Investigating lead poisoning in children—could surveillance help?

Abstract

Lead poisoning in children (LPIC) is associated with serious health effects including neurodevelopmental problems. Population-level preventive measures have helped to reduce exposures to new sources of lead for children in high-income countries such as England. However, new LPIC cases can still occur through exposure to existing sources of lead in the environment. In this article, we discuss how development of laboratory surveillance of LPIC could aid investigation and control of environmental sources of lead. Environmental risks are a particular concern for child health due to the higher exposures in comparison to adults and also the potential effects for growth and development. In recognition of this, the World Health Organization European Region (WHO EURO) has developed The Children’s Environment and Health Action Plan for Europe (CEHAPE) to help tackle environment-related child disease among European member states. In addition to tackling morbidity related to air pollution and inadequate sanitation, a key goal of this plan is ‘to reduce the risk of disease and disability arising from exposure to hazardous chemicals (such as heavy metals)’.1 The UK is one of the EURO member states committed to CEHAPE and has a number of pre-existing policies related to environmental risks. However, a need has been identified in the UK to improve knowledge of patterns of poisoning in children and information about the settings in which children are exposed.2 High-income countries such as the UK and USA have been successful in using population-wide measures such as legal restrictions to restrict the use of lead such as drinking water pipes, toys and paint. However, children can still be exposed to environmental lead that had accumulated prior to these interventions. These exposures can be associated with a range of health effects such as headaches, fatigue and abdominal pain. The most recently published evidence for childhood lead …