Key Points

This report describes the screening program for childhood lead poisoning conducted in Normandy between 2016 and 2023. The previous report covered the period from 2008 to 2017.

Total recorded blood lead levels

• 787 blood lead level measurements were recorded from 2016 to 2023, including 599 for initial screening and 188 for follow-up testing;

• The annual number remained stable between 2016 and 2018 (an average of approximately 73 blood lead levels per year) and then doubled in 2019. After a decline in 2020 (91 blood lead level tests in 2020), the number rose in 2021 and 2022. In 2023 (n=62), however, it was the lowest recorded since 2016. This trend was observed in all departments of Normandy.

Among all children undergoing initial screening

• Screening activity was more pronounced in 2019 and 2022 in connection with localized events;

• The majority of children undergoing initial screening resided in the Eure and Seine-Maritime departments;

• 45% (n=272) of initial screenings were ordered before the age of 7;

• The main reported risk factors were housing, lead-based paint, and lead poisoning in another child in the household;

• The geometric mean blood lead level was 11.5 µg/L.

Children with blood lead levels above the warning threshold

• 11% (n=60) of children had blood lead levels above the watch level (greater than 25 µg/L and less than 50 µg/L), including 6% (n=33) among those under 7 years of age (target group);

• 52% (n=17) of children under 7 years of age who were screened for the first time between 2016 and 2022 underwent a follow-up blood lead level test, of whom less than half (35%) did so within timeframes consistent with HCSP recommendations.

Incident cases of lead poisoning

• 42 cases of lead poisoning were diagnosed between 2016 and 2023. The detection rate was increasing, rising from 2.2% during the period 2008–June 2015 (before changes to reporting threshold regulations) to 7% for 2016–2023;

• 38 cases had at least one reported risk factor;

• The highest positive predictive values (PPV) were for high-risk leisure activities, adoptions, children of migrants, and apprentices;

• Follow-up blood lead levels were measured in 68% (n=25) of cases, mostly within 6 months of the initial screening. For the majority of these cases, a decrease in blood lead levels was observed at the first follow-up.