Top 5 Takeaways

1. New BLRV: The CDC updated the blood lead reference value (BLRV) to 3.5 μg/dL, down from 5 μg/dL, to better address lead exposure disparities in children.
2. Health Implications: The updated BLRV allows for earlier medical and environmental interventions for children with BLLs between 3.5 and 5 μg/dL.
3. Screening Recommendations: Public health and clinical professionals should focus screening efforts on high-risk populations and follow federal Medicaid and state requirements for BLL testing.
4. Laboratory Challenges: Laboratories may need to update practices and technologies to accurately measure BLLs at the new reference value of 3.5 μg/dL.
5. Health Equity: The updated BLRV aims to advance health equity and environmental justice by prioritizing communities with the most need for lead exposure prevention.

Original Article Author and Citation

Corresponding Author

Perri Zeitz Ruckart, LeadInfo@cdc.gov

Suggested Citation

Ruckart PZ, Jones RL, Courtney JG, et al. Update of the Blood Lead Reference Value — United States, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1509–1512. DOI: http://dx.doi.org/10.15585/mmwr.mm7043a4

Summary

The CDC has updated the blood lead reference value (BLRV) for children to 3.5 μg/dL from the previous 5 μg/dL. This change aims to address and reduce disparities in lead exposure among children. The new BLRV is based on the 97.5th percentile of blood lead levels in U.S. children aged 1–5 years, using data from the 2015–2016 and 2017–2018 NHANES cycles. The updated reference value will help guide medical and environmental follow-up actions and prioritize communities for primary prevention efforts.

Methods

The BLRV update was based on recommendations from the Lead Exposure and Prevention Advisory Committee (LEPAC), which analyzed the most recent NHANES data cycles. The BLRV is determined using the 97.5th percentile of blood lead levels in children aged 1–5 years. The update process involved reviewing new scientific evidence and technological advancements in blood lead testing.

Discussion

Despite a significant decline in average blood lead levels in U.S. children over the past decades, certain populations remain at high risk for lead exposure. These include children living in older housing, non-Hispanic Black children, and those from low-income households. The updated BLRV aims to address these disparities and promote health equity by enabling earlier intervention and prioritizing high-risk communities.

Conclusion

The updated BLRV of 3.5 μg/dL represents a critical step in reducing lead exposure and its harmful effects on children. Public health and clinical professionals are encouraged to adopt this new reference value to guide interventions and prevention efforts. Continued focus on high-risk populations and collaboration between public health entities and healthcare providers will be essential in mitigating lead exposure and advancing health equity.

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