Childhood Lead Poisoning Prevention Program

1
Childhood Lead Poisoning Prevention Program

• Julianne Vollmer MS
• Program Coordinator
• January 26, 2006

2
History of Childhood Lead Poisoning Prevention
Program

• 1990 - NM Environment Department and EPA did
  study of lead in soil near smelters in Socorro,
  NM.
• 1990 - NMDOH offered blood lead level (BLL)
  screening to residents.
• 1991 - ATSDR Funded study to examine drop in BLLs
  after cleanup.

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History

• 1993 - NMDOH received CDC grant for childhood
  lead poisoning prevention.
• 1993 to 2000 - Lead program funded by CDC. Staff
  includes program manager, epidemiologists, case
  mangers/health educators, clerk.
• April 1993 - NM Administrative Code requires
  that all BLL test done on NM residents be
  reported to NMDOH.

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History

• July 1995 - 600 NM adults surveyed by phone
  about knowledge, attitudes, and beliefs regarding
  childhood lead poisoning.
• 85 knew old homes often painted with lead-based
  paint.
• 34 believed parent could tell when child was
  lead poisoned.
• 67 unaware of role of diet.
• 12 had a household member who worked with lead -
  of these 45 took measures to prevent take home
  lead exposure.

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History

• Program very active during CDC funding
• Lead tests done by NM State Lab
• Numerous free clinics
• PSAs and media information compaign
• Educational outreach
• NM and Navajo Nation epidemiology reports
• Lead Poisoning Prevention Task Force

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History

• Task force works to develop interim screening
  guidelines and influence legislation.
• 1998 and 1999 - Task force makes 2
• attempts to pass legislation to require NM
• to certify lead paint inspectors/risk
  assessors. Attempts fail. Certification still
  done by EPA region 6.

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History

• Spring 1999 CDC binational study of lead levels
  in children along the border.
• Sampled 941 children and 2 had BLLs gt10
  µg/dL.
• 2001 - CDC funding no longer available. Scaled
  down version of Program continues despite loss of
  staff and revenue.

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History

• Testing drops as state lab no longer doing BLLs
  and free clinics no longer available.
  Misconception among health care providers that
  there no longer is a lead program in NM.
• Environmental health staff increase efforts to
  revitalize program.

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History

• September, 2001 - Efforts began to develop data
  sharing agreement with State Medicaid.
• December, 2001 - NMDOH requests NM state Medicaid
  to support filter paper testing and reimburse for
  cost of test.

10
History

• October, 2002 - MOA signed to share data with
  State Medicaid on BLL tests on children lt6
  yrs/age.
• April, 2003 - State Medicaid approved
  reimbursement for filter paper testing.

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History

• June 2003 - Letters sent to all Medicaid
  providers reminding them of EPSDT requirements
  for lead testing and informing them of Medicaid
  reimbursement for filter paper testing.
• Lead risk questionnaire updated and screening
  guidelines finalized.

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History

• 2003 to present - BLL testing of children
  essentially doubles and equals 1997 screening
  levels.
• 2004 - EPA Environmental Education Grant lead
  education for teen parents and pregnant teens.
  Pilot program presented to 6 teachers and 100
  students in 2 schools. 3 workshops presented to
  an additional 15 teachers.

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History

• May and August 2004 - Issued press releases on
  lead in Mexican candy along with information on
  other sources of lead and health effects.
• December, 2004 - Informal phone survey about
  consumption of Mexican candy in 30 families with
  children with EBLLs. Candy consumption very low.

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History

• March and April, 2005 - Distributed Orange County
  Register lead posters to schools, WIC clinics,
  Head Start, and teen parent programs.
• Gave information for TV, radio and newspaper
  interviews, always stressing importance of
  screening, multiple sources, and health effects.
  

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History

• January, 2005 - assisted Santa Fe Boys and Girls
  Club in successful application for EPA grant for
  lead screening and education.
• May to June, 2005 - BHO tested lead in soils and
  indoor in dust Sunland Park, NM
• January, 2006 - Lead risk questionnaire updated.
  Working with WIC clinics to have questionnaire
  distributed to parents

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Surveillance

• 1994 to 1998 36,244 children tested for lead,
• 3.2 (1127) had EBLLs.
• 1999 to 2003 16,525 children tested for lead,
• 1.6 (271) had EBLLs.

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NM Childhood Lead Surveillance Data
of Children Tested
1994 2005
of children screened of NM children lt6
years of age screened
6,000
data for 2005 incomplete based on 11 months
Denominator derived from US census data
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NM Childhood Lead Surveillance Data of NM
Children Tested for Lead Who Have EBLLs gt10
µg/dL 1994 2004
for children lt 6 years of age
19
Challenges

• Limited funding - Program supported by NIOSH
  money only.
• Limited staff.
• Misconception continues that lead poisoning
  doesnt happen in NM.
• Very low testing of Medicaid recipients.

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Challenges Medicaid

• 28,00 children born in NM each year.
• In 2004 70 of children aged 2 and under were
  enrolled in Medicaid in New Mexico.
• In 2003 and in 2004 only 1 of children aged 2
  and under enrolled in Medicaid were tested for
  lead.

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Successes

• Increased screening since Medicaid reimbursement
  for filter paper testing.
• Increased awareness among teen parents.
• Recent publicity from lead in Mexican candy seen
  as opportunity for education of general public.

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Future plans

• Updated lead risk questionnaire and case
  management guidelines will be posted on NMDOH web
  site and mailed to all Medicaid providers along
  with information on health effects of BLLs lt10
  µg/dL.
• Recommendations for testing of pregnant women
  will be mailed to obstetricians.

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Future Plans

• Collaborate with IHS and Navajo Nation to provide
  education on dangers of lead from lead glazes
  used in pottery making - effects on pregnant
  women and children.
• Continue work with Medicaid Input into letter
  sent to parents of all Medicaid enrolled children
  prior to first and second birthday stressing
  importance of lead screening.

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Future Plans

• Continued efforts to seek funding and increase
  program capacity.
• Conduct testing in immigrant and migrant
  population.
• Expand educational outreach and screening in high
  risk areas.