Lead is a ubiquitous toxic agent that is especially damaging to the young child and the developing fetus. Unlike many environmental health risks, the risks associated with lead are no longer theoretical but have been observed for many years. Indeed, the first regulation of lead in paint was enacted in the 1920s.

Currently, because of growing evidence of lead toxicity at lower concentrations, the U.S. Centers for Disease Control and Prevention recently lowered its lead-exposure guideline to 10 ug/dl lead in blood from 25 ug/dl. Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations addresses the public health concern about the logistics and feasibility of lead screening in infants and children at such low concentrations. This book will serve as the basis for all U.S. Public Health Service activities and for all state and local programs in monitoring lead.

Contents

• Committee on Measuring Lead in Critical Populations
• Board on Environmental Studies and Toxicology
• Commission on Life Sciences
• Other Recent Reports of the Board on Environmental Studies and Toxicology
• Preface
• Executive Summary
• 1. Introduction
  • Perspective on Issues
  • Historical Background
  • Scope and Organization of the Committee Report
• 2. Adverse Health Effects of Exposure to Lead
  • Clinical Intoxication in Children
  • Intoxication in Adults
  • Reproductive and Developmental Effects
  • Cardiovascular Effects
  • Mechanisms of Toxicity
  • Summary
• 3. Lead Exposure of Sensitive Populations
  • Historical Overview of Anthropogenic Lead Contamination
  • Source-Specific Lead Exposure of Sensitive Populations
  • Summary
• 4. Biologic Markers of Lead Toxicity
  • Biologic Markers of Exposure
  • Biologic Markers of Effect
  • Biologic Markers of Susceptibility
  • Summary
• 5. Methods for Assessing Exposure to Lead
  • Introduction
  • Sampling and Sample Handling
  • Measurement of Lead in Specific Tissues
  • Mass Spectrometry
  • Atomic-Absorption Spectrometry
  • Anodic-Stripping Voltammetry and Other Electrochemical Methods
  • Nuclear Magnetic Resonance Spectroscopy
  • The Calcium-Disodium Edta Provocation Test
  • X-Ray Fluorescence Measurement
  • Quality Assurance and Quality Control
  • Summary
• 6. Summary and Recommendations
  • Sources of Lead Exposure
  • Adverse Health Effects of Lead
  • Markers of Lead Exposure and Effect
  • Techniques to Measure Lead Exposure and Early Toxic Effects
• References

The project was supported by the Comprehensive Environmental Response, Compensation, and Liability Act Trust Fund through cooperative agreement with the Agency for Toxic Substances and Disease Registry, U.S. Public Health Service, Department of Health and Human Services.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Academy of Sciences is a private, non-profit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council.