Counseling to prevent childhood lead poisoning

Excessive lead exposure continues to be a pervasive and serious threat to the health and well-being of the nation's children. The current guidelines issued by the Centers for Disease Control and Prevention (CDC) recommend education (during well-child visits) regarding the major preventable sources of lead and how to prevent excessive exposure. To determine if parents receive counseling to prevent excessive lead exposure in their children, a survey of parental knowledge on prevention of lead exposure was administered to parents of children recently identified as having elevated blood lead levels. Surveys were administered by lead program outreach workers prior to an educational visit in urban neighborhoods of Boston, Massachusetts. Parents of 139 children (88% ethnic minorities; mean age: 31 months) with recently identified elevated blood lead levels (mean: 1 mumol/L) participated. Fifty-one percent first learned of their child's elevated lead level at the time they were contacted by an outreach worker. Seventy-one percent did not recall having been counseled regarding lead poisoning or its prevention prior to this contact. Before the outreach visit, 17% had been counseled but after the elevated lead was detected. Only 12% of the parents had received preventive counseling prior to detection of the elevated lead level. We conclude that despite CDC recommendations, adequate counseling for preventing lead poisoning does not occur for a substantial number of children who have elevated lead levels.