A Science-based Public Health Approach to Reducing Lead Exposure

By Tom Burke, PhD, MPH

One of the top great public health achievements in recent history has been reducing childhood lead exposure. However, the events in Flint underscore the continuing public health challenge of protecting our most vulnerable communities. Lead exposure has very real health effects, including effects on the developing brain. Lead can affect almost every organ and system in your body. Children six years old and younger are most susceptible to the effects of lead, which can include behavior and learning problems, lower IQ and hyperactivity, slowed growth, hearing problems, and anemia.

Over the past 50 years, EPA has worked with federal and state partners to reduce or eliminate the use of lead in gasoline, paint, plumbing pipes, food cans, and many other products. More recently, EPA has cleaned up lead-contaminated waste sites and established standards for dealing with old, lead-based paint. In addition, the public health and medical communities have worked together to increase awareness, identify those who are at risk, and provide blood lead testing for communities. Because of these collective actions, blood lead levels – the amount of lead measured in people’s blood – have declined by more than 90% since the mid-1970s. This is truly a public health achievement.

The median concentration of lead in the blood of children between the ages of 1 and 5 years dropped from 15 µg/dL in 1976–1980 to 1.2 µg/dL in 2009–2010, a decrease of 92%. The concentration of lead in blood at the 95th percentile in children ages 1 to 5 years dropped from 29 µg/dL in 1976–1980 to 3.4 µg/dL in 2009–2010, a decrease of 88%. The largest declines in blood lead levels occurred from the 1970s to the 1990s, following the elimination of lead in gasoline. 

Lead in children ages 1 to 5 years: Median and 95th percentile concentrations in blood, 1976-2014. Click the image for a larger version.

Despite an overall decline in lead exposure around the country, some communities still experience high levels of lead exposure from old, lead-based paint, corroding lead pipes, and industrial waste sites. As we’ve worked to reduce exposures from these sources, our understanding of the health effects of lead exposure has increased. We now know that exposure to even small amounts of lead can be harmful. Thus, it remains a priority to continue reducing lead exposure, especially in these vulnerable communities.

EPA is taking a coordinated, public health approach to dealing with lead so we can continue our progress in reducing lead exposures. This approach outlines a common set of public health principles, listed below, that will guide the Agency’s work related to lead.

  • There is no known threshold for the effects of lead.
  • The best way to reduce a child’s exposure to lead is to address all potential sources of exposure.
  • Reducing and minimizing sources of lead exposure is a long-term goal.
  • Children’s vulnerability to lead exposure through any source varies with their age.
  • When evaluating new actions, EPA uses a common set of science-based analytical tools to measure the impacts on children’s and adults’ blood lead levels and health.
  • While the public health goal is to eliminate exposure, national sampling of blood lead levels helps to track progress and identify children and communities at highest risk for effects.

EPA’s activities have been a cornerstone of the Nation’s progress in reducing lead exposure. However, our work is not done. Through this coordinated public health approach, EPA and partners will continue to identify and address environmental sources of exposure and prevent the harmful effects of lead in our communities.

About the Author: Thomas Burke, Ph.D. is the Deputy Assistant Administrator of EPA’s Office of Research and Development as well as the Agency’s Science Advisor. He served as the Jacob I. and Irene B. Fabrikant Professor and Chair in Health, Risk and Society and the Associate Dean for Public Health Practice and Training at the Johns Hopkins Bloomberg School of Public Health prior to coming to EPA. Before his time at Johns Hopkins, Dr. Burke was Deputy Commissioner of Health for the State of New Jersey and Director of the Office of Science and Research in the New Jersey Department of Environmental Protection.

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