Lab Matters Fall 2024 | Page 27

ENVIRONMENTAL HEALTH

Timeline of Key Laboratory Developments in the United States

1971 : Lead-based Paint ( LBP ) Poisoning Prevention Act of 1971 ; 40 μg / dL = undue absorption of lead ; BLLs of 80 μg / dL = lead poisoning ; CDC initiates lead poisoning prevention grant program for cities .

1972 : EPA initiates health-based regulation to remove lead from gasoline .

1974 : Safe Drinking Water Act authorizes EPA to set limits of lead in drinking water .

1978 : 1971 LBP ban in federal residences becomes effective . CDC defines elevated blood lead level as 30 μg / dL .

1988 : The Lead Contamination Control Act of 1988 authorizes CDC to support local and state agencies to develop comprehensive childhood lead poisoning prevention programs ( CLPPPs ).

1990 : Clean Air Act bans leaded gasoline .

1991 : CDC lowers blood lead level of concern to 10 µ g / dL . CDC CLPPP receives funding to support a comprehensive program that recommended universal screening and provides guidance on case management ( 1991-1997 ).

1993 : Centers for Medicare and Medicaid Services ( CMS ) adopts CDC ’ s universal screening requirements for children receiving Medicaid benefits .

1995 : CDC and the Council of State and Territorial Epidemiologists ( CSTE ) develop national surveillance system for monitoring BLLs . BLLs become the first national notifiable noninfectious condition . CDC CLPPP begins collecting pediatric BLL surveillance data from state health departments .

1996 : Leaded gasoline ban becomes effective .

1998 : CDC recommends targeted screening and focuses on improving surveillance .

2012 : CDC replaces “ level of concern ” with BLRV to identify children with BLLs that are much higher that most US children . BLRV was set at 5 µ g / dL , based on the 97.5 percentile of the estimated blood lead distribution in children 1-5 years old using data from the National Health and Nutrition Examination Survey ( NHANES ).

2012 – 2013 : Congress reduces CDC CLPPP appropriations to $ 2 million , resulted in the loss of extramural funding of state and local CLPPPs ( previously $ 36 million ).

2014 : Congress restores CDC CLPPP funding to $ 13 million after Flint , MI water contamination . Funding is used for surveillance and community-based strategies and partnerships to focus on children who are at high risk .

2016 : Water Infrastructure Improvements for the Nation ( WIIN ) Act allocates $ 35 million to CDC to enhance childhood lead poisoning prevention activities ; to establish a voluntary Flint , MI lead exposure registry ; and to establish the Lead Exposure and Prevention Advisory Committee ( LEPAC ).

2017 : FDA issues a safety recall to discontinue using Magellan Diagnostics ’ Lead-Care Testing Systems for analyzing venous blood samples . To promote accurate measurements of BLLs , CDC sponsors a voluntary external quality assurance program for laboratories .

2021 : CDC updates its BLRV from 5 µ g / dL to 3.5 µ g / dL , based on NHANES data .

Source : https :// www . cdc . gov / lead-prevention / php / about-clppp / timeline . html