The absence of fully effective treatment for lead encephalopathy, and the suggestive evidence that lead poisoning may cause brain damage even in the absence of overt encephalopathy, have led to massive efforts to prevent such damage.
These preventive efforts have been directed toward screening to identify children who have absorbed an undue amount of lead from their environment, reducing their further exposure to lead, and removing already absorbed lead from those most in danger of developing ill effects. This approach has been codified in the Surgeon General's Report of 19701 which makes the following recommendations:
1. All young children who live in or visit old dilapidated buildings should have periodic blood lead determinations.
2. Any child with repeated blood lead levels over 40µg/100 ml whole blood should be considered to be at risk of lead poisoning, h ave current sources of exposure to lead investigated and corrected, and be followed closely to ensure that he does not develop higher blood lead levels or clinical symptoms.
3. All children with blood lead levels between 50 and 79µg/100 ml should have diagnostic tests for metabolic and clinical evidence of lead poisoning and be treated immediately if such evidence is present.
4. All children with blood lead levels over 80µg/100 ml should be hospitalized immediately and treated with chelating agents.
Many aspects of this approach are subjects of current controversey, and the last word will not be written until much better knowledge of the natural history and ecology of lead poisoning is available.
Lead Toxicity in a Family as a Result of Occupational Exposure
