source of childhood exposure in the United States (USDHHS, 1995). An important route of exposure in young children is the ingestion of lead-based paint chips, lead-impregnated plaster, and contaminated dirt or dust found in homes built before 1950 (NCHS, 1984). Although all economic and racial subgroups of children are at risk of exposure, the prevalence of elevated lead levels remains highest for poor children living in the inner city. It is unlikely that childhood lead intoxication can be eliminated without further reductions in the lead content of paint, dust, and soil in inner-city areas (IOM, 1995).
The problem of childhood lead intoxication is reflected in Objective 11.4 of Healthy People 2000: National Health Promotion and Disease Prevention Objectives (USDHHS, 1991):
Reduce the prevalence of blood lead levels exceeding 15 µg/dL among children aged 6 months through 5 years to no more than 500,000 by the year 2000. In addition, reduce blood lead levels exceeding 25 µg/dL among children (6 months through 5 years) to zero by year 2000.
At the time this objective was established, data for 1984 showed that 3 million young children had blood lead levels exceeding 15 µg/dL, and 234,000 had levels exceeding 25 µg/dL.
Current strategies to reduce the exposure of children to lead include abatement of lead hazards in homes and further reduction of lead levels in soil and drinking water. Abatement of lead in homes requires substantial resources, since the cost of abatement of a single residential structure can range from $3,000 to $15,000 (CDC, 1991). Title X of the Housing and Community Development Act of 1992 makes some provisions for funding residential lead abatement in communities. In addition, the act creates a process for involving federal agencies (e.g., the Department of Housing and Urban Development [HUD] and the Environmental Protection Agency [EPA]), local governments, and private owners in the abatement process.
Population-based strategies to reduce the availability of lead in soil and drinking water are under way in communities across the United States. Implementing these strategies is expensive and may raise controversies that position residents against government officials (or the business community). For example, soil remediation at Smuggler Mountain, a Superfund site near Aspen, Colorado, caused public outcry when residents learned that current blood lead levels of children were relatively low and that the process of soil remediation might result in a temporary increase in