Up to 365,000 more children across the USA will be considered at risk of lead poisoning under new guidelines released today by the Centers for Disease Control and Prevention.

In an important shift, the CDC cut in half the amount of lead that will lead to medical monitoring and other actions in children ages 1 to 5.It’s the first time in more than 20 years that the CDC has revised its action level on lead poisoning.

Now any child with more than 5 micrograms per deciliter of lead in their blood will be considered at risk. This afternoon, the CDC said the new guidelines increase the patient population nationwide to about 442,000 from about 77,000 using the latest available data. (The CDC had previously said about 250,000 were affected under the current standard.)

The new levels mark the first change to the standard in 20 years and come with a huge caveat. The CDC doesn’t “have the funding, staff or control over the means to implement” them, it said in a statement. “A commitment to implement actions cannot be made due to our lack of control over available resources.”

The CDC’s funding for lead-poisoning prevention was slashed 94% this year by Congress, from $29 million in fiscal year 2011 to $2 million. The CDC is reducing staff in its Lead Poisoning Prevention Program from 26 to six full-time employees.

Still, the new guidelines are necessary. “It’s about time,” says John Rosen, a professor of pediatrics at Children’s Hospital at Montefiore in New York City. Pediatricians will be on alert about the “enormous impact that a blood lead level of 5 can have, forever, on a child’s life and future academic success.”

Children can be exposed to lead from a variety of sources. While lead-based paint is the best-known source, a USA TODAY investigation last month revealed the danger posed by lead-contaminated soil around forgotten factory sites that spewed lead particles into neighborhoods for decades before closing in the 1960s or 1970s. Other sources of exposure include soil contaminated from years of leaded gasoline emissions.

The new guidelines are based on recommendations made by the CDC’s Advisory Committee on Childhood Lead Poisoning Prevention work group. The group suggested, and the CDC agreed, that the old standard of 10 micrograms per deciliter should be replaced. Until now, almost all laboratories would have told parents that if a child’s blood-lead levels are less than 10, they’re fine, says Perry Gottesfeld, who co-chaired the CDC advisers’ work group.

That’s simply wrong, according to Gottesfeld, executive director at Occupational Knowledge International, a California-based non-profit group. “Any lead is too much lead,” he says.

Instead, the CDC is moving toward what’s known as a reference value approach, says Rebecca Morley, national director of the National Center for Healthy Housing in Columbia, Md. The value is based on levels found in the 2.5% children nationally with the most lead in their blood, which is at 5, according to data from the National Health and Nutrition Examination Survey or NHANES.

Because it’s a moving target, it’s likely to slowly fall as environmental levels of lead decrease, given lowered pollution and the fact that lead is no longer allowed in paint. The advisory panel suggested that the CDC reset the trigger level every four years, Gottesfeld says.

Lead exposure is especially dangerous in children 6 years old and younger because their brains are developing. It can cause cognitive and behavioral problems, learning disabilities and at high levels seizures and even death.
Another major shift is that the CDC says the goal is no longer testing and treating, but instead making sure kids aren’t exposed in the first place.

“There’s no good treatment. Prevention is the only way to make sure kids are growing up to their fullest abilities, so they’re not impaired from a neurological standpoint,” Gottesfeld says.

“If I’m a parent and I read this today, what it means is you need to have a heightened awareness of our surroundings to understand your risks in your home or where your children are going to child care,” says Ruth Ann Norton, executive director of the Coalition to End Childhood Lead Poisoning.

Multiple studies have shown impairment at levels below 10. A report by the National Toxicology Program found that blood-lead levels lower than 5 can lead to “losses in IQ, cognitive and academic impairment as well as ADHD,” Rosen says.

At these levels, there is no treatment beyond removing the child’s exposure to lead. Chelation therapy, which involves giving chemicals that bind to lead so it can be excreted from the body, is reserved for children who have blood lead levels over 45, Rosen says.

Congress has gotten involved in the budget issues around lead. Monday, 26 members released a letter decrying the loss of funding for the Lead Poisoning Prevention Program in 34 states.

“I commend the CDC for allowing science not politics to drive their adoption of these new limits,” Rep. Ed Markey, D-Mass., said Wednesday.

The new levels are important not just for children in the USA but internationally, because many nations use CDC benchmarks as their own. “Last time, the World Health Organization picked up the CDC standards, and it became the global standard,” Gottesfeld says.

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By Elizabeth Weise and Alison Young, USA TODAY