Globally, childhood blood lead levels have fallen precipitously in developed countries since the 1970s following action by international bodies such as the WHO and Food and Agricultural Organization (FAO) of the United Nations. These reductions have been affected by the activities of national agencies such as the US EPA and US Centers for Disease Control and Prevention in the establishment of air lead and blood lead standards, the introduction of legislation to remove lead from petrol, paint and consumer products and tighter restrictions on lead emissions. The outcome of recent major international reviews of research into the effects of low-level lead exposures (e.g. by WHO, USA health and environmental agencies, German and Canadian health bodies) has resulted in recommendations to reduce and eliminate lead exposures. By contrast, Australian policy responses to the incontrovertible evidence that adverse neurocognitive and behavioural effects that occur at levels well below the current national goal of 10μg/dL have stalled. The delayed response by Australia occurs at a time when blood lead levels in two of Australia's three primary lead mining and smelting cities: Port Pirie, South Australia and Broken Hill, New South Wales, are rising. In the third city, Mount Isa, Queensland, there is still no systematic, annual testing of childhood blood lead values. This is despite the fact that Mount Isa has the highest lead (and other toxic metals such as cadmium and arsenic) emissions to the environment (120tonnes of lead in 2011/12) from any single point source in Australia. It is clear that both state and national policy approaches to the ongoing risks of lead exposure need to be revised urgently and in line with contemporary international standards. Recommended changes should include a new lower blood lead intervention level of no more than 5μg/dL, with a national goal for all children under 5years of age to have a blood lead level of below 1μg/dL by 2020. In order to achieve any new lower exposure goals other relevant lead standards including air, dust, soil and water must also be revised downwards.