Lead poisoning is a serious, but preventable, public health problem that
can result in long-lasting neurological damage to young children. Lead poisoning
is defined as a blood lead level greater than or equal to 10 µg/dL
of whole blood.
Most cases remain undiagnosed and untreated because low blood lead levels are not often associated with overt symptoms. However, blood lead levels as low as 10 µg/dL can adversely affect intelligence, learning, behavior, and development. At extremely high levels (45 µg/dL or higher), lead poisoning can cause seizures, coma, and even death in children.
Great advances have been made in reducing lead exposure during the past 20 years. Lead is no longer present in gasoline, new supplies of house paint, or cans used for food or beverages. Lead also has been reduced in industrial emissions, drinking water, hazardous waste and consumer goods.
As a result, there has been a decline of more than 80 percent in children's blood lead levels since the mid 1970s. In 1978, roughly 14.8 million children in the United States suffered from lead poisoning. By the late 1990s, that number had declined to 434,000 (2.2%) children, according to estimates of the Centers for Disease Control (CDC). The Department of Health and Human Services' Healthy People 2010 initiative has set a national goal of eliminating blood lead levels greater or equal to 10 µg/dL among children aged 1-5 years by 2010.
Sources of exposure to lead:
- Lead based paint
- Lead contaminated dust, soil, and water
- Lead containing materials in parental occupations or hobbies
- Lead containing tiles and ceramic ware
- Lead containing imported mini-blinds
- Lead contaminated food
- Some cosmetics and folk remedies
- Lead polluted air in industrial sites and smelters
- Other items such as necklaces, lunch boxes and toys
Risk factors for lead poisoning in Miami-Dade County:
- Living in a home built before 1950
- Living in a recently remodeled home built before 1978
- Living in central urban area or close to major highways
- Having a sibling or playmate with lead poisoning
- Having been exposed to lead poisoning in another country
Miami-Dade County Childhood Lead Poisoning Prevention Program
Lead poisoning is a reportable disease. Miami-Dade County Health
Department has received about 400 reports of elevated blood lead
levels annually from 1999 to 2004. One of the most important objectives
of the CDC funded Miami-Dade County Childhood Lead Poisoning Prevention
Program (CLPPP) since its inception in 1999 has been to increase
lead screening among children at high risk of lead poisoning. In
following and modifying the CDC recommendations for targeted screening
of children for lead poisoning, Miami-Dade County CLPPP has issued
screening guidelines for primary care physicians.
CLPP Program activities include:
- o Surveillance
o Screening
o Education
o Case management
o Environmental investigations
o Policy development
Surveillance:
o Passive and Active Surveillance
o Databases
o Stellar
-Case Management
-Environmental Investigations
o Merlin
- Reporting to the State of Florida
- Extended data
o Lead Risk Assessment Questionnaire
Community Outreach Education and Training:
o Presentations
-Medicaid providers during orientation sessions
-Head Start
-Community Organizations
-WIC
- JMH North
o Health Fairs
Case management services (10 µg Pb/dL):
o Risk Assessment Questionnaire
-Assess exposure
-Identify at-risk siblings and playmates
o Education
-Lead poisoning prevention
-Nutrition
-Advise on follow-up care
o Facilitate medical care access
-Inform provider of follow-up recommendations
-Refer to WIC, Healthy Start, Children Medical Services and
other social services
Environmental Investigations:
o Home Investigations
- BLL’s greater than or equal to 20 µg Pb/dL
- BLL’s persistently greater than or equal to 15 µg
Pb/dL
- Increase in BLL
- More than one lead poisoned child in home
o From 1999 to 2004, 24 childcare centers were investigated
per year
Reporting Guidelines
Who?
All healthcare providers are required to report lead poisoning
[Florida Statute 381.0031(1, 2) and Florida Administrative Code
64D-3]
What?
Reportable level: greater than or equal to 10 µg Pb/dL
blood. HIPAA not a concern!
How?
Call (305) 470-6877 or fax report form to (305) 470-5533.
To report a case or for screening questions:
Miami-Dade County Health Department Childhood Lead Poisoning
Prevention Program Phone: (305) 470-6877 Fax: (305) 470-5533
For medical management questions:
Poison Control Center 1-800-222-1222 (24 hours a day,
7 days a week)
Providing a Barrier Between Your Children and Lead Hazards (downloadable
brochure)
Childhood
Lead Online Resources
Lead
Poisoning Answers
The following information can be downloaded as a Microsoft PowerPoint
presentation.
» Download
Screening Guidelines
If you want to submit a Childhood Lead Poisoning Prevention Reporting
Form, please complete this questionnaire:
» Childhood
Lead Poisoning Prevention Reporting Form
Also, the following questionnaires can help you assess the risk
of lead poisoning in children:
» Childhood
Lead Risk Questionnaire
» Childhood
Lead Risk Questionnaire for healthcare professionals
»
Report
a disease
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