LEPAC 2022 Annual Report to HHS

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 2022 and six 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 both meetings in 2022, LEPAC held a series of presentations followed by facilitated discussions on current Federal efforts to prevent, reduce, and eliminate childhood lead exposure.

On October 28, 2021 CDC updated the Blood Lead Reference Value (BLRV) from 5.0 μg/dL to 3.5 μg/dL as recommended by LEPAC during the May 2021 LEPAC meeting. The BLRV is a policy tool that can be used by public health practitioners, healthcare providers, and others to identify children with blood lead levels higher than most other children. During the May 2022 LEPAC meeting, CDC described actions to implement LEPAC’s other recommendations related to updating the BLRV, including outreach to stakeholders and partners; the creation of new communication products to inform audiences affected by the revised BLRV; and continued direct support and guidance to state and local health departments through CDC’s Childhood Lead Poisoning Prevention Program. LEPAC formally sunset the BLRV workgroup due to the successful completion of the workgroup’s objectives.

In addition to discussion of the BLRV, a key theme of the May 2022 LEPAC meeting was discussion of opportunities to improve federal lead poisoning prevention efforts at the state, tribal, local, and territorial level. Federal members of LEPAC provided an overview of lead poisoning-related activities, including a presentation by EPA on new Federal funding made available to jurisdictions through the Bipartisan Infrastructure Law for lead service line replacement. Other presenters from the state and local level provided an overview of their experiences navigating multiple Federal funding streams related to lead poisoning prevention.

During the December 2022 meeting, LEPAC held a series of focused presentations and discussion on lead sources in schools and childcare facilities, school nursing practices, and lead remediation efforts in schools and childcare facilities. Facilitated discussion highlighted the need for additional capacity building, training, and education on lead poisoning prevention for school officials and childcare workers, including the need to raise awareness of existing Federal resources to address lead exposure in school and childcare facilities.

Based on recommendations from the May 2022 LEPAC meeting, the chair proposed establishing a new work group to gather and review information on relevant literature to define and update the status of adult lead exposures in the United States. Topics for the work group to consider include epidemiology of adult lead exposure; take-home lead exposure from jobs and hobbies; long-term effects from lead exposure; best practices for preventing adult lead exposure; communication strategies for adult lead exposure.

• The Blood Lead Reference Value Workgroup, established by LEPAC in 2020, was sunset following the implementation of its recommendations by CDC. The Blood Lead Reference Value Workgroup and LEPAC recommended that CDC adopt a revised reference value of 5 micrograms of lead per deciliter of blood (μg/dL) (based upon most recent National Health and Nutrition Examination Survey cycles from 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.
• LEPAC discussed the creation of a new workgroup to define and update the status of adult lead exposures in the United States. The new workgroup is expected to begin meeting in 2023.
• LEPAC held a series of presentations and discussions related to lead exposure in school and childcare facilities and discussed opportunities to build capacity, provide training, and raise awareness of lead poisoning prevention in these settings.

• The LEPAC will hold its next meeting during summer 2023 following the appointment of new members to the advisory committee. LEPAC expects to hold one meeting in 2023.
• Additional information including meeting notes can be found on the LEPAC website

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. Eight are Federal agency representatives and the remaining 7 do not work for the federal government. 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. The committee also has six non-voting liaison members representing organizations with an interest in lead poisoning prevention, including organizations representing state and local health departments.

Tammy Barnhill-Proctor, M.S.
Supervisory Education Program Specialist
Office of Innovation and Early Learning
Office of Elementary and Secondary Education
U.S. Department of Education
Washington, DC
Term: 7/10/19-6/30/22 

Jeanne Briskin, M.S.
Director
Office of Children’s Health Protection
U.S. Environmental Protection Agency
Washington, D.C.
Term: 12/2/19-6/30/22 

Wallace Chambers Jr., Ph.D., M.A.S., M.H.A.
Deputy Director
Environmental Public Health
Cuyahoga County Board of Health
Parma, OH
Term: 10/15/21–6/30/23 

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

Michael Focazio, Ph.D., M.S.
Program Coordinator
U.S. Geological Survey
Reston, VA
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, PA
Term: 7/1/19-6/30/22  

Nathan Graber, M.D., M.P.H.
Clinical Associate Professor
Department of Pediatrics
Albany Medical Center
Albany, NY
Term: 10/20/21-6/30/23 

Kristina M. Hatlelid, Ph.D., M.P.H.
Toxicologist
U.S. Consumer Product and Safety Commission
Rockville, MD
Term: 6/14/21-6/30/22 

Karla Johnson, M.P.H.
Administrator
Marion County Public Health Department
Indianapolis, IN
Term: 10/15/21–6/30/23 

Donna Johnson-Bailey, MPH, RD
Senior Nutrition Advisor
USDA Food and Nutrition Service
Office of Policy Support
Alexandria, VA
Term: 1/28/20-6/30/22

Erika Marquez, PhD, M.P.H.
Assistant Professor
School of Public Health
University of Nevada, Las Vegas
Las Vegas, NV
Term: 10/15/21–6/30/23 

Howard Mielke, Ph.D., M.S.
Professor
Department of Pharmacology
Tulane University School of Medicine
New Orleans, LA
Term: 12/8/21-06/30/22 

Anshu Mohllajee, Sc.D., M.P.H.
Research Scientist Supervisor I
California Department of Public Health
Childhood Lead Poisoning Prevention Branch
Richmond, CA
Term: 10/18/21–6/30/23 

Jill Ryer-Powder, Ph.D., M.N.S.P.
Principal Health Scientist
Environmental Health Decisions
Ladara Ranch, CA
Term: 10/15/21–6/30/22

Wallace Chambers Jr., M.P.H.
LEPAC Member
Deputy Director
Environmental Public Health
Cuyahoga County Board of Health 

Nathan Graber, M.D., M.P.H.
LEPAC Member
Pediatrician
St. Peter’s Health Partners Medical Associates 

Bruce Lanphear, M.D., M.P.H.
Professor
Simon Frasier University