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DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL AND PREVENTION

National Center for Environmental Health

Division of Emergency and Environmental Health Services

Healthy Homes/Lead Poisoning Prevention Branch

Advisory Committee on

Childhood Lead Poisoning Prevention

November 14-16, 2011

Atlanta, Georgia

Record of the Proceedings

TABLE OF CONTENTS

Page

Attachment 1: List of Participants .......................................................................................... A1-1

Attachment 2: Glossary of Acronyms..................................................................................... A2-1

Meeting Minutes............................................................................................................................ 1

November 14, 2011 Opening Session: November 16, 2011 ................................................................................... 1

CDC Healthy Homes/Lead Poisoning Prevention Branch Chief's Report............................... 3

Overview of the Rhode Island Healthy Housing Program ....................................................... 8

Overview of Child Blood Lead Studies in Puerto Rico .......................................................... 12

Update by the Laboratory Methods Workgroup .................................................................... 15

Update by the Educational Intervention Workgroup.............................................................. 20

Update by the Lead in Consumer Products Workgroup........................................................ 22

Public Comment Session ...................................................................................................... 26

November 15, 2011 Opening Session: November 15, 2011 ................................................................................. 27

Update on National Performance Measures of Blood Lead in Children................................ 28

PANEL PRESENTATION:

UPDATE BY THE BLOOD LEVEL OF CONCERN WORKGROUP ..................................... 30

Introduction ..................................................................................................................... 30

Scientific Rationale.......................................................................................................... 31

Reference Value Approach to Evaluate Blood Lead Levels ........................................... 36

Laboratory Methods ........................................................................................................ 38

Health Management ........................................................................................................ 40

Community Interventions ................................................................................................ 41

Environmental Interventions............................................................................................ 42

Research Needs ............................................................................................................. 44

Open Discussion on the LOC Document ........................................................................ 45

Public Comment Session ...................................................................................................... 52

November 16, 2011 Opening Session: November 16, 2011 ................................................................................. 54

Update on the Lead Poisoning Outbreak in Zamfara State, Nigeria ..................................... 54

ACCLPP Business Session .................................................................................................. 57

Public Comment Session ...................................................................................................... 61

Closing Session .................................................................................................................... 61

ATTACHMENT 1

Page A1-1

List of Participants

(Note: The Chair and Designated Federal Official opened the floor for introductions on November 14, 15 and 16, 2011 and confirmed the presence of a quorum with the ACCLPP voting members and non-voting ex-officio members on all three days of the meeting.)

ACCLPP Members Dr. George Rhoads, Chair Dr. Deborah Cory-Slechta Dr. Kim Dietrich Dr. Sher Lynn Gardner Mr. Perry Gottesfeld Dr. Kimberly Hansen Dr. Michael Kosnett Mr. David McCormick Ms. Elizabeth McKee-Huger Dr. Patrick Parsons Dr. Brenda Reyes Dr. Megan Sandel Mr. Dana Williams, Sr.

Ex-Officio Members Dr. Walter Alarcon (National Institute for

Occupational Safety and Health) Dr. Warren Friedman (U.S. Department of

Housing and Urban Development) Dr. Kristina Hatlelid (U.S. Consumer

Product Safety Commission) Ms. Lori Michaelson

(U.S. Department of State) Ms. Jacqueline Mosby (U.S. Environmental

Protection Agency) Dr. Walter Rogan (National Institute of

Environmental Health Sciences) Ms. Cynthia Ruff (Centers for Medicare and

Medicaid Services

Liaison Members Dr. Carla Campbell

(American Academy of Pediatrics) Mr. Steve Hays (American Industrial

Hygiene Association) Ms. Jane Malone

(National Center for Healthy Housing) Ms. Ruth Ann Norton (National Coalition to

End Childhood Lead Poisoning)

Dr. George Rodgers, Jr. (American Association of Poison Control Centers)

Dr. Donald Simmons (Association of Public Health Laboratories)

Designated Federal Official Dr. Mary Jean Brown

Chief, Healthy Homes/Lead Poisoning Prevention Branch, CDC

CDC Representatives Dr. Thomas Sinks

NCEH/ATSDR Deputy Director Dr. Sharunda Buchanan, EEHS Director Behrooz Behbod Sandy Bonzo Barry Brooks Bernadette Burden Jay Dempsey Tim Dignam Kayim Harris Robin Ikeda Jeffrey Jarrett Robert Jones Claudine Johnson Sarah Merkle Edward Murray Paris Ponder Rose Glass Pue Marissa Sucosky Denise Tevis Connie Thomas Tiffany Turner Will Wheeler Joyce Witt

Guest Presenters and Members of the Public Craig Boreiko (International Lead

Zinc Research Organization)

Timmerly Bullman (Environmental Planning Specialists, Inc.)

Forrest Daly (Georgia Childhood Lead Poisoning Prevention Program, Georgia Lead Hazard Control Program)

Cynthia Driscoll (Jones Day)

Joel de Jesus (Magellan Biosciences)

Richard Gragg (Florida A&M University

School of the Environment)

[via teleconference]

Carolyn Grossman (Magellan Biosciences) Christopher Saranko (Environmental

Planning Specialists, Inc.) Michael Shaw (National Coalition to End

Childhood Lead Poisoning) Gwen Smith (Georgia Department of

Public Health) Robert Vanderslice (Rhode Island

Department of Health)

AAP ACCLPP ADHD APHA APHL ASV BLL CDC CERCLA

CLIA CLPPP CMS CoC CPSC CPWG DOS EBLLs ED EEHS EIS EIWG EPA FDA FEP GFAAS GHHI HHLPPB HHLPSS HHS HRSA HUD ICP-MS IDEA IV LAMP LBP LOC LOD LOQ LPP LSLs LWG MDI

ATTACHMENT 2

Glossary of Acronyms

American Academy of Pediatrics Advisory Committee on Childhood Lead Poisoning Prevention Attention Deficit Hyperactivity Disorder American Public Health Association Association of Public Health Laboratories Anodic Stripping Voltammetry Blood Lead Level Centers for Disease Control and Prevention Comprehensive Environmental Response, Compensation and Liability Act Clinical Laboratory Improvement Amendments Childhood Lead Poisoning Prevention Program Centers for Medicare and Medicaid Services Certificate of Conformance U.S. Consumer Product Safety Commission Lead in Consumer Products Workgroup Department of State Elevated Blood Lead Levels Department of Education Division of Emergency and Environmental Health Sciences Early Intervention Services Educational Intervention Workgroup U.S. Environmental Protection Agency Food and Drug Administration Free Erythrocyte Porphyrin Graphite Furnace Atomic Absorption Spectrometry Green and Healthy Housing Initiative Healthy Homes/Lead Poisoning Prevention Branch Healthy Homes Lead Poisoning Surveillance System Department of Health and Human Services Health Resources and Services Administration U.S. Department of Housing and Urban Development Inductively Coupled Plasma Mass Spectrometry Individual with Disabilities Education Act Intravenous Lead and Multi-element Proficiency Lead-Based Paint Level of Concern Level of Detection Level of Quantitation Lead Poisoning Prevention Lead Service Lines Laboratory Methods Workgroup Mental Development Index

Page A2-1

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