LEPAC Annual Report to HHS (2022)

At a glance

Read the 2022 annual report from the Lead Exposure Advisory Committee (LEPAC) to the U.S. Department of Health and Human Services. The committee submits this report as determined by the Secretary or as required by Congress.

LEPAC activities

2022 LEPAC Annual Report – Printable PDF

The objective of the Lead Exposure and Prevention Advisory Committee (LEPAC) is to review research and federal programs and services related to lead poisoning and to identify effective services and best practices for addressing and preventing lead exposure in communities.

Following the enactment of Public Law 114-322, "Water Infrastructure Improvements for the Nation Act" and subsequent nomination of committee members, LEPAC has held two meetings in 2022 and six meetings in total since its establishment in 2018. A brief summary of committee actions is available below. Detailed meeting notes and meeting presentations are available on the LEPAC website.

During both meetings in 2022, LEPAC held a series of presentations followed by facilitated discussions on current Federal efforts to prevent, reduce, and eliminate childhood lead exposure.

On October 28, 2021 CDC updated the Blood Lead Reference Value (BLRV) from 5.0 μg/dL to 3.5 μg/dL as recommended by LEPAC during the May 2021 LEPAC meeting. The BLRV is a policy tool that can be used by public health practitioners, healthcare providers, and others to identify children with blood lead levels higher than most other children.

During the May 2022 LEPAC meeting, CDC described actions to implement LEPAC's other recommendations related to updating the BLRV, including outreach to stakeholders and partners; the creation of new communication products to inform audiences affected by the revised BLRV; and continued direct support and guidance to state and local health departments through CDC's Childhood Lead Poisoning Prevention Program. LEPAC formally sunset the BLRV workgroup due to the successful completion of the workgroup's objectives.

In addition to discussion of the BLRV, a key theme of the May 2022 LEPAC meeting was discussion of opportunities to improve federal lead poisoning prevention efforts at the state, tribal, local, and territorial level. Federal members of LEPAC provided an overview of lead poisoning-related activities, including a presentation by EPA on new Federal funding made available to jurisdictions through the Bipartisan Infrastructure Law for lead service line replacement. Other presenters from the state and local level provided an overview of their experiences navigating multiple Federal funding streams related to lead poisoning prevention.

During the December 2022 meeting, LEPAC held a series of focused presentations and discussion on lead sources in schools and childcare facilities, school nursing practices, and lead remediation efforts in schools and childcare facilities. Facilitated discussion highlighted the need for additional capacity building, training, and education on lead poisoning prevention for school officials and childcare workers, including the need to raise awareness of existing Federal resources to address lead exposure in school and childcare facilities.

Based on recommendations from the May 2022 LEPAC meeting, the chair proposed establishing a new work group to gather and review information on relevant literature to define and update the status of adult lead exposures in the United States. Topics for the work group to consider include epidemiology of adult lead exposure; take-home lead exposure from jobs and hobbies; long-term effects from lead exposure; best practices for preventing adult lead exposure; communication strategies for adult lead exposure.

Summary of committee actions

The Blood Lead Reference Value Workgroup, established by LEPAC in 2020, was sunset following the implementation of its recommendations by CDC. The Blood Lead Reference Value Workgroup and LEPAC recommended that CDC adopt a revised reference value of 5 micrograms of lead per deciliter of blood (μg/dL) (based upon most recent National Health and Nutrition Examination Survey cycles from 2015-2018) and implement a plan to address barriers associated with specimen collection, testing, messaging, and capacity of affected agencies and stakeholders at the federal, state, and local levels.

LEPAC discussed the creation of a new workgroup to define and update the status of adult lead exposures in the United States. The new workgroup is expected to begin meeting in 2023.

LEPAC held a series of presentations and discussions related to lead exposure in school and childcare facilities and discussed opportunities to build capacity, provide training, and raise awareness of lead poisoning prevention in these settings.

Looking ahead

The LEPAC will hold its next meeting during summer 2023 following the appointment of new members to the advisory committee. LEPAC expects to hold one meeting in 2023.

Additional information including meeting notes can be found on the LEPAC website.

Appendix I LEPAC Member Roster

Lead Exposure and Advisory Committee (LEPAC) Member Roster

The committee consists of 15 voting Federal and non-Federal members, including the Chair, appointed by the HHS Secretary. Members include experts in the fields of epidemiology, toxicology, mental health, pediatrics, early childhood education, special education, diet and nutrition, and environmental health. Eight are Federal agency representatives and the remaining 7 do not work for the federal government. CDC has previously solicited Federal members from HHS, the Consumer Product Safety Commission, Department of Agriculture, Department of Education, Department of Housing and Urban Development, Environmental Protection Agency, Occupational Safety and Health Administration, and the U.S. Geological Survey. Federal membership of the committee may change over time depending on the needs of the committee.

Non-Federal members are deemed Special Government Employees (SGEs) and were solicited via a Federal Register Notice. A Federal Register Notice soliciting new SGE members for LEPAC was issued in fall 2021. All members are invited to serve for a term of not more than three years, and the HHS Secretary may reappoint members for consecutive terms.

CDC also selected a Federal employee to serve as the Designated Federal Official (DFO) to attend each meeting and ensure that all procedures are within applicable statutory, regulatory, and HHS General Administration Manual directives. The committee also has six non-voting liaison members representing organizations with an interest in lead poisoning prevention, including organizations representing state and local health departments.

Designated Federal Officer

Paul Allwood, Ph.D, M.P.H, R.S.

Branch Chief

Lead Poisoning Prevention and Surveillance Branch (proposed)

Division of Environmental Health Science and Practice

National Center for Environmental Health

Centers for Disease Control and Prevention

Chair

Matthew Ammon, M.S.

DirectorOffice of Lead Hazard Control and Healthy Homes

U.S. Department of Housing and Urban Development

Washington, DC

Term: 7/1/19-6/30/22

Members

Tammy Barnhill-Proctor, M.S.

Supervisory Education Program Specialist. Office of Innovation and Early Learning. Office of Elementary and Secondary Education. U.S. Department of Education. Washington, DC. Term: 7/10/19-6/30/22

Jeanne Briskin, M.S.

Director. Office of Children's Health Protection. U.S. Environmental Protection Agency. Washington, D.C. Term: 12/2/19-6/30/22

Wallace Chambers Jr., Ph.D., M.A.S., M.H.A.

Deputy Director. Environmental Public Health. Cuyahoga County Board of Health. Parma, OH. Term: 10/15/21–6/30/23

Tiffany DeFoe, M.S.

Director. Office of Chemical Hazards-Metals. Occupational Safety & Health Administration. U.S. Department of Labor. Washington, D.C. Term: 7/1/19-6/30/22

Michael Focazio, Ph.D., M.S.

Program Coordinator. U.S. Geological Survey. Reston, VA. Term: 7/1/19-6/30/22

Monique Fountain Hanna, M.D., M.P.H., M.B.A.

Senior Regional Medical Consultant. Health Resources and Services Administration. Philadelphia, PA. Term: 7/1/19-6/30/22

Nathan Graber, M.D., M.P.H.

Clinical Associate Professor. Department of Pediatrics. Albany Medical Center. Albany, NY. Term: 10/20/21-6/30/23

Kristina M. Hatlelid, Ph.D., M.P.H.

Toxicologist. U.S. Consumer Product and Safety Commission. Rockville, MD. Term: 6/14/21-6/30/22

Karla Johnson, M.P.H.

Administrator. Marion County Public Health Department. Indianapolis, IN. Term: 10/15/21–6/30/23

Donna Johnson-Bailey, MPH, RD

Senior Nutrition Advisor. USDA Food and Nutrition Service. Office of Policy Support. Alexandria, VA. Term: 1/28/20-6/30/22

Erika Marquez, PhD, M.P.H.

Assistant Professor. School of Public Health. University of Nevada, Las Vegas. Las Vegas, NV. Term: 10/15/21–6/30/23

Howard Mielke, Ph.D., M.S.

Professor. Department of Pharmacology. Tulane University School of Medicine. New Orleans, LA. Term: 12/8/21-06/30/22

Anshu Mohllajee, Sc.D., M.P.H.

Research Scientist Supervisor I. California Department of Public Health. Childhood Lead Poisoning Prevention Branch. Richmond, CA. Term: 10/18/21–6/30/23

Jill Ryer-Powder, Ph.D., M.N.S.P.

Principal Health Scientist. Environmental Health Decisions. Ladara Ranch, CA. Term: 10/15/21–6/30/22

Appendix II BLRV Workgroup

Blood Lead Reference Value (BLRV) Workgroup Member Roster

The workgroup was comprised of eight experts in the fields of lead screening, prevention, laboratory issues, and surveillance. The workgroup was required to have at least two SGEs who are currently LEPAC members and a DFO from the CDC. In coordination with the DFO, the LEPAC Chair named a chair for this workgroup from the participating SGEs. In 2021, the BLRV Workgroup finalized a report to LEPAC that discussed how to define the BLRV; how the BLRV is currently used by the Centers for Disease Control and Prevention (CDC) and other entities; the status of the BLRV; and the BLRV Workgroup's recommendations. Following implementation of LEPAC's recommendations, the BLRV workgroup was formally sunset in 2022.

The full report is available on the LEPAC website.

Designated Federal Officer

Ginger Chew, Sc.D.

Health Scientist

Division of Environmental Health Science and Practice

National Center for Environment Health

Centers for Disease Control and Prevention NCEH, CDC

Workgroup Chair

Jill Ryer-Powder, Ph.D., M.N.S.P.

LEPAC Member

Principal Health Scientist

Environmental Health Decisions

Members

Wallace Chambers Jr., M.P.H.

LEPAC Member. Deputy Director. Environmental Public Health. Cuyahoga County Board of Health

Nathan Graber, M.D., M.P.H.

LEPAC Member. Pediatrician. St. Peter's Health Partners Medical Associates

Bruce Lanphear, M.D., M.P.H.

Professor. Simon Frasier University

Julianne Nassif, M.S.

Director of Environmental Health. Association of Public Health Laboratories (APHL)

Amanda Reddy, M.S.

Executive Director. National Center for Healthy Housing (NCHH)

Mark Werner, Ph.D., M.S.

Director. Bureau of Environmental and Occupational Health. Wisconsin Department of Public Health

Nsedu Obot Witherspoon, M.P.H.

Executive Director. Children's Environmental Health Network (CEHN)