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February 8, 1995

Childhood Lead Poisoning in 1994-Reply

Author Affiliations

US Environmental Protection Agency Washington, DC

JAMA. 1995;273(6):458-459. doi:10.1001/jama.1995.03520300028025

In Reply.  —Dr Cunningham agrees that there is a need for a more targeted approach to lead screening. Certainly a tenet of public health is that our preventive efforts are most effective when we focus on those who are most at risk. However, how can we target in the absence of supportive data? In 1991, the CDC concluded that it would not be possible to predict which communities are at low enough risk of childhood lead exposure that screening would not be required.1 The NHANES III data2 would indicate that surveillance of lead exposure and reassessment of the CDC guidelines may well result in screening being more targeted in the future. In the meanwhile, unless there are data and methods available to determine which areas are of low risk, it is sound public policy for legislatures to follow the CDC guidelines.Dr Schoen is certainly entitled to his

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