Current problems of lead poisoning]

In collaboration with private associations and public services, we screened a targeted population for serum lead levels and observed lead poisoning (serum Pb > 100 micrograms/l) in 6 out 44 children living in precarious conditions in Poitiers, France. This observation underscores some of the major problems encountered in the battle against lead poisoning in western countries. First, the social, economical or legal situation of the population at risk often results in exclusion from the normal health care network. If after a coordinated effort based on mutual trust, children exposed to lead poisoning can be identified, the second problem is to identify the source of intoxication. Scaling paint in the current housing may be incriminated, but how can the true source be identified when the populations concerned change residence often and may be unwilling to disclose their previous residence due to fear of reprisals for themselves or the new occupants? And if the source is identified, the cost of rehabilitation or the illegal situation of the family may raise further problems requiring adapted solutions. The prevention of lead poisoning calls for a targeted screening program, combined efforts of public authorities and health care workers, and close cooperation with private associations. All intoxicated children should be removed from the source of exposure and their families protected from the risk of sanctions. Only an active and practical public health policy can provide the solution to this continuing public health problem.