1A-S1-1文本框: A HEALTHY VILLAGE IS REQUIRED TO RAISE A HEALTHY CHILD Rosen, JF. Children’s Hospital at Montefiore. The Albert Einstein College of Medicine. New York, USA. Objective: This is a current review of childhood lead (Pb) poisoning (CLPB) in the United States. Results: CLPB is widely pervasive in the U.S. from the widespread use of leaded paint until its ban in 1978. About 25 million homes still contain hazardous lead paint; and about 1 million children have Pb poisoning annually, based upon the definition of a blood lead level (B-Pb) >10 ug/dl, although there is no known threshold below which Pb is without adverse effects. The primary public health advance occurred in the 1980s, when leaded gasoline was phased out. This led to a five-fold decrease in the average B-Pb in U.S. children to 3 ug/dl. Chelation therapy for B-Pbs >45 ug/dl stops the progression of CLPB to its symptomatic-acute stage, but severe-overt neurological sequelae are permanent. Despite guidelines from the CDC for chelation treatment in children with B-Pb >44 ug/dl, the management of children with B-Pbs of 20-44 ug/dl is unclear. Elevated B-Pbs (20-44 ug/dl) are known to produce irreversible neurotoxic effects in untreated children; and a randomized-controlled clinical trial of DMSA treatment in this group failed to reverse adverse effects of Pb, such as deficits in academic achievement, abstract thinking, conceptual reasoning, attention span, and executive and visual-perceptual skills. Conclusions: Permanent primary prevention, before a child becomes Pb-poisoned, is the only method to prevent this disease, whether the source of exposure is from leaded paint or industrial sources. Collective and concerted actions are needed to prevent this devastating disease. There is nowhere else to hide this widespread public health problem.