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Editorial
Lead poisoning cannot be consigned to history books yet: new guidance to help us to reach that goal
  1. Alan M Emond
  1. Centre for Academic Child Health, University of Bristol Medical School, Bristol BS8 1NU, UK
  1. Correspondence to Professor Alan M Emond, Centre for Academic Child Health, University of Bristol Medical School, Bristol BS8 1NU, UK; alan.emond{at}bristol.ac.uk

https://doi.org/10.1136/archdischild-2019-318756

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    Lead remains a widespread environmental contaminant: although removal of lead from petrol has resulted in atmospheric lead concentrations falling in many industrialised countries, humans are still exposed through food, water, soil and old paint.1 2 Young children are particularly vulnerable to lead exposure, because of direct ingestion or hand-to-mouth behaviour, and children absorb lead more readily than adults. Once absorbed, lead is stored in bones and teeth, to be slowly released over many years. There is no safe blood lead concentration (BLC) in children, and there appears to be a gradient of effect of lead on the developing nervous system3 and the haematological, renal and reproductive systems.4 Although the USA, Australia and France have recommended that action should be taken for BLCs in children above 5 µg/dL (0.24 μmol/L), until recently the public health action level in England has been set at >10 µg/dL (≥0.48 μmol/L), regardless of age.

    What are the new guidelines?

    From 5 July 2021, the BLC threshold (referred to as the ‘public health intervention concentration’) at which public health action is recommended in England has reduced to ≥5 µg/dL (0.24 μmol/L), for children under 16 years and for pregnant women. The higher threshold of ≥10 µg/dL (≥0.48 μmol/L) will still apply to adults. There are two main reasons for the change. First, …

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    Footnotes

    • Correction notice This article has been updated since it was first published. Public Health England is now called the UK Health Security Agency.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.