Theodore H. Tsoukalas, PhD, Public Health Institute, P.O. Box 27690, San Francisco, CA 94127, (415) 722-8968, theotskl@aol.com and Amy G. Cantor, MHS, School of Medicine, University of Texas Health Science Center at San Antonio, 5303 Hamilton-Wolfe Rd, #820, San Antonio, TX 78229.

The removal of lead from paint (1978) and gasoline (1991) represents two fundamental measures towards the mitigation of US pediatric blood lead levels (BLL). Further advances in lead exposure source identification and measurement suggest substantial variability among children along race, ethnic origin, and socio-economic status. Despite its removal from paint and gasoline, lead has an overwhelming presence in US commerce and the bio-physical environment. Thus, a multitude of policy relevant challenges exists suggesting the presence of an ongoing institutional failure in national efforts to eliminate lead exposure. In this analysis, institutional failure is generally defined as the inadequate translation of evidence-based scientific knowledge to lead poisoning prevention policies. The analysis undertaken in this study is twofold. First, it demonstrates the rise and consequences of institutional failure in 3 types of lead exposure: household paint, leaded gasoline, and culturally-linked use of lead-containing foods and medicines. Secondly, it identifies policy relevant challenges associated with institutional failure ranging from gaps in clinical surveillance, to inaccurate exposure measurement at low BLLs, and policy development interference by powerful stakeholders. It is suggested that in order to eliminate institutional failure in lead poisoning prevention the gap between evidence-based research and policy must be adequately bridged. To do so, safety standards must be solely based on health criteria, accurate measurements of BLL at low levels of exposure must be developed, and stronger policy implementation and enforcement is needed.

Learning Objectives:

• At the conclusion of the session, participants will be able to (a) list three contributing factors associated with the rise of institutional failure in US pediatric lead poisoning prevention policy, and (b) recognize the persistence of lead in commerce and the environment.
• Articulate the emergence of consequences of institutional failure in the prevention of lead exposure from leaded gasoline, household paint, and lead containing foods and medicines.
• Describe the processes by which stakeholders interfere in the development of more effective pediatric lead poisoning prevention policies.
• Identify at least 3 conditions necessary for the elimination of institutional failure in US pediatric lead poisoning prevention policy.

Keywords: Environmental Health, Children

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.