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March 1988

Lead Poisoning and Public Policy

Author Affiliations

Division of Environmental Disease Control Maryland Department of the Environment Room 214 201 West Preston St Baltimore, MD 21201

Am J Dis Child. 1988;142(3):251-252. doi:10.1001/archpedi.1988.02150030017005

Sir.—It was heartening to read the excellent report by Amitai et al1 and the editorial by Sayre2 on deleading houses. This is a subject that for too long has been regarded as the sole territory of environmental officials, who frequently are misinformed regarding the exposure pathways by which lead reaches children. The treatment and management of lead poisoning requires close coordination between medical providers and environmental agencies. The importance of lead dust in the pathogenesis of lead poisoning is now gaining recognition, but, sadly, public policy lags behind the very real health implications of this emerging knowledge. The public health approach to lead poisoning is maintained in most jurisdictions in the secondary prevention mode, that is, using the child as the indicator of exposure. The theory behind this is that only children who eat paint chips or gnaw on painted surfaces are at risk. Perhaps this approach

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