EPA’s Lead Warning Ad Called Heavy-Handed : TV spot was yanked in the Northwest, where the hazard is believed rare. Critics say costly tests aren’t for everyone.

It’s the kind of public service spot usually aired on television in the wee hours of the morning. The scene is a child’s bedroom filled with toys. As a musical mobile rotates above a crib, the urgent voice of actress Phylicia Rashad warns of an unseen threat.

“Poisonous lead that hides in dust, in paint, in water. A child can eat it, drink it, even breathe it. . . . One out of six preschoolers has high levels of lead in their blood.” Viewers are told to call an 800 number for a brochure that lists as Step 1: Get your child tested for lead poisoning, even if he or she seems healthy.

While stations around the country played this ad last year, it was blacked out in much of the Northwest. The U.S. Environmental Protection Agency, one of the sponsors, pulled the spots at the urging of Washington state medical authorities--among them the state’s chief health officer, who advised that it not be shown.

Their argument: The campaign needlessly scares parents over an environmental hazard they believe is relatively rare in Washington and other parts of the West. Moreover, some say, blood lead testing is an expensive and anxiety-producing procedure with erratic accuracy, and only children with extremely high levels are treated for poisoning.

“It’s a frightening, frightening commercial,” said Dr. Abraham Bergman, the head of pediatrics at Harborview Medical Center in Seattle and a persistent critic of federal efforts to get every child’s blood tested for lead. The same blackout may occur here again this spring as the EPA plans another lead awareness campaign using the same announcements.

“This is not a medical question,” said Bergman, who after 30 years of practice in Seattle has never seen a case of lead poisoning. “The EPA has no expertise (in medicine), yet they become zealots.” Instead, he suggests, the government should throw its finite resources into environmental controls in those places where lead is still a problem, and toward more pressing public health concerns where it is not.

Where the lead is, and where it isn’t, is at the crux of this often-heated debate. “In an ideal world, we’d like to be screening those who need it, and not screening those who don’t,” said Dr. Peter Briss of the national Centers for Disease Control and Prevention. In the meantime, “the benefits of identifying the higher level cases are worth the testing.”

High levels have often been linked to lead paint in older urban housing more common to Eastern cities, and less frequently in similar neighborhoods of California and the West. Critics argue that many areas of the West have such low levels that blood testing is one of the least efficient ways to find poisoning cases.

A study in Orange County last year found so few children with high levels that it concluded: “In jurisdictions with newer housing, initial screening (an interview) for a history of possible lead exposure alone” may be enough.

At sufficient levels, lead can damage a number of systems in the body, especially the developing brain and nervous system in fetuses and preschool-age children. Lead was banned in paint and gasoline by the early 1980s. The CDC radically lowered the blood lead safety threshold in 1991, even as studies were showing drops in the nation’s blood lead level.

“On average, most Americans’ lead exposure has declined,” Briss said. “This is the good news. The bad news is that there is an increasing body of evidence that lead has more subtle effects” at the lower levels, including small but significant effects on IQ.

Cost estimates of testing every American child range from the CDC’s guess of under $1 billion over five years, to the tens of billions of dollars when associated expenses are included, such as abatement.

Advocates of universal screening say geography is no reliable predictor of lead problems. “It sounds attractive to say, ‘That’s not a problem here, our housing stock isn’t at risk,’ ” said Thomas Burke of the Johns Hopkins School of Public Health. “But there’s lots of missing pieces, and we don’t understand all the pathways of exposure. Do you want to err on the side of the angels, or on the other side?”

But opponents contend that in an age of drug-addicted and HIV babies, where less than half the country’s toddlers are fully immunized against routine diseases, the angels may be on many sides, all of them expensive to fix.

They also say the push for universal screening breeds a false confidence in the public mind about what testing can medically accomplish. “There is no ‘treatment’ for moderately or slightly elevated blood lead levels,” Bergman said. When those levels turn up in an individual, “you don’t do anything anyhow,” he said.

The need for universal screening is also being questioned in other areas. The 45,000-member American Academy of Pediatrics wrestled with it last year before deciding to recommend two tests before children turn 2 years old.

But in February, the academy’s journal, Pediatrics, published articles examining the debate over blanket screening. In a commentary, associate editor Dr. Birt Harvey expressed doubt over the policy’s cost-effectiveness.

Tobacco Debate Heats Up

Tobacco opponents sharpen their attack as the tobacco industry defends itself from allegations that cigarettes contain harmful chemicals.

Questionable Mix

The eight chemicals among cigarette additives most questioned by tobacco opponents:

* Megastigmetrienone: a flavoring tobacco companies contend is found naturally in grapefruit juice and considered safe by the food industry. FDA could not confirm that.

* Dehydromenthofurolactone: a flavoring tobacco companies say is found in peppermint and considered safe by the food industry. FDA couldn’t confirm that.

* Ethyl furoate: found naturally in coffee, kiwi and peanuts. FDA has not formally ruled on the issue, but said the food industry considers it safe.

* Maltitol: a sweetener used in chewing gum and candy for diabetics. The food industry considers it safe, but FDA has not ruled on a petition questioning the safety.

* Sclareolide: a synthetic form of a naturally occurring tobacco element. The food industry considers it safe.

* Tobacco extract: used to boost flavor of tobacco; companies say it does contain a small amount of nicotine.

* Ammonia: a processing aid. FDA considers certain forms of ammonia safe in foods but could not comment on the type in cigarettes.

* Methoprene: an insecticide that toxicologists say is biodegradable and works by stopping insects from growing to adulthood.

Generations of Smokers

A breakdown according to age group of current cigarette smokers and those who said they ever smoked cigarettes.

Ever smoked Current smoker 12 to 17 years old 37.9% 10.8% 18 to 25 years old 71.2% 32.2% 26 years and over 77.6% 28.2%

Sources: Times wire reports, U.S. Substance Abuse and Mental Health Services Administration