Should the Centers for Disease Control and Prevention’s Childhood Lead Poisoning Intervention Level Be Lowered?

Bernard, Susan M.

doi:10.2105/ajph.93.8.1253

Cited by 47 publications

(36 citation statements)

References 71 publications

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“…Despite the accumulating data, CDC and some policy makers believe that CDC should retain the current 10 μg/dL blood lead standard (Bernard, 2003). They argue that a program targeted at levels below 5 μg/dL offers little benefit for the increased costs that would be incurred.…”

Section: Introductionmentioning

confidence: 99%

A rationale for lowering the blood lead action level from 10 to 2μg/dL

Gilbert¹,

2006

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Fifteen years ago, in 1991, the U.S. Centers for Disease Control and Prevention (CDC) established 10 μg/dL as the lowest level of concern for children's blood lead levels. This value is extremely important because, historically, policy makers and public health officials generally have acted to remove sources of lead exposure only after the CDC's level of concern had been exceeded. A growing body of evidence, however, reveals that blood lead levels below 10 μg/dL may impair neurobehavioral development. There is now sufficient and compelling scientific evidence for the CDC to lower the blood lead action level in children. This review argues that a level of 2 μg/dL is a useful and feasible replacement. Although it can be argued, in turn, that no threshold for the health effects of lead is demonstrable, analytically a blood level of 2 μg/dL is readily and accurately measured and provides a benchmark for successful prevention. Lowering the level of concern would encourage and accelerate the investments needed to ensure that children are protected from lead exposure in their homes, schools, and play settings. Such a program would also offer economic advantages because of the coupling between lead, educational attainment, earnings and anti-social conduct. By lowering the blood action level, CDC will promote policies and initiatives designed to further reduce children's exposure to this potent developmental neurotoxicant.

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Section: Introductionmentioning

confidence: 99%

A rationale for lowering the blood lead action level from 10 to 2μg/dL

Gilbert¹,

2006

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“…Some studies have shown that the increase in the auditory threshold was correlated with the levels of lead in blood 12,[13][14][15] while others did not confirm this finding 16,17 . Only a single study considered the cumulative lead level, given by the index calculation of the long term exposure to the metal, similar to that proposed in this study.…”

Section: Discussionmentioning

confidence: 96%

Avaliação audiológica em crianças com baixo nível de exposição cumulativa ao chumbo

et al. 2012

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Objetivo verificar a ocorrência de perda auditiva sensorioneural em crianças com baixo nível de exposição cumulativa ao chumbo. Métodos 156 crianças intoxicadas por chumbo, 94 do sexo masculino e 62 do sexo feminino, na faixa etária entre 18 meses a 14 anos e 5 meses, foram submetidas a análise longitudinal do nível de Plumbemia em sangue, bem como audiometria tonal liminar e emissões otoacústicas evocadas por estímulo transiente. Resultados a população pesquisada apresentou um valor médio de Plumbemia estimada de 12,2±5,7mg/dL (faixa entre 2,4-33mg/dL); todas as crianças apresentaram resposta normal na audiometria tonal liminar em 20 dBNA nas frequências testadas, 0,5; 1; 2 e 4 kHz, para ambas as orelhas; as emissões otoacústicas evocadas por estímulo transiente estiveram presentes para todas as frequências bilateralmente, nas 79 crianças pesquisadas. Conclusão não foi constatada perda auditiva sensorioneural em crianças com histórico de baixo nível de exposição cumulativa por chumbo, assim como não foi encontrada lesão de células ciliadas externas na cóclea, mesmo que subclínicas.

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“…The Centers for Disease Control (CDC) estimate that 24 million houses with lead paint still exist in the United States, at least 4 million of which are inhabited by young children (CDC, 2004b). Not surprisingly, the families living in such houses are predominantly lower-income, members of minority groups, or both (National Research Council, 1993;Lamphear, Weitzman et al, 1996;Bernard, 2004).…”

Section: "Kennedy Krieger Cannot Understand How a Study Funded By Thementioning

confidence: 99%

Science ethics as a bureaucratic problem: IRBs, Rules, and Failures of control

Bozeman

Hirsch

2006

Policy Sci

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â€œInstitutionalized science ethicsâ€\x9D refers to the statutory, professional and institution-based ethical standards that guide and constrain scientists' research work. The primary institution responsible for implementing institutionalized science ethics is the Institutional Review Board. We examine the limitations of IRBs and institutionalized science ethics, using bureaucratic theory and, especially, theory related to the development and enactment of rules. We suggest that due to the very character of rules-based systems, improvements in IRB outcomes are unlikely to be achieved through either more or better rules or even by bureaucratic reform. Instead, we suggest that improvements in human subject protection can best be advanced through increased participation. Ours is not a call for more participation by the general public but participation, via â€œParticipant Review Boardsâ€\x9D of persons who are eligible, by the protocols of the research in question, to serve as subjects. This provides a level of legitimacy and face validity that cannot be obtained by IRB affiliates, even by â€œexternal representatives.â€\x9D In making these points, we review a recent science ethics controversy, the KKI/Johns Hopkins lead paint study. In spite of being approved by IRBs, the study resulted in a civil lawsuit that reached the Maryland Court of Appeals. The case illustrates the limits of institutionalized science ethics and the bureaucracies created for their enactment. The case also underscores the complex and equivocal nature of the ethical guidelines established under the National Research Act. Copyright Springer Science+Business Media, Inc. 2005

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Should the Centers for Disease Control and Prevention’s Childhood Lead Poisoning Intervention Level Be Lowered?

Cited by 47 publications

References 71 publications

A rationale for lowering the blood lead action level from 10 to 2μg/dL

A rationale for lowering the blood lead action level from 10 to 2μg/dL

Avaliação audiológica em crianças com baixo nível de exposição cumulativa ao chumbo

Science ethics as a bureaucratic problem: IRBs, Rules, and Failures of control

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