Needleman H L
Lead Research Group, University of Pittsburgh Medical Center, Pa., USA.
Am J Public Health. 1998 Dec;88(12):1871-7. doi: 10.2105/ajph.88.12.1871.
In 1991, the Public Health Service published the Strategic Plan for the Elimination of Childhood Lead Poisoning. This document marked a fundamental shift in federal policy from finding and treating lead-poisoned children to authentic primary prevention. It spelled out a 15-year strategy to achieve this goal and provided a cost-benefit analysis showing that the monetized benefits far exceeded the costs of abatement. A strong national effort to eliminate the disease developed. Now, 7 years after publication of the plan, primary prevention of lead exposure has been abandoned. This article examines the role of some prevailing attitudes and institutions in derailing the effort. Some institutions--the lead industry, real estate interests, and insurance interests--behaved as anticipated. Others, including private pediatricians, the American Academy of Pediatrics, some federal agencies, and a public interest group ostensibly dedicated to eliminating lead poisoning, also played an unexpected part in derailing the plan.
1991年，公共卫生服务部发布了《消除儿童铅中毒战略计划》。该文件标志着联邦政策从发现和治疗铅中毒儿童转向真正的一级预防的根本性转变。它阐述了实现这一目标的15年战略，并提供了成本效益分析，表明货币化的收益远远超过了减排成本。一场强大的全国性消除该疾病的努力由此展开。如今，在该计划发布7年后，铅暴露的一级预防已被放弃。本文探讨了一些普遍存在的态度和机构在破坏这一努力中所起的作用。一些机构——铅行业、房地产利益集团和保险利益集团——的表现不出所料。其他机构，包括私人儿科医生、美国儿科学会、一些联邦机构以及一个表面上致力于消除铅中毒的公共利益集团，在破坏该计划的过程中也扮演了意想不到的角色。
