Chronic lead poisoning in children today: a pathology linked to poverty and social exclusion.

Despite the recognition of lead poisoning in children as a major public hea lth problem in France since the 1980's, the setting-up of systematic detect ion of lead poisoning at a national level has not yet been done. The main s ource of intoxication in children is in paintings containing ceruse in hous ing built before 1948. Moderate chronic poisoning, although leading to irre versible lesions, particularly of the central nervous system, remains usual ly unnoticed. The biological diagnosis is mainly based upon blood lead leve l, completed by the protoporphyrine-zinc level. Large scale identification of dangerous housing and the control of rehabilitation are the only means a vailable to decrease the incidence of lead poisoning. Targeted screening is difficult because it concerns children excluded from classical health care systems. Prevention and long-term treatment requires elimination of the so urce of lead intoxication after an environmental inquiry. This raises the p roblems of rehousing and follow-up of intoxicated children. (C) 1999 Elsevi er, Paris.