Lead Exposure in Children in England

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Hello all and welcome to the Environmental Public Health Tracking (EPHT) Community of Practice (CoP) on Knowledge Hub. The work shown in this CoP is managed by the Environmental Epidemiology Group (EEG) within Public Health England (PHE). 

Lead is one of the biggest environmental hazards for children and can cause toxicity even at low blood lead concentrations. There is no known safe threshold of exposure. Exposure to Lead is a harmful and often neglected health risk in high income and especially in low income countries, regarded unsafe at any level and especially for children and pregnant women. Consequences of high exposure can range from fatigue, developmental delay and learning difficulties to anaemia, abdominal pain and hearing loss.


The Environmental Epidemiology group started with a pilot study in collaboration with the British Paediatric Surveillance Unit, the study ran from 2010-2012 and was titled  Surveillance of Lead in Children (SLiC). The final SLiC report is available to read here. 46 confirmed cases of children with raised blood lead concentrations were found over the study period, a likely underestimate of the number of children affected. Since then, the Lead Exposure in Children Surveillance System (LEICSS) was established, whereby our group is responsible for publishing annual reports on the current levels of confirmed Lead poisoning cases in children <16 years old in England. You can read our two previous reports here.

Our latest report was published this month and is now available to read online. 36 cases of lead exposure in children were notified to PHE in 2019. Much like the preceding years, the vast burden of lead poisoning in children tends to occur in males and those between 1-4 years old. The average detection rate for England between 2015 and 2019 was 3.92 cases per million children (0-15 years old)- read more in the report here.

Despite all the delays and disruptions to normal workflows due to COVID-19, we are still proposing that the public health intervention level for lead be lowered from ≥10μg/dL (≥0.48μmol/L) to ≥5μg/dL (≥0.24μmol/L) for children under 16 years and for pregnant women. This is in line with the intervention level in the USA and other European countries. A working group dedicated to actioning this change in intervention level has been communicating with stakeholders to support and progress this change, which is anticipated to be in effect by late spring.

Moving forward, hopefully reducing the health intervention level will increase clinical and public awareness of the importance of preventing lead exposure in the womb and at a young age and will improve the national surveillance of children with this problem. It is currently an under reported condition.


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