Scientific Publications

Below you’ll find a variety of helpful resources, research, and data about childhood lead poisoning prevention.

Some of the documents below refer to a blood lead level of 5 micrograms per deciliter (μg/dL) as the CDC’s blood lead reference value. CDC uses a blood lead reference value of 3.5 micrograms per deciliter to identify children with blood lead levels that are higher than most children’s levels. This new level is based on the U.S. population of children ages 1-5 years who represent the top 2.5% of children with the highest blood lead levels. For more information, refer to Blood Lead Reference Value.

Some of the documents below may also refer to a blood lead level of 10 micrograms per deciliter (μg/dL) as the CDC level of concern for adverse health outcomes in children. This terminology is outdated, and readers are referred to the ACCLPP recommendations of 2012.

Some of the documents on this page are presented for historical purposes and are not being maintained or updated.

CDC

LeBlanc TT, Svendsen ER, Allwood PB. Ubiquitous Lead— A Challenge for the Future of Public Health. Am J Public Health. 2022; 112(S7):S628-S628.
LeBlanc TT, Svendsen ER, Allwood PB. Ubiquitous Lead: Risks, Prevention–Mitigation Programs, and Emerging Sources of Exposure: Introduction and Contents of the Issue. Am J Public Health. 2022; 112(S7):S630-S631.
Breysse PN. Welcome to the AJPH Supplement on Ubiquitous Lead: Risks, Prevention–Mitigation Programs, and Emerging Sources of Exposure. Am J Public Health. 2022; 112(S7):S632-S634.
Allwood PB, Falk H, Svendsen ER. A Historical Perspective on the CDC Childhood Lead Poisoning Prevention Program. Am J Public Health. 2022. 112(S7):S635-S639.
Breysse PN, Cascio WE, Geller AM, Choiniere CJ, Ammon M. Targeting Coordinated Federal Efforts to Address Persistent Hazardous Exposures to Lead. Am J Public Health. 2022. 112(S7):S640-S646.
Calabrese T, Corcoran P, Limjuco S, Bernardi C, Plattos A, et al. An Innovative Approach to Increase Lead Testing by Pediatricians in Children, United States, 2019–2021. Am J Public Health. 2022. 112(S7):S647-S650.
Zartarian V, Poulakos A, Garrison VH, Spalt N, Tornero-Velez R, et al. Lead Data Mapping to Prioritize US Locations for Whole-of-Government Exposure Prevention Efforts: State of the Science, Federal Collaborations, and Remaining Challenges. Am J Public Health. 2022. 112(S7):S658-S669.
Ruckart PZ, Bove FJ, Dallas C. Evaluating the Effectiveness of State-Level Policies on Childhood Blood Lead Testing Rates. J Public Health Manag Prac. 2022.
Egan KB, Dignam T, Brown MJ, Bayleyegn T, Blanton C. Using Small Area Prevalence Survey Methods to Conduct Blood Lead Assessments among Children. Int. J. Environ. Res. Public Health. 2022; 19(6151):1-14.
Ruckart PZ, Jones RL, Courtney JG, LeBlanc TL, Jackson W, Karwowski MP, Cheng P, Allwood P, Svendsen ER, Breysse PN. Update of the Blood Lead Reference Value — United States, 2021. MMWR. 2021; 70(43):1509-1512.
Egan KB, Cornwell CR, Courtney JG, Ettinger AS. Blood Lead Levels in U.S. Children Ages 1–11 Years, 1976–2016. Environ Health Perspect. 2021; 129(3):1-11.
Courtney JG, Chuke SO, Dyke K, Credle K, Lecours C, Egan KB, Leonard M. Decreases in Young Children Who Received Blood Lead Level Testing During COVID-19 — 34 Jurisdictions, January–May 2020. MMWR. 2021; 70(5):155-161.

Partners

Totoni S, Fabisiak JP, Beasley VR, Arnemo JM, Schultz JH, et al. Biting the Bullet: A Call for Action on Lead-Contaminated Meat in Food Banks. Am J Public Health. 2022. 112(S7):S651-S654.
Yendell S, Janowiak D, Yannarelly J, Rezania Z, Haugen K, et al. Tackling the Lead Gremlins: A Response to Take-Home Lead Exposure in a Minnesota Industrial Facility, 2019. Am J Public Health. 2022. 112(S7):S655-S657.
Oda G, Sharma A, Lucero-Obusan C, Schirmer P, Holodniy M. Exposure Sources Among Veterans With Elevated Blood Lead Levels, United States, 2015‒2021. Am J Public Health. 2022. 112(S7):S670-S678.
Cradock AL, Barrett JL, Poole MK, Flax CN, Vollmer L, Hecht C. Lead Concentrations in US School Drinking Water: Testing Programs, Prevalence, and Policy Opportunities, 2016‒2018. Am J Public Health. 2022. 112(S7):S679-S689.
Armatas C, Loper B, Tandoc A, Materna BL. Industries With the Highest Occupational Blood Lead Test Results, California Occupational Blood Lead Registry, 2020‒2021. Am J Public Health. 2022. 112(S7):S690-S694.
Redmon JH, Kondash AJ, Norman E, Johnson J, Levine K, et al. Lead Levels in Tap Water at Licensed North Carolina Child Care Facilities, 2020–2021. Am J Public Health. 2022. 112(S7):S695-S705.
Anil L, Ma Z, Nambiar A, Watkins SM. Blood Lead Level Testing and Retesting Among Newly Arriving Refugee Children, Pennsylvania, 2015–2019. Am J Public Health. 2022. 112(S7):S706-S714.
Present PS, Berg K, Snow M, Richardson K. Detecting New Sources of Childhood Environmental Lead Exposure Using a Statistical Surveillance System, 2015–2019. Am J Public Health. 2022. 112(S7):S715-S722.
Gottesfield P. Lead Industry Influence in the 21st Century: An Old Playbook for a “Modern Metal”. Am J Public Health. 2022. 112(S7):S723-S729.
Hore P, Kolapo A, Sedlar S, Patel K, Saper RB. Health Remedies as a Source of Lead, Mercury, and Arsenic Exposure, New York City, 2010–2019. Am J Public Health. 2022. 112(S7):S730-S740.

Hore P, Alex-Oni K, Bardhi N, Sedlar S. Notes from the Field: Lead Poisoning in a Family of Five Resulting from Use of Traditional Glazed Ceramic Ware — New York City, 2017–2022. MMWR. 2022; 71:743–744
Hore P, Ahmed M, Sedlar S, Saper R, Nagin D, Clark N. Blood Lead Levels and Potential Risk Factors for Lead Exposures Among South Asians in New York City. [PDF 373 KB] J Immigrant Minority Health. 2017; 19:1322–1329.

CDC

Cornwell CR, Egan KB, Zahran HS, Mirabelli MC, Hsu J, Chew GL. Associations of blood lead levels with asthma and blood eosinophils in US children. Pediatr Allergy Immunol. 2020; 31(6):695-699.
Dignam T, Hodge J, Chuke S, Mercado C, Ettinger A, Flanders DW. Use of the CUSUM and Shewhart control chart methods to identify changes of public health significance using childhood blood lead surveillance data. Environmental Epidemiology. 2020; 4(2):e090.
Breysse PN. Lead Elimination for the 21st Century. J Public Health Manag Prac. 2019; 25(1 Supp):S3-S4.
Caldwell KL, Cheng P-Y, Vance KA, Makhmudov A, Jarrett JM, Caudill SP, Ho D-P, Jones RL. Robert. LAMP: A CDC Program to Ensure the Quality of Blood-Lead Laboratory Measurements. J Public Health Manag Prac. 2019; 25(1 Supp):S23-S30.
Dignam T, Kaufmann RB, LeStourgeon L, Brown MJ. Control of Lead Sources in the United States, 1970-2017: Public Health Progress and Current Challenges to Eliminating Lead Exposure. J Public Health Manag Prac. 2019; 25(1 Supp):S13-22.
Egan KB, Tsai RJ, Chuke SO. Integrating Childhood and Adult Blood Lead Surveillance to Improve Identification and Intervention Efforts. J Public Health Manag Prac. 2019; 25(1 Supp):S98-S104.
Ettinger AS, Leonard ML, Mason J. CDC’s Lead Poisoning Prevention Program: A Long-standing Responsibility and Commitment to Protect Children From Lead Exposure. J Public Health Manag Prac. 2019; 25(1 Supp):S5-S12.
Ettinger AS, Ruckart PZ, Dignam T. Lead Poisoning Prevention: The Unfinished Agenda. J Public Health Manag Prac. 2019; 25(1 Supp):S1-S2
Lockamy-Kassim E, Friedberg J, Newby C, Lecours C, Credle K, Leonard M. Identifying and Chronicling Childhood Lead Poisoning Prevention Program Achievements With “Success Stories”. Public Health Manag Prac. 2019; 25(1 Supp):S111-S114.
Mason J, Ortiz D, Pappas S, Quigley S, Yendell S, Ettinger AS. Response to the US FDA LeadCare Testing Systems Recall and CDC Health Alert. J Public Health Manag Prac. 2019; 25(1 Supp):S91-S97.
Ruckart PZ, Ettinger AS, Hanna-Attisha M, Jones N, Davis SI, Breysse PN. The Flint Water Crisis: A Coordinated Public Health Emergency Response and Recovery Initiative. J Public Health Manag Prac. 2019; 25(1 Supp):S84-S90.
Trinh E, Mason J. Evaluation of the Implementation of CDC’s Health Alert Related to the FDA LeadCare Recall From the State Health Department Perspective. J Public Health Manag Prac. 2019; 25(1 Supp):S105-S110.
Whitehead LS, Buchanan SD. Childhood Lead Poisoning: A Perpetual Environmental Justice Issue? J Public Health Manag Prac. 2019; 25(1 Supp):S115-S120.
Raymond J, Brown MJ. Childhood Blood Lead Levels in Children Aged <5 Years — United States, 2007–2014. MMWR. 2017; 66:1-10.
Kennedy C, Yard E, Dignam T, Buchanan S, Condon S, Brown MJ, et al. Blood Lead Levels Among Children Aged <6 Years — Flint, Michigan, 2013–2016. MMWR. 2016; 65(25):650-4.
Kaufman JA, Brown MJ, Umar-Tsafe NT, Adbullah MB, Getso KI, Kaita IM, et al. Prevalence and risk factors of elevated blood lead in children in gold ore processing communities, Zamfara, Nigeria, 2012. J Health Pollut. 2016; 6(11):2-8.

Partners

Asburry A, Blatt M. Improving Childhood Lead Poisoning Surveillance and Data Management in Arizona Through an Evaluation of the Transition to a New Surveillance System. J Public Health Manag Prac. 2019; 25(1 Supp):S58-S62.
Bressler JM, Yoder S, Cooper S, McLaughlin J. Blood Lead Surveillance and Exposure Sources Among Alaska Children. J Public Health Manag Prac. 2019; 25(1 Supp):S71-S75.
Bruce SA, Christensen KY, Coons MJ, Havlena JA, Meiman JG, Walsh RO. Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance. J Public Health Manag Prac. 2019; 25(1 Supp):S51-S57.
Cluett R, Fleisch A, Decker K, Frohmberg E, Smith AE. Findings of a Statewide Environmental Lead Inspection Program Targeting Homes of Children With Blood Lead Levels as Low as 5 μg/dL. J Public Health Manag Prac. 2019; 25(1 Supp):S76-S83.
Gettens GC, Drouin BB. Successfully Changing a State’s Climate to Increase Blood Lead Level Testing. J Public Health Manag Prac. 2019; 25(1 Supp):S31-S36.
Haboush-Deloye A, Marquez E, Marshall M, Gerstenberger SL. Evaluation of the Blood Lead Screening Component of the Southern Nevada Childhood Lead Poisoning Prevention Program. J Public Health Manag Prac. 2019; 25(1 Supp):S37-S43.
Hore P, Alex-Oni K, Sedlar S, Nagin, D. A Spoonful of Lead: A 10-Year Look at Spices as a Potential Source of Lead Exposure. J Public Health Manag Prac. 2019; 25(1 Supp):S63-S70.
Wang, Amy; Rezania, Zaynab; Haugen, Kathryn M. B.; Baertlein L, Yendell SJ. Screening for Elevated Blood Lead Levels: False-Positive Rates of Tests on Capillary Samples, Minnesota, 2011-2017. J Public Health Manag Prac. 2019; 25(1 Supp):S44-S50.

CDC

Raymond J, Brown MJ. Childhood Blood Lead Levels — United States, 2007–2012. MMWR. 2015; 62(54);76-80.
Basir M, Umar-Tsafe N, Getso K, Kaita IM, Nasidi A, Sani-Gwarzo N, et al. Assessment of blood lead levels among children aged ≤5 Years — Zamfara State, Nigeria, June–July 2012. MMWR. 2014; 63(15):325-7. [Brown MJ].
Raymond J, Wheeler W, Brown MJ. Lead screening and prevalence of blood lead levels in children aged 1–2 years—Child Blood Lead Surveillance System, United States, 2002–2010 and National Health and Nutrition Examination Survey, United States, 1999–2010 and National Health and Nutrition Examination Survey, United States, 1999–2010. MMWR. 2014; 63(Suppl 2).
CDC. Blood Lead Levels in Children Aged 1–5 Years — United States, 1999–2010. MMWR. 2013; 62(13):245-248.
Dooyema CA, Neri A, Lo Y-C, Durant J, Dargan PI, Swarthout T, et al. Outbreak of fatal childhood lead poisoning related to artisanal gold mining in northwestern Nigeria, 2010. Environ Health Perspect. 2012; 120:601-607.
Lo Y-C, Dooyema CA, Neri A, Durant J, Jefferies T, Medina-Marino A, et al. Childhood lead poisoning associated with gold ore processing: a village-level investigation—Zamfara State, Nigeria, October–November 2010. Environ Health Perspect. 2012; 120:1450-1455.
CDC. Infant Lead Poisoning Associated with Use of Tiro, an Eye Cosmetic from Nigeria – Boston, Massachusetts, 2011. MMWR. 2012; 61(30):574-576.
CDC. Lead Poisoning in Pregnant Women Who Used Ayurvedic Medications from India — New York City, 2011–2012. MMWR. 2012; 61(33):641-646.
CDC. Take-Home Lead Exposure Among Children with Relatives Employed at a Battery Recycling Facility — Puerto Rico, 2011. MMWR. 2012; 61(47):967-970.
CDC. CDC Health Disparities and Inequalities Report – United States, 2011 [PDF – 3.01 MB]. MMWR. 2011; 60(Suppl):1-116.
CDC. Lead Poisoning of a Child Associated with Use of a Cambodian Amulet — New York City, 2009. MMWR. 2011; 60(03):69-71.
Thurtle N, Greig J, Cooney L, Amitai Y, Ariti C, Brown MJ, et al. Description of 3,180 courses of chelation with dimercaptosuccinic acid in children ≤5 y with severe lead poisoning in Zamfara, Northern Nigeria: A retrospective analysis of programme data. PLoS Med. 2014; 11(10):e1001739.

Partners

Hore P, Ahmed M, Nagin D, Clark N. Intervention model for contaminated consumer products: a multifaceted tool for protecting public health. Am J Public Health. 2014;104(8):1377-1383.

CDC

CDC. Notes from the Field: Outbreak of Acute Lead Poisoning Among Children Aged <5 Years — Zamfara, Nigeria, 2010. MMWR. 2010; 59(27):846.
CDC. Children with Elevated Blood Lead Levels Related to Home Renovation, Repair, and Painting Activities — New York State, 2006–2007. MMWR. 2009; 58(03):55-58.
Iqbal S, Blumenthal W, Kennedy C, Yip FY, Pickard S, Flanders WD, Loringer K, Kruger K, Caldwell KL, Jean Brown M. Hunting with lead: association between blood lead levels and wild game consumption. Environ Res. 2009; 109(8):952-9.
CDC. Deaths Associated with Hypocalcemia from Chelation Therapy—Texas, Pennsylvania, and Oregon, 2003–2005. MMWR. 2006; 55(8):204-207.
CDC. Death of a Child After Ingestion of a Metallic Charm—Minnesota, 2006. MMWR. 2006; 55(12):340-341.

CDC

CDC. Blood Lead Levels—United States, 1999–2002. MMWR. 2005; 54(20):513-516.
CDC. Elevated Blood Lead Levels in Refugee Children—New Hampshire, 2003–2004. MMWR. 2005; 54(2):42-46.
Erratum: Vol. 54, No. 2 MMWR. 2005; 54(3):76.
CDC. Lead Exposure from Indoor Firing Ranges Among Students on Shooting Teams — Alaska, 2002–2004. MMWR. 2005; 54(23):577-579.

CDC. Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water—District of Columbia, 2004. MMWR. 2004; 53(12):268-270. Addendum: Following the release of the MMWR, “Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water — District of Columbia, 2004”, some reports have suggested erroneously that the Centers for Disease Control and Prevention has determined that lead in residential tap water at concentrations as high as 300 parts per billion is ‘safe’. CDC would like to reiterate the key message from the 2004 article that because no threshold for adverse health effects in young children has been demonstrated (no safe blood level has been identified), all sources of lead exposure for children should be controlled or eliminated. Lead concentrations in drinking water should be below the U. S. Environmental Protection Agency’s action level of 15 parts per billion. Read more about Lead in Drinking Water

CDC. Brief Report: Lead Poisoning from Ingestion of a Toy Necklace—Oregon, 2003. MMWR. 2004; 53(23):509-511.
CDC. Childhood Lead Poisoning from Commercially Manufactured French Ceramic Dinnerware—New York City, 2003. MMWR. 2004; 53(26):584-586.
CDC. Lead Poisoning Associated with Ayurvedic Medications—Five States, 2000–2003. MMWR. 2004; 53(26):582-584.
CDC. Surveillance for Elevated Blood Lead Levels Among Children – United States, 1997–2001. MMWR. 2003; 52(SS-10):1-21. [PDF – 333 KB]
CDC. Childhood Lead Poisoning Associated with Tamarind Candy and Folk Remedies—California, 1999–2000. MMWR. 2002; 51(31):684-686.
CDC. Fatal Pediatric Lead Poisoning—New Hampshire, 2000. MMWR. 2001; 50(22):457-459.
CDC. Occupational and Take-Home Lead Poisoning Associated With Restoring Chemically Stripped Furniture—California, 1998. MMWR. 2001; 50(13):246-248.
CDC. Trends in Blood Lead Levels Among Children—Boston, Massachusetts, 1994–1999. MMWR. 2001; 50(17):337-339.

CDC

CDC. Blood Lead Levels in Young Children—United States and Selected States, 1996–1999. MMWR. 2000; 49(50):1133-1137.
**CDC. Elevated Blood Lead Levels Among Internationally Adopted Children—United States, 1998. MMWR. 2000; 49(5):97-100.
CDC. Lead Poisoning Associated with Imported Candy and Powdered Food Coloring—California and Michigan. MMWR. 1998; 47(48):1041-1043
CDC. Children with Elevated Blood Lead Levels Attributed to Home Renovation and Remodeling Activities–New York, 1993-1994. MMWR. 1997; 45(51&52):1120-1123.
CDC. Update: Blood Lead Levels—United States, 1991–1994. MMWR. 1997; 46(7):141.
Erratum: Vol. 46, No. 7 MMWR. 1997; 46(26):607
CDC. Targeted Screening for Childhood Lead Exposure in a Low Prevalence Area—Salt Lake County, Utah, 1995–1996. MMWR. 1997; 46(10):213-217.
CDC. Blood Lead Levels Among Children in a Managed-Care Organization—California, October 1992–March 1993. MMWR. 1995; 44(34):627-629, 635.
CDC. Blood Lead Levels Among Children—Rhode Island, 1993–1995. MMWR. 1995; 44(42):788-791.
CDC. Lead Poisoning Associated with Use of Traditional Ethnic Remedies—United States. MMWR. 1993; 42(27):521-524.

** These documents are being kept on this website for historical purposes and are no longer in print.