Adverse effects of lead on health have been shown for lead concentration in blood (or blood lead level) below 100 µg/L. This value currently defines childhood lead poisoning.

Therefore, the HCSP advocates a policy of exposure reduction to the lowest possible level. For 2017, it sets the following objectives of reduction of the blood lead level of the general population:

• an expected geometric mean blood lead level of 12 μg/L;
• 98 % of the population with a blood lead level below 40 μg/L.

It further recommends to focus screening, medical care and prevention of intoxications on the most exposed people.

The HCSP proposes two blood lead levels to organize the prevention of childhood lead poisoning:

• a rapid intervention level of 50 μg/L, entailing the mandatory reporting of cases, triggering an environmental investigation and all the collective and individual measures currently initiated when the blood lead level is equal to or above 100 μg/L; it would thus be the new operational definition of childhood lead poisoning;
• a vigilance level of 25 μg/L; its exceedance indicates the probable existence of at least one source of lead exposure in the environment and justifies providing information to families on the lead hazards and on the usual sources of uptake, as well as a close biological surveillance along with hygiene and dietary advice aiming at reducing contact.

These new reference levels will have to be updated every 10 years.

Alert values are also proposed for the main sources of lead in the environment (soils, house dust, tap water).

Finally, the HCSP recommends that all the data collected on the lead contamination of contact environments (soils, house dust, drinking water) and individuals (blood lead levels) be recorded to set up a national database as a tool for knowledge and management purposes.

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