Management of children with slightly elevated blood lead levels.
OBJECTIVE
To determine whether counseling of parents reduced blood lead levels in their young children.


METHODS
A lead exposure study was conducted in the vicinity of a defunct lead smelter. A total of 827 volunteers including 490 children younger than 6 years participated in the study. The mean venous blood lead level in the 490 children was 0.33 mumol/L (6.9 micrograms/dL), with a range of 0.03 to 1.94 mumol/L (0.7 to 40.2 micrograms/dL). A total of 78 (16%) children had blood lead levels > or = 0.48 mumol/L (10 micrograms/dL). However, only 5 (1%) of the children had blood lead levels of > or = 1.21 mumol/L (25 micrograms/dL). The blood lead levels in this community were much lower than levels reported in earlier studies in many areas of the United States, when lead levels in air and in food were higher. Most houses in the study community were built before 1920 and had high lead paint levels. High levels of lead were also found in many house dust and soil samples. Intervention consisted of home visits and counseling of parents of children with blood lead levels of > or = 0.48 mumol/L (10 micrograms/dL).


RESULTS
In children with initial blood lead levels of > or = 0.48 mumol/L (10 micrograms/dL) the blood lead test was repeated 4 months later. The arithmetic mean blood lead level 4 months later showed a decrease from 0.72 mumol/L (15 micrograms/dL) to 0.38 mumol/L (7.8 micrograms/dL). An additional blood sample was taken 1 year after the first sample in a subset of 30 children. These children showed a mean blood lead level of 0.43 mumol/L (9 micrograms/dL) at the 1-year follow-up, whereas their mean blood lead level at the 4-month follow-up had been 0.38 mumol/L (8 micrograms/dL).


CONCLUSIONS
Educating parents proved a very effective tool. Further studies are needed in larger populations to evaluate the effectiveness of this approach.
Kimbrough
R D
RD
Institute for Evaluating Health Risks, Washington, DC 20005.
LeVois
M
M
Webb
D R
DR
D002675:Child, Preschool; D003376:Counseling; D004781:Environmental Exposure / Q000032:analysis; D005260:Female; D006266:Health Education; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood / Q000628:therapy*; D008297:Male; D010290:Parents
D007854:Lead