Document qakOMrB0DxjEqqdxGeaavMaex

Visit Report ss&fev; m# Date; Location: Persons Present: Subject: December 5, 1973 Office of LIA 292 Madison Avenue New York, New York Dr. V.F. Guinee, New York City Health Department Mr. P.E. Robinson, LIA Mr. J.F. Smith, LIA Dr. J.F. Cole, ILZRO/LIA Dr, D.R. Lynam, ILZRO/LIA Mr. J. Callaghan, Hill & Knowlton k Expansion of LIA Activities in Pediatric Lead Poisoning Dr. Guinee was asked to meet with the staff of LIA and Hill & Knowlton to provide his thoughts on the possible role LIA may play to assist efforts to prevent pediatric lead poisoning. Dr. Guinee noted that most of the federal funds available in this area have been aimed at screening programs but that very little had been done in the area of housing repairs. He noted that the New York City program had an active housing repair program as part of their overall activities. The New York City repair program consisted of the replacement of door frames and window sills together with the use of wall board to cover up deteriorating walls. He noted that a screening program without an effective repair program would not really be effective in preventing pediatric lead poisoning. Dr. m Guinee also noted that the mechanical devices used to determine the quantity of lead in paint on walls has been less than satisfactory. He pointed out that virtually every reading from machines in the dilapidated housing areas will give a positive lead reading. Therefore, it was his feeling that this device is no more useful than an inspection of deteriorated housing areas. A screening program in which blood lead analyses are taken, is, of course, of great value. Dr. Guinee noted that the New York City program is based on an action level of 60 ug Pb/IOOG blood. The New York City program has been criticized because many feel that a level of 40 or even 35 should be cause for concern./ However, Dr. Guinee argued that no one has shown an effect of blood lead / concentrations belpw 80 and therefore he felt thal: to obtain maximum value from the screening program that action should be taken only on a worst-case-first basis. He noted that New York's screening program which has screened nearly 50% of all children residing in dilapidated areas showed initially that 3% of the population had blood leads of 60 or more. This percentage has been reduced to 2% in 1971 and 1% in 1972. He felt that any program using a 35 or 40 ug Pb/IOOG of blood as the action level would involve so many cases that it would be impractical to carry out a meaningful repair program, and, therefore, it was likely that nothing would be done. LIA-7 67 46 WeiTWPPttf, ' ' ' " r }'j ' 1 ;' .',, , " ' ' > . 'I ' I , ~ ` I I J y F''>i V ' Dr. Guinee suggested that LIA wight best play $ ppj.p by prpv^^g and direction to cities and professionals conperned about pediatpic lead . . poisoning. During the pourse of the discussion, it was suggested th^b a manual aimed at city official's be prepared which outlines the New Yqpk . City experience and highlights the "worst-case-first" philosophy. Further, it was suggested that "Facts About Lead and Pediatrics" be revised and updated so as to make it more useful to pediatricians and purses. It was also suggested that a series of seminars be conducted around fhe country and that other communications devices such as tapes and programmed learning techniques be considered. It was left that Hill & Knowlton would prepare a program based on these discussions which would be submitted to LIA for consideration. Sincerely, 1 v Jerome F. Cole, Sc.D. Deputy Director cc: Fir, J. Callaghan y Dr. D.R, Lynam Dr. S.F. Radtke Mr. P.E. Robinson Mr. J.F. Smith Dr. E.B. McCabe I sw / LIA-76747