This study was conducted to develop a method that would accurately assess children's exposure to lead in schools in Philadelphia, Pennsylvania. We examined three wipe sample protocols: one included accessible surfaces such as desktops and windowsills, the second included inaccessible surfaces such as the top of filing cabinets and light fixtures, and the third included hand wipes of the study participants. Surface wipes were collected at 10 locations from accessible and inaccessible classroom surfaces (n = 11 at each location) and from the palms of student subjects in the same locations (n = 168). We found a significant difference in lead dust concentrations determined by the three protocols (F = 4.619; 2,27 degrees of freedom; p = 0.019). Lead dust concentrations were significantly elevated at the inaccessible surfaces yet they were uniformly low on the accessible surfaces and the children's palms. These findings were consistent with observed changes in blood lead levels of study participants: after 6 months of exposure to the study locations, 156 of 168 children experienced no change in blood lead level, whereas 12 experienced only a minimal change of 1-2 microg/dL. The mere presence of lead in inaccessible dust in the school environment does not automatically constitute a health hazard because there may not be a completed exposure pathway.