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Dangers of Lead Still Linger

by Dixie Farley

FDA orders the detention at U.S. borders of items known to possibly contain potential harmful levels of lead, including the Middle East eye cosmetics, the foreign digestive remedies, lead crystal baby bottles, and many other prohibited items. Lead sources outside FDA's purview include lead-based artists' paints, lead solder used in electronics work and stained glass, fishing weights, lead toy soldiers, and old painted toys and furniture.

Reflecting that these many lead sources are not all in every family's environment, new CDC screening guidance calls for state lead-poisoning prevention programs to identify communities at risk of high exposure and recommend appropriate screening. (See the accompanying article, "Screening and Treatment.") To this end, CDC funded 30 state and 10 local programs in 1996.

When announcing the new guidance, Health and Human Services Secretary Donna E. Shalala said, "Lower lead levels for America's children constitute a public health achievement of the first importance. But a significant number of children are still at risk for high lead exposure, and we have to finish the job on their behalf."

Dixie Farley is a staff writer for FDA Consumer.

Screening and Treatment

Decisions about who needs lead screening should be made by individual doctors as well as state health departments, who can examine local lead hazards and conditions to determine which children are at risk of lead exposure, according to 1997 guidance issued by the national Centers for Disease Control and Prevention.

A new screening test is especially suited for use in isolated U.S. rural areas and in developing countries. In September 1997, FDA approved the LEADCARE In Office Test System, a portable blood lead screening kit for health professionals' use in areas lacking refrigeration and other complex equipment needed with previously approved tests. Manufacturers developed the quick, easy and reliable kit in conjunction with CDC. FDA has approved three drugs that bind to, or chelate, lead molecules so the body can remove them in urine and stool. Calcium Disodium Versenate (edetate calcium disodium) requires injections or intravenous infusion in the hospital. Along with this drug, BAL (dimercaprol), also injected, may be used. The pediatric oral drug Chemet (succimer) may be taken at home, but it's important to eliminate the lead sources. Like other chelator drugs, Chemet should not substitute for effective environmental assessment and removal of the source of lead exposure. These drugs may have side effects, however, so doctors closely monitor their patients during treatment.

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