Severe lead poisoning requiring the attention of a physician occurs only in a very small percentage of children. In contrast, the behavioral consequences of subtle lead poisoning are widespread. Lead has been consistently associated with lower scores on neurologic tests. Reaction times and attention are poorer in lead exposed children. There is a consistent monotonic increase in "bad" reports from teachers in association with increasing dentine lead levels. Failure in high school and reading disabilities are related to lead levels.
The US Alameda County Lead Poisoning Prevention Program (ACLPPP) has a three-pronged approach; educating parents, property owners and health-care providers to protect children from lead poisoning. The spark for creating the program was a 1987 study by the California Department of Health Services showing high levels of lead in the bloodstreams of Alameda County children. (The major sources of this lead are paint and soil around some houses built before 1978 and most built before 1950, car exhaust, and some ceramics and home remedies.) Since its start in 1991, the ACLPPP has become a model for other counties in the state. Among 432 children whose initial blood tests found too much lead, 90 percent showed a significant drop in blood lead levels after case managers from ACLPPP had worked with their families. The most impressive evidence of the program's success in prevention is the drop in the percentage of kids with elevated blood levels when they're first tested. In 1992, 26 percent of the children tested for lead had elevated levels at the initial screening. By 1995, that had dropped to 9 percent.
The dangers of lead poisoning go unrecognised because of: (1) a common belief that lead is an inner city problem; (2) the notion that poisoning is the mother's fault; (3) the belief that the problem was solved with the removal of lead from gasoline and paint; (4) the disinterest of academic pediatricians; (5) the activity of the lead industry; (6) the neglect of government (e.g. housing and urban development agencies, environmental protection agencies, consumer protection agencies; and (7) the belief that the problem is too large to handle.
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