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Childhood Lead Poisoning Prevention Program

Childhood Lead Poisoning Prevention Program. Julianne Vollmer MS Program Coordinator January 26, 2006. History of Childhood Lead Poisoning Prevention Program. 1990 - NM Environment Department and EPA did study of lead in soil near smelters in Socorro, NM.

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Childhood Lead Poisoning Prevention Program

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  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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. History • Spring 1999 – CDC binational study of lead levels in children along the border. Sampled 941 children and 2% had BLLs >10 µg/dL. • 2001 - CDC funding no longer available. Scaled down version of Program continues despite loss of staff and revenue.

  8. 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.

  9. 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 <6 yrs/age. • April, 2003 - State Medicaid approved reimbursement for filter paper testing.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. NM Childhood Lead Surveillance Data # of Children Tested 1994 – 2005† # of children screened % of NM children * <6 years of age screened 6,000 † data for 2005 incomplete based on ~ 11 months * Denominator derived from US census data

  18. NM Childhood Lead Surveillance Data % of NM Children* Tested for Lead Who Have EBLLs >10 µg/dL 1994 – 2004 * for children < 6 years of age

  19. Challenges • Limited funding - Program supported by NIOSH money only. • Limited staff. • Misconception continues that lead poisoning doesn’t happen in NM. • Very low testing of Medicaid recipients.

  20. 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.

  21. 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.

  22. 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 <10 µg/dL. • Recommendations for testing of pregnant women will be mailed to obstetricians.

  23. 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.

  24. 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.

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