The risk of lead poisoning among 155 of 234 eligible children (mean age, 4.8 years) enrolled in university affiliated day care centers with elevated environmental lead sources was determined at the Department of Pediatrics and University Hygienic Laboratory, The University of Iowa, Iowa City. Elevated levels of lead in paint (2.4% - 40% lead) were found in all six centers tested. Three centers were found to have elevated lead levels in windowsill dust (62000-180000 g Pb/sqM) or soil (530-1100 mg Pb/kgm). Questionnaires completed by parents showed low risk of lead exposure in the homes. Blood lead levels were less than 10 mcg/dL in all but one child. [1]

COMMENT. The lead-safe home environment, careful supervision, and good personal hygiene of these children would explain the relatively low blood lead levels despite elevated environmental lead levels in the day care centers. Major, costly lead abatement efforts would have been unwarranted in this situation.

Pediatric neurologists evaluating children with ADHD are cognizant of the role of lead exposure in the etiology of learning and behavior problems. The home and play environment questionnaire is important in determining the need for blood lead level determinations. Treatment guidelines for lead exposure in children are outlined in an American Academy of Pediatrics Committee on Drugs report [2]. Chelation therapy is indicated in patients with blood lead levels of 45 mcg/dL and above, and sometimes in those with persistent levels of 25-45 mcg/dL, despite environmental abatement. Chelation is not indicated for levels less than 25 mcg/dL