examination Survey, the only source of periodic, nationally-representative data on blood lead levels in the United States. Data from this survey are used to track trends in blood lead levels and to support regulatory and policy decisions aimed at protecting at-risk populations. In 2001, CDC developed the High-Intensity Targeted Screening (HITS) for Childhood Lead Poisoning Program to improve the nation's ability to target and screen children for lead poisoning and to prevent exposure to lead. The program includes door-to-door screenings, interventions, capacity building and partnership building and has been launched in two inner-city communities in Chicago.

Centers for Medicare & Medicaid Services (CMS): Children from low-income families are at higher risk for becoming lead poisoned than other children. Through the federal-state Medicaid program, CMS is working with other HHS agencies and the state Medicaid agencies to increase lead screening of at-risk children. Through the Early and Periodic Screening, Diagnostic and Treatment program, all Medicaid-eligible children should receive a blood lead screening test at ages 1 and 2 as well as lead poisoning treatment and follow-up services.

Health Resources and Services Administration (HRSA): HRSA plays an integral role in conducting childhood lead poisoning prevention outreach and education efforts for at-risk populations. In fiscal year 2002, HRSA is providing more than $21.2 million in grants directly to poison control centers. HRSA supports the National Lead Training and Resource Center in Louisville, Ky., which provides education and training to health-care professionals who work in the field of childhood lead-poisoning prevention. HRSA also funds the Nationwide EP Screening and Blood Lead Proficiency Program, which certifies laboratories that perform blood lead screenings as meeting national standards. Finally, HRSA works to ensure appropriate screening of children at federally supported community health centers.

Food and Drug Administration (FDA): FDA monitors the levels of lead in food products. The agency's most recent Total Diet Studies in 1999 showed that, since 1982, the daily intakes of lead from food dropped dramatically for the entire population. FDA also has established maximum levels for leachable lead in ceramicware and has banned lead solders in metal food cans and tin-coated lead foil capsules for wine bottles. In addition, FDA continues to identify controllable sources of dietary lead in food additives and food.

National Institutes of Health (NIH): The National Institute of Environmental Health Sciences (NIEHS) at NIH has been studying the health effects of lead for more than 20 years. Information from these studies supported the actions to remove the lead from gasoline. Today, NIEHS scientists and grantees are researching how low levels of lead affect people, the effectiveness of treating lead-poisoned children with a drug to prevent lead-induced deficits in IQ, and whether calcium supplements given to pregnant women reduce the transfer of lead from their bones into their fetuses.

More information on the President's Task Force on Environmental Health Risks and Safety Risks to Children is available at www.hhs.gov/news/press/2001pres/20011024a.html.

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