Preventing exposure is the only effective approach to preventing toxicity.
Primary prevention of lead exposure in children
This necessitates the removal of lead from the environment prior to a child being exposed.[41]Centers for Disease Control and Prevention (CDC). Lead poisoning prevention. Childhood lead poisoning prevention program. January 2022 [internet publication].
https://www.cdc.gov/nceh/lead/prevention/default.htm
The effectiveness of this approach has been demonstrated by the decrease in population blood lead with removal of lead from gasoline. Likewise, removing lead from paint in the US has dramatically improved the outlook for lead exposure for children.[5]Centers for Disease Control and Prevention (CDC). Blood lead levels: United States, 1988-1991. MMWR Morb Mortal Wkly Rep. 1994;43:545-548.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00032080.htm
http://www.ncbi.nlm.nih.gov/pubmed/8035771?tool=bestpractice.com
Improved canning methods and other approaches have dramatically decreased lead exposure from food, as have removal, replacement, and discontinuation of lead water pipes and lead solders in water systems.[18]Levin R, Brown MJ, Kashtock ME, et al. Lead exposures in U.S. children, 2008: implications for prevention. Environ Health Perspect. 2008;116:1285-93.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18941567
http://www.ncbi.nlm.nih.gov/pubmed/18941567?tool=bestpractice.com
[19]Maas RP, Patch SC, Morgan DM, et al. Reducing lead exposure from drinking water: recent history and current status. Public Health Rep. 2005;120:316-21.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1497727&blobtype=pdf
http://www.ncbi.nlm.nih.gov/pubmed/16134575?tool=bestpractice.com
Current evidence indicates that household educational interventions are ineffective in reducing blood lead levels in children as a population health measure.[42]Nussbaumer-Streit B, Mayr V, Dobrescu AI, et al. Household interventions for secondary prevention of domestic lead exposure in children. Cochrane Database Syst Rev. 2020 Oct 6;10:CD006047.
https://www.doi.org/10.1002/14651858.CD006047.pub6
http://www.ncbi.nlm.nih.gov/pubmed/33022752?tool=bestpractice.com
Trials in low- and middle-income countries, and in differing socioeconomic groups in high-income countries, are required.
Limiting occupational exposure to lead
Can be achieved by good air exchange and filtration, appropriate use of protective clothing, and restrictions on eating and drinking in work areas. The National Institute for Occupational Safety and Health (NIOSH) provides information for workers and employers about reducing exposure to lead.
National Institute for Occupational Safety and Health: lead
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Education of lead-exposed workers has been promoted but appears to have little effect; better quality studies are required.[43]Allaouat S, Reddy VK, Räsänen K, et al. Educational interventions for preventing lead poisoning in workers. Cochrane Database Syst Rev. 2020 Aug 28;(2):CD013097.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013097.pub2/full
Objectives and screening
The US Department of Health and Human Services Healthy People 2030 goal is to reduce the blood lead levels of children (ages 1 to 5 years) to ≤1.18 micrograms/dL, and of adults to ≤1.74 micrograms/dL.[44]US Department for Health and Human Services. Healthy People 2030. Reduce exposure to lead - EH‑08 [internet publication].
https://health.gov/healthypeople/objectives-and-data/browse-objectives/environmental-health/reduce-exposure-lead-eh-08
[45]US Department of Healthand Human Sciences. Healthy People 2030. Reduce blood lead levels in children aged 1 to 5 years - EH‑04 [internet publication].
https://health.gov/healthypeople/objectives-and-data/browse-objectives/housing-and-homes/reduce-blood-lead-levels-children-aged-1-5-years-eh-04
Mandatory lead screening programs exist in many areas to detect all children with lead poisoning. In the US, the Medicaid program requires blood lead screening tests at age 1 and age 2 years.[46]Medicaid.gov. Lead screening [internet publication].
https://www.medicaid.gov/medicaid/benefits/early-and-periodic-screening-diagnostic-and-treatment/lead-screening/index.html
Children aged between 24 and 72 months, with no record of a previous blood screening test, are required to receive one.