LEPAC Annual Report to HHS (2021)

At a glance

Read the 2021 annual report from the Lead Exposure Advisory Committee (LEPAC) to the U.S. Department of Health and Human Services. The committee submits this report as determined by the Secretary or as required by Congress.

Image of a person's hand and partial arm pointing to bar and pie charts.


Annually for 5 years (pending funding availability) as determined necessary by the Secretary or as required by Congress, the Committee shall submit a report to the Secretary, the Committees on Finance, Health, Education, Labor, and Pensions, and Agriculture, Nutrition, and Forestry of the Senate and the Committees on Education and the Workforce, Energy and Commerce, and Agriculture of the House of Representatives.

The report shall include 1) an evaluation of the effectiveness of the Federal programs and services available to individuals and communities exposed to lead; 2) an evaluation of additional lead exposure research needs; 3) an assessment of any effective screening methods or best practices used or developed to prevent or screen for lead poisoning; 4) input and recommendations for improved access to effective services relating to health care, education, or nutrition for individuals and communities impacted by lead exposure; and 5) any other recommendations for communities affected by lead exposure, as appropriate.

2021 LEPAC Annual Report – Printable PDF

Summary of committee actions

The Blood Lead Reference Value Workgroup, established by LEPAC in 2020, recommended to LEPAC that CDC adopt a revised reference value of 3.5 micrograms of lead per deciliter of blood (μg/dL) (based upon most recent NHANES cycles 2015-2018) and implement a plan to address barriers associated with specimen collection, testing, messaging, and capacity of affected agencies and stakeholders at the federal, state, and local levels.

As a result of recommendations made by the BLRV Workgroup, LEPAC unanimously recommended CDC lower the BLRV from 5.0 μg/dL to 3.5 μg/dL. The BLRV is a policy tool that helps target children in the upper end of the population blood lead distribution in order to prioritize prevention efforts and evaluate their effectiveness.

LEPAC held a series of presentations and discussions related to the Federal Lead Action Plan and other federal activities to prevent, reduce, and eliminate childhood lead exposure.

LEPAC discussed environmental justice activities and Federal efforts to identify areas with higher risk of lead exposure through the creation of mapping tools.

LEPAC activities

The objective of the Lead Exposure and Prevention Advisory Committee (LEPAC) is to review research and federal programs and services related to lead poisoning and to identify effective services and best practices for addressing and preventing lead exposure in communities. Following the enactment of Public Law 114-322, "Water Infrastructure Improvements for the Nation Act" and subsequent nomination of committee members, LEPAC has held two meetings in 2021 and four meetings in total since its establishment in 2018. A brief summary of committee actions is available below. Detailed meeting notes and meeting presentations are available on the LEPAC website.

During the May 2021 meeting, the Blood Lead Reference Value (BLRV) Workgroup, established by LEPAC in 2020, previewed its draft findings and recommendations to revise the BLRV. Since no safe blood lead level has been identified, CDC uses a population-based reference value to identify children with blood lead levels greater than 97.5% of the children aged 1 to 5 years. The blood lead reference value is not a clinical reference level defining an acceptable range of blood lead levels in children nor is it a health-based toxicity threshold; rather it is a policy tool that helps target children in the upper end of the population blood lead distribution in order to prioritize prevention efforts and evaluate their effectiveness.

After discussion, LEPAC unanimously voted in favor of lowering the reference value to from 5.0 μg/dL to 3.5 μg/dL based on the most recent National Health and Nutrition Examination Survey (NHANES) data. Once recommendations were finalized by the Committee, LEPAC transmitted the final recommendations to the HHS Secretary for consideration. For additional discussion on the BLRV Workgroup or its recommendations, please view Appendix II.

LEPAC continued earlier discussions of the Federal Lead Action Plan1during the May 2021 meeting. The Federal Lead Action Plan focuses on reducing sources of lead exposures, expanding efforts to identify children in high-risk communities for targeting intervention and services, enhancing risk communication efforts, and advancing the scientific understanding of multi-media lead exposures and their relationship to blood lead levels. Following a presentation about the FLAP, LEPAC members discussed integrating social and economic factors into strategic planning, collaborating with lead-related research across the nation, incorporating primary prevention efforts, assessing lead in ammunition, and identifying communities with children at high risk of lead exposure.

During the December 2021 meeting, CDC provided an update on the status of LEPAC's recommendations to CDC and CDC's decision to lower the BLRV from 5.0 μg/dL to 3.5 μg/dL on October 28, 2021. CDC also described other actions to implement LEPAC's recommendations, including outreach to stakeholders and partners; the creation of new communication products to inform audiences affected by the updated BLRV; and continued direct support and guidance to state and local health departments through CDC's Childhood Lead Poisoning Prevention Program.

During this meeting, committee members also discussed mapping and other data-related efforts to identify populations at higher risk of lead exposure. LEPAC also hosted a series of presentations, followed by facilitated discussions, on current Federal efforts to prevent, reduce, and eliminate childhood lead exposure. Federal members of LEPAC presented on specific actions undertaken by their federal agencies and provided other informational updates to improve the coordination of ongoing federal activities to prevent childhood lead exposure. Additionally, federal members presented their agencies' environmental justice efforts to prevent, reduce, or eliminate sources of lead exposure.


Looking ahead

The LEPAC will hold its next meeting on May 12, 2022 from 9:00 AM to 4:30 PM EST.

The Committee will consider next steps for reporting on best practices for programs and interventions and identifying research gaps, including the potential creation of new workgroups. Specifically, the committee with continue discussion of environmental justice activities and community-based efforts to prevent lead exposure. Additional information including meeting notes can be found on the LEPAC website.

Appendix I LEPAC Member Roster

Lead Exposure and Advisory Committee (LEPAC) Member Roster

The committee consists of 15 voting Federal and non-Federal members, including the Chair, appointed by the HHS Secretary. Members include experts in the fields of epidemiology, toxicology, mental health, pediatrics, early childhood education, special education, diet and nutrition, and environmental health. Half of the committee (eight members) consists of Federal representatives.

CDC has previously solicited Federal members from HHS, the Consumer Product Safety Commission, Department of Agriculture, Department of Education, Department of Housing and Urban Development, Environmental Protection Agency, Occupational Safety and Health Administration, and the U.S. Geological Survey. Federal membership of the committee may change over time depending on the needs of the committee.

Non-Federal members are deemed Special Government Employees (SGEs) and were solicited via a Federal Register Notice. A Federal Register Notice soliciting new SGE members for LEPAC was issued in fall 2021. All members are invited to serve for a term of not more than three years, and the HHS Secretary may reappoint members for consecutive terms.

CDC also selected a Federal employee to serve as the Designated Federal Official (DFO) to attend each meeting and ensure that all procedures are within applicable statutory, regulatory, and HHS General Administration Manual directives.

Designated Federal Officer

Paul Allwood, Ph.D, M.P.H, R.S.

Branch Chief

Lead Poisoning Prevention and Surveillance Branch (proposed)

Division of Environmental Health Science and Practice

National Center for Environmental Health

Centers for Disease Control and Prevention

Atlanta, Georgia 30329-4027


Matthew Ammon, M.S.


Office of Lead Hazard Control and Healthy Homes

U.S. Department of Housing and Urban Development

Washington, District of Columbia 20410

Term: 7/1/2019-6/30/2022


Tammy Barnhill-Proctor, M.S.

Supervisory Education Program Specialist. Group Leader. Office of Innovation and Early Learning Programs. U.S. Department of Education. Washington, District of Columbia 20202. Term: 7/10/2019-6/30/2022

Jeanne Briskin, M.S.

Director. Office of Children's Health Protection. U.S. Environmental Protection Agency. Washington, District of Columbia 20460. Term: 12/2/19-6/30/22

Wallace Chambers Jr., M.H.A.

Deputy Director. Environmental Public Health. Cuyahoga County Board of Health. Parma, Ohio 44130. Term: 10/15/2021–6/30/2023

Tiffany DeFoe, M.S.

Director. Office of Chemical Hazards-Metals. Occupational Safety & Health Administration. U.S. Department of Labor. Washington, District of Columbia 20002. Term: 7/1/19-6/30/22

Michael Focazio, Ph.D., M.S.

Program Coordinator. U.S. Geological Survey. Reston, Virginia 20192. Term: 7/1/19-6/30/22

Monique Fountain Hanna, M.D., M.P.H., M.B.A.

Senior Regional Medical Consultant. Health Resources and Services Administration. Philadelphia, Pennsylvania 19107. Term: 7/1/19-6/30/22

Nathan Graber, M.D., M.P.H.

Clinical Associate Professor. Department of Pediatrics. Albany Medical Center. Albany, New York 12208. Term: 10/20/2021-6/30/2023

Kristina M. Hatlelid, Ph.D., M.P.H.

Toxicologist. Division of Health Sciences U.S. Consumer Product and Safety Commission. Rockville, Maryland 20850. Term: 6/14/2021-6/30/2022

Karla Johnson, M.P.H.

Administrator. Marion County Public Health Department. Indianapolis, Indiana 46205. Term: 10/15/2021–6/30/2023

Donna Johnson-Bailey, MPH, RD

Senior Nutrition Advisor, Food and Nutrition Service Food, Nutrition and Consumer Services. U.S. Department of Agriculture Office of Policy Support. Alexandria, Virginia 22314. Term: 1/28/2020-6/30/2022

Erika Marquez, Ph.D., M.P.H.

Assistant Professor. School of Public Health. University of Nevada, Las Vegas. Las Vegas, Nevada 89154-3030. Term: 10/15/2021–6/30/2023

Howard Mielke, Ph.D., M.S.

ProfessorDepartment of PharmacologyTulane University School of MedicineNew Orleans, Louisiana 70112Term: 12/8/2021-06/30/2022

Anshu Mohllajee, Sc.D., M.P.H.

Research Scientist Supervisor I. California Department of Public Health. Childhood Lead Poisoning Prevention Branch. Richmond, California 94804. Term: 10/18/2021–6/30/2023

Jill Ryer-Powder, Ph.D., M.N.S.P.

Principal Health Scientist. Environmental Health Decisions. Ladara Ranch, California 92118. Term: 10/15/2021–6/30/2022

NOTE: Terms for current special government employee (SGE) members have been staggered to end during either June 2022 or 2023. A Federal Register Notice was published to solicit nominations for new appointments to the LEPAC for current members whose terms are expiring in June 2022. Nominations were due by November 1, 2021.

Appendix II BLRV Workgroup Member Roster

Blood Lead Reference Value (BLRV) Workgroup Member Roster

The workgroup was comprised of eight experts in the fields of lead screening, prevention, laboratory issues, and surveillance. The workgroup was required to have at least two SGEs who are currently LEPAC members and a DFO from the CDC. In coordination with the DFO, the LEPAC Chair named a chair for this workgroup from the participating SGEs.

In 2021, the BLRV Workgroup finalized a report to LEPAC that discussed how to define the BLRV; how the BLRV is currently used by the Centers for Disease Control and Prevention (CDC) and other entities; the status of the BLRV; and the BLRV Workgroup's recommendations. The full report is available on the LEPAC website.

Designated Federal Officer

Ginger Chew, Sc.D.

Health Scientist

Division of Environmental Health Science and Practice

National Center for Environment Health

Centers for Disease Control and Prevention NCEH, CDC

Workgroup Chair

Jill Ryer-Powder, Ph.D., M.N.S.P.

LEPAC Member

Principal Health Scientist

Environmental Health Decisions


Wallace Chambers Jr., M.H.A.

LEPAC Member. Deputy Director. Environmental Public Health. Cuyahoga County Board of Health

Nathan Graber, M.D., M.P.H.

LEPAC Member. Clinical Associate Professor. Department of Pediatrics. Albany Medical Center

Bruce Lanphear, M.D., M.P.H.

ProfessorSimon Frasier University

Julianne Nassif, M.S.

Director of Environmental Health. Association of Public Health Laboratories (APHL)

Amanda Reddy, M.S.

Executive DirectorNational Center for Healthy Housing (NCHH)

Mark Werner, Ph.D., M.S.

Director. Bureau of Environmental and Occupational Health. Wisconsin Department of Public Health

Nsedu Obot Witherspoon, M.P.H.

Executive Director. Children's Environmental Health Network (CEHN)