Surveillance of Lead in Children study

Lead poisoning in children is associated with a range of effects, including reduction in IQ and disruptive behaviour.  Changes in the law have removed many sources of lead from the environment, such as the European requirement for all new cars to run on unleaded petrol from 1990, and this has led to a decrease in levels of lead in blood in the population.  However, it is known that a small number of children are still being exposed to harmful levels of lead, for example from old lead paint.

A project is underway involving paediatricians, toxicologists and public health professionals in the UK and Republic of Ireland to investigate how common lead poisoning is among children and what the causes are. 

Latest news - October 2011

The interim report on the SLIC study data for 2010/2011 was published in September 2011.  The full report for 2010/2011, including the updates from SLIC, can be downloaded from the BPSU website.

The study team is regularly receiving notifications of new cases of lead poisoning in children and is working alongside medical staff to obtain further information. Cases are also being referred by clinicians for public health follow up by Health Protection Units and local authorities to prevent further exposure.

Frequently asked questions on lead poisoning for paediatricians are available in our Guidance for professionals section on lead incidents, alongside an public health action card and environmental investigation and remediation advice.  Information for the public, including FAQs and how to remove lead paint are also available.

Aims

The main surveillance aims and objectives of this study are:

• to investigate the incidence of clinically diagnosed blood lead concentrations ≥10μg/dl in children aged 0-15 years in the UK and Republic of Ireland
• to describe the treatment and health outcomes for children one year after diagnosis
• to report the proportion of cases where a lead source was identified and to describe these sources
• to raise awareness among paediatricians about the possibility of lead poisoning
• to provide support in managing children with elevated blood lead concentrations, including the involvement of clinical toxicologists and public and environmental health professionals, who will work to prevent further exposure.

Methods

Paediatricians in the UK and Republic of Ireland diagnosing children under the age of 16 with elevated blood levels ≥10µg/dl will report cases on the British Paediatric Surveillance Unit (BPSU) monthly notification card for a period of two years.  In addition, new cases diagnosed by clinical toxicologists in the UK will be reported.  To ensure the maximum number of cases is identified, there will also be reporting from specialist laboratories that test for metals in blood samples. 

The case notifications will be received by scientists at the HPA, who will send questionnaires at the time of diagnosis and after 12 months to the clinician, asking for information on diagnosis, treatment and possible sources of exposure to lead. 

Clinicians treating children will be encouraged to inform their local Health Protection Unit and Local Authority environmental health department, which can work with the family to investigate the source, check if other people (such as siblings) are at risk and suggest ways to prevent further exposure.

Researchers will not be told the names of cases and data will be kept securely and destroyed when the study is finished.  The study has approval from the Executive Committee of the BPSU and the NHS National Research Ethics Committee, reference 10/H0706/10.

SLIC study protocol card (PDF, 112 KB)

Benefits for public health

Clinically recognised lead poisoning is a preventable disease and this study will enhance our understanding of environmental lead exposure in children. 

Data gathered during this surveillance will enable us to estimate the incidence of lead poisoning in children in the UK and Republic of Ireland, describe the sources of environmental exposure and identify the sections of society most at risk.

These findings could be used to inform health policy, including clinical guidance for paediatricians managing cases and the dissemination of information about lead to parents and the public.

The benefits of the study to health protection are discussed in an article in the Chemical Hazards and Poisons Report:
Summary of key benefits to health of SLIC study (PDF, 41 KB)

Timeline

Case notification began on 1 July 2010.  New cases are being recruited until 30 June 2012, with follow up continuing until July 2013.  An interim report was published on the BPSU website in September 2011 at www.rcpch.ac.uk/bpsu.

Partners

Health Protection Agency - Centre for Radiation, Chemical and Environmental Hazards
Associate partners:
British Paediatric Surveillance Unit
National Poisons Information Service
Supra-Regional Assay Service
Health Protection Scotland
Health Service Executive, Republic of Ireland
Public Health Agency for Northern Ireland
Public Health Wales

Further information

Clinicians involved in the study who would like to report a case or ask a question should email slic@hpa.org.uk or write to:

Surveillance of Lead in Children study
Health Protection Agency
Centre for Radiation, Chemicals and Environmental Hazards
Chilton, Didcot
Oxfordshire OX11 0RQ

Find a Health Protection Unit responsible for an area.

Last reviewed: 25 October 2011