Newly recognized pathways of exposure to lead in the middle-income home.

* Most official childhood lead-poisoning prevention efforts focus on children living in poor neighborhoods in older houses.

* Healthy People 2010 and the U.S. Department of Housing and Urban Development have determined that the children at greatest risk of lead poisoning are those living in poor neighborhoods in older housing stock.

* The American Academy of Pediatrics (AAP) recommends universal screening only for children enrolled in the Women, Infants and Children Supplemental Food Program.

* The latest National Health and Nutrition Examination Survey (NHANES) report showed a decline in mean blood lead levels in children nationwide.

* As a result, the Centers for Disease Control and Prevention (CDC) and AAP have retreated from previous recommendations for universal screening of all children.

* With the removal of lead from gasoline in the United States, lead-based paint on the exterior and interior walls of homes is considered to be the most serious pathway of childhood exposure to lead.

* But a newly recognized pathway involves the introduction of antique painted artifacts into middle and upper-income American homes.

* A current trend in home decorating that promotes the use of expensive antiques or used artifacts with chipped, chalky, or peeling paint may be exposing a different population of children to lead.

* Items such as old painted furniture, windows, doorframes, and toys with peeling, chipped, or chalky paint are featured in attractive layouts in the popular media.

* Of particular concern is the widespread availability of old toys and jewelry in antiques stores, in second-hand stores, at garage sales, and over the Internet.

* Also, collectors prefer antiques with original paint on the surface, even if the paint is worn and deteriorated.

* Children in families who own or can purchase such items are not likely to qualify for universal screening or to fit into the officially recognized population of children most at risk for lead poisoning.

* The authors conducted a study to

1. assess the extent to which antiques with damaged paint are promoted in the popular home-decorating print media and over the Internet and

2. gauge whether a casual shopper is apt to purchase lead-hazardous antiques in the United States.

* Some of the magazine photographs showed visual characteristics indicative of potential lead hazards:

-- peeling and chipped paint on a metal bed and a toy box in a child's bedroom,

-- food being served on breadboards with old paint, and

-- deteriorated paint on a floor.

* Antique toys were also widely displayed in the photographs.

* In a sampling of antiques stores, lead-painted items were easily available.

* Within the first five minutes in each of 13 stores, it was possible to find and purchase an object that tested positive on a lead swab test.

* Items that tested positive for lead included

-- a drinking glass featuring Garfield the Cat,

-- tops of salt and peppershakers,

-- a pewter pitcher and pewter bowl,

-- old Pyrex casserole dishes, and

-- a metal necklace in the shape of a turtle, with a chain long enough to allow a child to put the necklace in her mouth.

* It appears that the lead hazards of the past are re-entering American homes.

* The children at risk from the reintroduction of these hazards will not fall into the officially recognized risk categories.

* They are not likely to qualify for the lead-screening programs recommended by AAP and CDC.

* At the same time, none of the federal agencies tasked with reducing and eventually eliminating childhood lead poisoning in the United States has as yet identified this pathway.

This department, Practical Stuff! originated from you, our readers. Many of you have expressed to us that one of the main reasons you read the Journal of Environmental Health is to glean practical and useful information for your everyday work-related activities. In response to your feedback, we dedicate this section to you with salient points to remember about two to three articles in each issue.