Tools for Measuring Human Lead Exposure: A Review of Methods and Implications for Future Research and Practice

Targeted to policymakers and others without technical scientific backgrounds, it first provides a high-level introduction to the science of lead exposure and related biomarkers, and presents a conceptual framework for evaluating lead exposure measurement methods that considers both the intrinsic characteristics of the method and the use case for measurement. [...] Third, it reviews the state of the science for methods to measure current lead exposure, typically in the form of blood lead measurement, including the strengths and weaknesses of specific methods. [...] Characteristics of measurement approaches and performance in resource-constrained settings In considering the merits and drawbacks of the methods currently available for measuring blood lead levels for different use cases in a resource-constrained environment, it is useful to think about how they perform on the following dimensions: • Cost: Given the fiscal constraints of many low and middle-incom. [...] We consider the strengths and weaknesses of the full portfolio; evaluate the portfolio’s performance for each of the five use cases of lead exposure measurement described in Part 1; and present a forward-looking agenda for research and development to address the most relevant gaps in the toolkit vis-à-vis the needs of LMIC policymakers, clinicians, and researchers. [...] Objectives of the roundtable are as follows: • To take stock of the state-of-the-science on lead exposure measurement, including the advantages and disadvantages of different methods; • To clarify areas of uncertainty with respect to the accuracy and precision of different methods, and inform a research agenda for further validation/calibration where necessary/useful; and • To consider the technic.