LEAD poisoning is the No. 1 environmental health threat to children.
So whatever else Congress may do with health-care reform this year, it is imperative to provide for testing blood for lead, as the Clinton administration proposes.
A National Academy of Sciences report on measuring exposure to lead, released in October, confirms a large body of evidence that lead poisoning at very low levels is a widespread problem.
The report contains the most up-to-date and authoritative findings on the health effects of lead.
For decades, the lead industry tried to call into question and to obscure scientific evidence on the toxicity of lead.
Although ultimately unsuccessful, its efforts delayed regulations banning lead in paint, gasoline and other products.
By generating doubt, the industry weakened resolve for environmental regulation, cleanup and prevention efforts.
The academy's support for the toxicity threshold in children recommended by the Centers for Disease Control and Prevention -- 10 micrograms of lead per deciliter of blood -- persuasively makes the case that low-level poisoning reduces I.Q., attention span and learning ability.
The most intensive exposure comes from old lead-based paint. More than half the young children in communities with dilapidated housing are being poisoned, with black children twice as likely to be poisoned as white children.
Because low-level poisoning does not present identifiable symptoms, routine testing of young children is indispensable.
If a parent or doctor waits until a child shows symptoms of high-level exposure, it is too late. The damage is already done and is virtually impossible to reverse.
In 1991, the Centers for Disease Control and Prevention called for universal testing of children beginning at about 1 year old. In April, the American Academy of Pediatrics endorsed routine testing.
Some pediatricians and health clinics are still reluctant to test for lead. Some are uninformed, some vexed because they cannot solve the problem by medical means. No matter what a pediatrician tells parents, they should insist on tests for their young children.
But testing is not prevention. Health reform should help finance solutions to such hazards as chipping and peeling paint and dangerous levels of lead dust in 2 million low-income homes.
This could involve such incentives for landlords and homeowners as low-interest loans or grants. It is only fair that the lead industry be taxed to help pay for these measures.
In October 1995, federal regulations will require disclosure in real estate transactions of lead hazards in pre-1978 housing -- a key step in keeping lead dust away from infants' hands and mouths.
Now, how about congressional support for testing blood and eliminating paint hazards?
David P. Rall, a physician, was director of the National Institute of Environmental Health Sciences from 1971 to 1990.