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1 INTRODUCTION
Pages 13-30

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From page 13...
... Screening programs identify about 12,000 children with evidence of lead toxicity each year (ATSDR, 1988) , but results of screening programs might seriously underestimate the magnitude of childhood lead exposure, primarily because few children are screened and because the false-negative rate of screening is high when screening is done with erythrocyte protoporphy rln.
From page 14...
... provide information on techniques for measuring environmental exposure of sensitive populations to lead. The Board on Environmental Studies and Toxicology in the NRC Commission on Life Sciences formed the Committee on Measuring Lead Exposure in Critical Populations to meet the need.
From page 16...
... Third, death from encephalopathy or massive brain damage is common in children with untreated blood lead concentrations of 150 ~g/~L and higher (NRC, 1972) , and approximately 10% of the concentration chat can cause death from brain damage might cause cognitive disturbances (as shown in epidemiologic studies)
From page 17...
... . Black columns, percentage of potentially fatal blood lead concentration at which intervention has been recommended.
From page 18...
... Occupational exposure at concentrations above those associated with reduced nerve conduction velocity, increased blood pressure, reduceci reserve capacity for blood formation, and adverse reproductive effects is still common and legally permissible. Figures I-3 and I~ show the decline in gasoline lead use and the decline in food lead in the typical infant diet in the United States.
From page 19...
... CL ~70 o 5 ID a) Q 60cn 80 ~5 a, ~50 19 An: A\\ \\~ -- -4 '\: '\ ,' -A Lead used in gasoline Average blood lead 40 - 16 \~\\ \ \ \ \ \ \ ' em\ \\'' ~ "'''"""1''''""'''1''"""'"1"''""'''1'"' 1976 1977 1978 1979 1980 Year - 15 - 14 - 13 ID to ID o o Q ID Q 12 ~ Q - 10 · 9 FIGURE 1-3 Lead used in gasoline production and average NHANES II blood lead (Feb.
From page 20...
... 20 ME4SU~G LID EXPOSURE B~ SE - 'T'VE PO~U"TIO~S 35 30 25 20 10 O~ ~I I r I I I ~9 ~\~\~\~6\0 F Isca year DGURE 1~ Average daily intakes of lead (based on FDA Total Diet Study)
From page 21...
... I - QODUCIlO~ 350 300 o c' ._ a) 250 E CD ° 200 ~ 150 o .° 1 00 ° 50 21 TO OF SO loo loo COCOON 'sol Coo Coo 0 Years ago FIGURE 1-5 Cumulative production of lead over historic time.
From page 22...
... The EPA Science Advisory Board and the Centers for Disease Control and Prevention concluded that published data clearly indicate that the upper limit of acceptable blood lead concentration is 10 Go/. This reduced acceptable blood concentration necessitates substantial improvement in analytic methods for measuring lead, as well as development of newer methods for measuring very low blood lead concentrations.
From page 23...
... Beginning of PaIllic-Health interest in Leal' Although it is probable that workers involved in the mining, smelting, and working of lead in ancient times were poisoned, technical details to support the assumption are not available. With the advent of the Industrial Revolution, however, interest in hazardous occupational lead exposures began to develop.
From page 24...
... Workers recognized sterility, abortion, stillbirth, and premature delivery as common, not only among female lead workers, but also among the wives of men who worked in the lead trades (Oliver, 1911; Hamilton and Hardy, 1949; Lane, 1949~. Indeed, those observations led a British Royal Commission in 1910 to recommend that women be excluded from the lead trades, a recommendation that was enforced in some countries by law Mane, 19491.
From page 25...
... j in ~ - 1 __ i I
From page 26...
... History of U.S. ChillIhooll LenIl-Screenino Programs Although several cases of childhood lead poisoning in the United States were reported in the first half of this century, little effort was made to understand the extent of poisoning in children until the 1950s, when caseworkers in a few large cities attempted to identify poisoned children as part of their family nutrition work.
From page 27...
... In 1981, the Maternal and Child Health Services Block Grant Act and the Omnibus Budget Reconciliation Act transferred the national administrative responsibility for childhood lead-poisoning prevention programs to the Division of Maternal and Child Health of the Bureau of Health Care Delivery and Assistance. Under the provisions of the block grant act, each state decides whether to use federal islands to support childhood lead-poisoning prevention efforts (NCEMCH, 1989~.
From page 28...
... The money was to be given to state and local agencies to perform childhood lead screening for medical and environmental followup and education about lead poisoning. The act specifically stated that the money was not to supplant other funding for childhood lead-poisoning prevention.
From page 29...
... The magnitude of human lead exposure deemed to be safe or without health effects continues to be reduced, to reflect improved identification of subtle toxic effects in sensitive populations. The committee considered measurement methods that could be useful in a world in which there might be no apparent threshold for particular neurobehavioral and other adverse health effects in vulnerable segments of the human population.
From page 30...
... The chapter describes the public-health implications of monitoring sensitive populations for lead exposure at low concentrations as recommended by CDC. Chapter 6 sets forth a comprehensive set of recommendations dealing with both the specifics and the generalities of the committee's charge.


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