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Lead

Laboratory Work Group Charge

The current charter of the Advisory Committee on Childhood Lead Poisoning Prevention expired on October 31, 2013. The ACCLPP has provided CDC and the Department of Health and Human Services (HHS) with extremely valuable scientific and technical advice related to the prevention of childhood lead poisoning. CDC is committed to childhood lead poisoning prevention. To address this important public health concern, CDC will continue to seek advice and guidance from external lead poison prevention experts.

1. Proficiency Testing (PT) Limits

The Laboratory Work Group (WG) will address whether Blood Lead proficiency testing (PT) acceptability limits should be more stringent than the current Clinical Laboratory Improvement Amendments of 1988 (CLIA ‘88) standard of ±4 µg/dL or ±10% (whichever is greater) and if so, what they should be.

The WG should draft a letter from the ACCLPP to the appropriate federal agency recommending that a change in CLIA ‘88 regulations be implemented that would tighten the minimum acceptable PT limits for blood lead.

2. Practice Standards for Point of Care Lead testing

The WG should address the need for recommended standards of practice for those using point of care blood lead testing.

3. Alternative matrices for assessing exposure to lead

The WG should investigate and report to the ACCLPP on the efficacy, reliability and validity of measuring lead in saliva as an index of lead exposure. To a lesser extent, the WG should investigate report to the ACCLPP on the reliability and validity of measuring lead in other non traditional matrices such as sweat, hair, nails and packed red cells as indices of lead exposure.

4. Environmental lead analytical issues

The WG should investigate and report back to the ACCLPP on the reliability of current technologies for assessing the lead content of paint, plastics and other environmental samples, laboratory capacity and capability for handling.

5. Reference intervals for adult lead exposure

The WG should investigate and report back to the ACCLPP on how clinical laboratories should report the reference interval for adult lead exposure. Currently, many labs report <30 µg/dL, <20 µg/dL as “normal” for adult blood lead levels.


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