John Libbey Eurotext

Environnement, Risques & Santé

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Screening for childhood lead poisoning in France from 1995 through 2002 Volume 6, issue 6, Novembre-Décembre 2007

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Institut de veille sanitaire (InVS), 12, rue du Val d’Osne, 94415 Saint-Maurice cedex, France, Centre antipoison et de toxicovigilance de Paris, Hôpital Fernand Widal, 200, rue du Faubourg Saint Denis, 75475 Paris cedex 10, Centre antipoison et de toxicovigilance de Lyon, Bâtiment A, 4 e étage, 162, avenue Lacassagne, 69424 Lyon cedex 03, Centre antipoison et de toxicovigilance de Lille, CHRU, 5, avenue Oscar Lambert, 59037 Lille cedex, Centre antipoison et de toxicovigilance d’Angers, CHRU, 4, rue Larrey, 49033 Angers cedex 01, Centre antipoison et de toxicovigilance de Bordeaux, Hôpital Pellegrin Tripode, Place Amélie Raba-Léon, 33076 Bordeaux cedex
  • Key words: child, France, lead poisoning, mass screening, population surveillance, risk factors
  • DOI : 10.1684/ers.2007.0115
  • Page(s) : 425-32
  • Published in: 2007

Introduction: Lead poisoning can cause neurodevelopmental and hematopoietic damage, especially in young children. Exposure to deteriorated lead-based paint in old buildings is one of the main risk factors. The objectives of the present study were 1) to count the children screened for lead poisoning and the new cases in France and to describe their distribution geographically and over time, and 2) to study their characteristics and the risk factors associated with a high blood lead level. Methods: The study population comprised all children with one or more blood lead tests in France from 1995 through 2002. Our data source was the Childhood Lead Poisoning National Monitoring System, which began recording blood lead levels and children’s characteristics in 1995. Results: In all, 36,151 children younger than 18 (35/100,000 children per year) were screened at least once. Most (95%) were younger than 7. Among those screened, 5,974 new cases were detected (incidence rate = 5.9/100,000 person-years). The percentage of screened children with a blood lead level above the cutoff point of 100 μg/L decreased regularly, from 24.5% in 1995 to 8.5% in 2002. Screening activity was concentrated in three of the 22 French regions (Ile-de-France = 61%, Rhônes-Alpes = 13% and Nord-Pas de Calais = 9 %) and 66% of the new cases lived in Paris or its suburbs. Moreover, two thirds of the children screened (64%) lived in old dilapidated housing and one in six had lead poisoning. Conclusion: The number of cases of childhood lead poisoning detected has decreased regularly since 1995. Nevertheless, the French screening activity for childhood lead poisoning remains much too heterogeneous. Even though risk factors for lead poisoning are not equally distributed within the country (old housing, industrial sites), numerous children exposed to lead are not screened in many regions and it is likely that many new cases are not identified.