Core Viewpoint - The article highlights the underestimation of lead exposure risks among children in China, particularly in light of a recent incident in Gansu province where a significant number of children were found to have elevated blood lead levels, raising concerns about public health and safety standards [1][2]. Summary by Sections Incident Overview - In Gansu's Tianshui City, 233 out of 251 children tested at a kindergarten were found to have abnormal blood lead levels, with some results showing lead levels exceeding 200 micrograms per liter (μg/L), far above the World Health Organization's recommended level of 50 μg/L [2]. Historical Context - Lead exposure among children in China was a severe public health issue in the late 1990s, with average blood lead levels reaching 97.10 μg/L and an overall poisoning rate of 36.01% [4]. In Gansu, a 2000 study showed an average blood lead level of 116.0 μg/L among children aged 3 to 5 [5]. Sources of Lead Exposure - The primary sources of lead exposure have shifted from leaded gasoline, which was phased out in the early 2000s, to industrial pollution and coal combustion. The increase in non-ferrous metal smelting and coal burning has significantly contributed to lead contamination in the environment [9][10]. Health Impacts - Lead exposure in children is linked to detrimental effects on cognitive development and behavior, with every 12 μg/L increase in blood lead levels correlating to a decrease of 1 point in cognitive ability scores. There is no safe threshold for lead exposure, as even low levels can cause harm [8][12]. Current Standards and Recommendations - China's current blood lead reference value of 100 μg/L is outdated compared to international standards, which have been lowered to 50 μg/L by the WHO and even lower in some countries. An estimated 6.7 million children in China would require intervention if the standard were updated [14][15]. Economic Implications - Updating the blood lead reference value to align with international standards could yield significant economic benefits, with potential annual economic gains estimated between 7.03 trillion yuan and 16.59 trillion yuan due to improved cognitive outcomes in children [16]. Policy Challenges - Despite calls from public health experts to update the blood lead reference value, progress has been slow, with no recent developments following a 2021 proposal to set the limit at 50 μg/L [16].