Childhood Lead Poisoning Screening Activity in France Between 1995 and 2002

Abstract

SAA3-PD-02 Introduction: Lead poisoning can be responsible for neurodevelopmental and hematopoietic damage, especially in young children. Deteriorated lead-based paint in old buildings is one of the main risk factors. In 1995, a Childhood Lead Poisoning National Monitoring System began recording blood lead level and characteristics of all children who had lead blood tests; the screening was targeted to children with a probability of high exposure to lead. The objectives of the present study were: 1) to enumerate children screened for lead poisoning and new cases, and 2) to describe their distribution over time as well as geographically, their characteristics, and their risk factors to lead poisoning. Methods: The study's population was children who had one or more lead blood test in France between 1995 and 2002. In order to take a precise census of the number of children screened for lead poisoning and new cases, 2 sources of data were crosschecked: data recorded in the Monitoring System and questionnaires filled by the local authorities of public health in 2003. Results: A total of 36,151 children (35 of 100 000 children per year) were screened at least once. Most of them (95%) were under 7. The probability, for a child under 7, to have a lead blood test once was 0.6%. The annual incidence of detected lead poisoning cases was 17 of 100 000 children under 7 (N = 5974). During the study period, the percentage of screened children who had a lead blood level above the threshold of 100 μg/L decreased regularly (from 24.5% in 1995 to 8.5% in 2002). The screening activity was concentrated in 3 of the 22 French regions (Ile-de-France = 61%, Rhônes-Alpes = 13% and the North area = 9%) and 66% of the new cases lived in Paris or the suburbs even though the population of children was less than 20% of the total of French children. Moreover, 64% of the screened children lived in an old and deteriorated housing. The percentage of old and uncomfortable housing in each region was not correlated to the percentage of lead poisoning cases. Discussion and Conclusion: The incidence of childhood lead poisoning decreased regularly since 1995. Nevertheless, the French childhood lead poisoning screening activity stayed too much heterogeneous. Even if risk factors of lead poisoning aren't equally distributed in the French territory (old housing, industrial sites), numerous children exposed to lead are not screened in many regions and all the new cases are not identified.