This survey included 1,239 children, representing 50% of the elementary school population of the lead smelting town of Port Pirie. Of these children, 7% had a capillary blood lead level equal to or greater than 30 micrograms/dl, which is the Australian National Health and Medical Research Council's "level of concern." There was a statistically significant difference in capillary lead levels by area of residence that was independent of age, sex, soil lead, rainwater tank lead, and school attended. A case-control study indicated that the following subset of factors was most predictive of an elevated blood lead level: household members who worked with lead in their occupations; living in a house with flaking paint on the outside walls; biting finger nails; eating lunch at home on school days; when at school, appearing to have relatively dirty clothing; when at school, appearing to have relatively dirty hands; and living on a household block with a large area of exposed dirt. A program to reduce the risk of elevated blood lead levels in Port Pirie children has been introduced.