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Lead Poisoning in Children: Decreasing Childhood Blood Levels in the Community

Lead Poisoning in Children: Decreasing Childhood Blood Levels in the Community. by Pamela C. Ba Ph.D. Student at Walden University. www.webelements.co... Introduction Topics of Discussion. Purpose of this presentation Definition of Lead (Pb) Sources of lead Lead Poisoning, Acute

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Lead Poisoning in Children: Decreasing Childhood Blood Levels in the Community

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  1. Lead Poisoning in Children: Decreasing Childhood Blood Levels in the Community by Pamela C. Ba Ph.D. Student at Walden University

  2. www.webelements.co...IntroductionTopics of Discussion • Purpose of this presentation • Definition of Lead (Pb) • Sources of lead • Lead Poisoning, Acute • Lead Poisoning, Chronic • Blood Levels of children in Michigan • Prevention and removal of lead-based paint • Learning Goals • Policies, Funding Earth provides enough to satisfy every man's need, but not every man's greed." - Mohandas K. Gandhi quoted in EF Schumacher, Small is Beautiful. The author of this paper will discuss topics that, hopefully, will educate, inspire, and motivate the audience to be more aware of the dangers of lead and lead based paint and the procedures to take to eliminate or prevent the hazards of lead.

  3. Purpose of This Paper www.saskschools.ca www.saburchill.com • Comprehensive explanation of lead poisoning • Significance of lead poisoning • Inform the community • Removal of lead-based paint • Preventive Measures www.saskschools.ca The author of this paper wishes to inform the community especially parents, relatives, and care givers of toddlers; teachers of pre-k children, support staff; and construction workers of the dangers of lead-based paint and the prevention measures to take once an individual (s) has been exposed to lead-based paint.

  4. Definition of Lead (Pb) • Bluish-gray metal (ATSDR, 2009) • Heavy, ductile, soft solid • A metallic element (Davis, 1997) • Insoluble in water • Soluble in dilute nitric acid • Atomic weight 207.2 (Davis, 1997) • Atomic number 82 (Davis, 1997) • Specific gravity 11.35 (Davis, 1997) • www.infomine.com Heavy, ductile, soft gray solid.  Sp. gr. 11.35; m.p. 327.4oC; b.p. 1755oC; soluble in dilute nitric acid;  insoluble in water but dissolves slowly in water containing a weak acid; resists corrosion; relatively impenetrable to radiation.  Poor electrical conductor; good sound and vibration absorber.  Non-combustible. “Lead is a naturally occurring bluish-gray metal found in small amounts in the earth’s crust. It is found in all parts of the environment. It comes from human activities such as: burning fossil fuels, mining, and manufacturing” (ATSDR, 2009) According to Davis (1997) lead is a metallic element whose compounds are poisonous. (p. 1085)

  5. Sources of Lead Environmentally friendly cars will soon cease to be an option...they will be necessary”- Fujio Cho, President of Toyota Motors, North American International Auto Show, 2004 www.investinchildren.us • Drinking water • Dust • Contaminated soil • Cosmetics • Batteries • Ammunition • Metal Products • Lead-based paints • Ceramic products • Caulking • Pipe Solder According to the Agency for Toxic Substances & Disease Registry (ATSDR) lead is used in the production of the following: batteries, ammunition, metal products (solder), devices to shield of health concerns, gasoline, paints, ceramic products, caulking, and pipe solder (ATSDR, 2009). Lead may be found in drinking water due to household plumbing that is made with lead materials. Also, airborne lead particles in homes can result from lead dust from outdoor sources (EPA, 2009).

  6. Acute Lead Poisoning www.fao.org www.ehponline.org • Abdominal pain • Encephalopathy • Headache • Confusion • Renal failure • Convulsions Clinical features of acute lead poisoning include: abdominal, neurologic symptoms of lead encephalopathy.In severe cases renal failure and convulsions can occur. Extremely high levels may lead to coma and death (Meyer, 2003b). According to Lewis (1997), convulsions are the characteristics of lead poisoning.

  7. Chronic Lead Poisoning Behavioral changes, Nephritis Peripheral neuropathy (Lewis 1997; World Health Organization [WHO]1995). www.reviewscout.co... Children are more vulnerable to lead exposure for three reasons: young children are more at risk of ingesting environmental lead through normal mouthing behaviors (Lanphear, 2002), absorption from the gastrointestinal tract is higher in children than adults (Ziegler, 1978), and the developing nervous system is thought to be far more vulnerable to the toxic effects of lead than the mature rain (Lidsky and Schneider, 2003). www.envirotechserv.

  8. Michigan Children Confirmed As Lead Poisoned keetsa.com www.envirotechserv. • Children aged 0 through 6 • A lead level of 10 micrograms/deciliter (µg1dL) is considered to be diagnostic of lead poisoning www.epa.gov Michigan Department of Community Health, Children Lead Poisoning Prevention Program confirmed in 2006 there were 1,613 children with a lead blood level of 10-14 µg/dL, 533 with a lead blood level of 15-19 µg/dL, and 379 with a lead blood level of 20+ µg/dL The total number of children 0-6 tested was 143, 326. (MDCH, 2007)

  9. Michigan Children Confirmed as Lead Poisoned-continued- Actions Taken For Elevated Blood Lead Levels • 10 -19 µg/dL – Referrals • 20 µg/dL and over – Medical management • 45 µg/dL and over - Hospitalization • 70 µg/dL or more - Medical emergencies www.investinchildren.us www.ilovemybaby.org www.investinchildren.us www.cityofberkeley. Referrals - a nursemakes a home visit to recommend a diet high in iron, calcium, and Vitamin C to decrease the potential for absorption of lead. Medical Management – referrals are made to the local health departments for home visits by both a nurse and an environmental health sanitarian who recommends actions for lead hazard control. Hospitalization – to remove the lead from the bloodstream. Medical emergencies – immediate hospitalization and the child(ren) can not return home/school until the environment has been removed. (MDCH, 2007)

  10. Preventive MeasuresLead-based paint www.reviewscout.co... • Collect paint chips, dust, dirt, rubble • Store larger lead-based paint (LBP) • Use a covered mobile dumpster • Contact local solid waste authorities www.thefunplace.co... www.rivcoph.org The Environmental Protection Agency encourages anyone that handles lead-based paint to use common sense. Collect the paint chips, etc in plastic trash bags for disposal. Store the LBP in containers until ready for disposal. If there is a covered mobile dumpster, store debris until the work is completed. Contact local solid waste authorities to determine where and how LBP debris can be disposed of (EPA, 2009).

  11. Michigan Department of Community Health / Childhood Lead Poisoning PreventionStatewide Lead Testing/Lead Screening Plan www.cityofberkeley. www.cityofberkeley. • Battle Creek • Grand Rapids • Lansing • Benton Harbor • Hamtramck • Muskegon/Muskegon Hts • Dearborn • Highland Park • Pontiac • Detroit • Jackson • Saginaw • Flint • Kalamazoo www.automedia.com www.minorityreporter.net MDCH strongly recommends that all children living in these communities be tested for lead poisoning at 12 and 24 months of age or between 36 and 72 months of age if not tested previously (Michigan Government, 2002).

  12. Lead Poisoning is invisible • Get tested – Call (810) 257-3833 • Take Lead Questionnaire • Fix meals high in iron and calcium • Eat liver, beef, spinach, greens, etc. • Get home tested • Clean, Clean, Clean • Stellar Program • Most children with lead poisoning do not look sick. Your child's doctor, family health center, or a clinic can do a simple blood test. You can get the results in about two weeks.  You may take thelead questionnaire to see if your children are at risk. Use warm water and an automatic dish washing powder that has phosphates in it (like Cascade). Wet mop floors, furniture and windowsills every week.  Keep children away from peeling paint and window sills. Fix healthy meals high in iron and calcium. Cook liver, beef or lean meats, spinach, greens, dried beans and vegetables. Serve raisins, peanuts, cheese, yogurt or ice cream for snacks or dessert. Wash children's hands, pacifiers and toys often. Lead poisoning can be prevented and treated. Call (810) 257-3833 for more information, or to learn how to get your home tested for lead (GCHD, 2009). Genesee County Health DepartmentChildhood Lead Poison Prevention Program www.investinchildren.us • County-wide surveillance of lead screening is conducted using the CDC-developed Stellar Program. In cooperation with the Health Department's Environmental Health Division, sources of lead in the home environment are identified. A hepa-vac loan program is available to residents to assist with the clean up of lead dust hazards. Educational information and presentations are also available. Call (810) 257-3833 for more information (GCHD, 2009).

  13. www.thejcdp.com Funding Opportunities for Lead Hazard Control • Community Development Block Grants (CDBG) • Community Reinvestment Act (CRA) • Department of Human Services (DHS) • Michigan State Housing Development Authority (MSHDA) CDBG funds may be structured as a fully payed back loan at a determined interest rate to a totally forgiven loan at the end of the affordability period. (5 years) All funds are processed by MSHDA. Call them at (517) 373-8370 or on the web at www.mshda.org. The CRA requires banks to offer loans to low income persons to assist in making home improvements at reasonable rates. There are two CRA programs, one is geared toward low to moderate income families, the second one is for rental property owners. More information can be obtained from MSHDA at (517) 373-8370. State of Michigan, FIA, offers assistance in finding suitable housing for their clients. FIA has published a brochure listing housing quality standards. For further information contact FIA at (517) 373-2035 or on the web at www.michigan.gov/fia MSHDA offers affordable housing programs including grant and award programs. Low interest loans and grants are awarded based upon qualification and income limit information. Call MSHDA at (517) 373-8370 or visit them on the web at www.mshda.org to find out more.  You may also get Information about these loan programs by calling the Michigan Lead Hazard Remediation Program at (616) 240-3926.

  14. Key Learning Goals • www.fotosearch.com www.reviewscout.co... • Wash toddler’s hands • Repair peeling and chipping paint • See a physician • Community resources • National Hotline Twenty percent of the U.S. population, nearly 55 million people, spend their days in our elementary and secondary schools. Students are at greater risk because of the hours spent in school facilities and because children are especially susceptible to pollutants (EPA, 2008). markgreensteinreal www.ledizolv.com/ Parents and caregivers of toddlers should supervise them in their hand washing. The peeling and chipping paint in the home and at school should be repaired immediately. See a physician if led poisoned is suspected. Call the National Lead Information Center at 800-424 LEAD (5323) to get general information on lead-based paint and lead-based paint hazards (EPA, 2008). You may also contact the Department of Housing and Urban Development for the Comprehensive and Workable Plan for the Abatement of Lead-Based Paint in Privately Owned Housing (EPA, 2008). The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions (Health Line, 2007).

  15. Policy Resources losangelesliabilityattorneys.co www.finkandplatz.co • Overcoming Barriers to Data-Sharing Related to the HIPAA Privacy Rule • A Guide for State and Local Childhood Lead Poisoning Prevention Programs • EPA Renovation, Repair and Painting Program Rule (RRP) • Housing and Urban Development’s (HUD) Lead Safe Housing Rule The HIPAA requirements and exceptions focuses on public health agencies and describes permissible uses of lead-related data under the HIPAA Privacy Rule. However, this privacy rule reflects publicly available guidance but does not constitute legal advice. The EPA RRP is a list the U.S. Environmental Protection Agency’s requirements and lists information for state officials, property owners, families, and contractors pertaining to the RRP rule. (EPA, 2008) The U.S. Department of Housing and Urban Development’s Lead Safe Housing Rule applies to all target housing that is federally owned and applies to target housing receiving federal assistance.

  16. Conclusion • Thank you very much. Lead is a harmful environmental pollutant that has been a threat to the health of children. (EPA, 2009). Lead poisoning in children can be prevented by not allowing small children to play or eat paint chips and by repairing peeling paint in the home, school, or where ever lead-based paint is suspected. Prepare healthy meals for children high in calcium and iron. Supervise the hand washing of small children and wash their toys often. To obtain more information about lead, lead-based paint, and the removal of lead-based paint, call your local health department. Thank you very much for allowing me to share the information about lead poisoning in children.

  17. References Agency for Toxic Substances & Disease Registry. (2009). Toxic substances portal: Lead. Retrieved June 2, 2009 from http://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=22 Centers for Disease Control and Prevention . (2005). Alliance for Health Homes. Protecting Children from Lead and other Environmental Hazards. Overcoming Barriers to Data-Sharing Related to the HIPPAAA Privacy Rule. A guide for State and Local Childhood Lead Poisoning Prevention Programs. Retrieved July 15, 2009 from http://www.cdc/nceh/lead/ Davis, F.A., (1997). Taber’s Cyclopedic Medical Dictionary (18th ed.). Philadelphia: Davis Company Environmental Protection Agency (EPA), (2008). Indoor Air Quality. An introduction to indoor air quality. Retrieved July 13, 2009 from http://www.epa.gov/iag/lead.html Genesee County Health Department. (2009). Childhood Lead Poison Prevention Program. Retrieved July 11, 2009 from http://www.gchd.us/Services/CommunityHealth/LeadPoisoning/ Genesee County Health Department. (2009). Lead Poisoning is Invisible. Retrieved July 11, 2009 from http://www.gchd.us/Library/lead_poisoning_is_invisible.asp Health Line (2007). Poison Control, or a local emergency number. Retrieved July 14, 2009 from http://www.healthline.com/adamcontent/lead-poisoning/2 Image Results for Pictures of Lead Poisoning. (n.d.) Retrieved July 10, 2009 from http://im ages.google.com/images?sourceid=navclient&rlz=1T4RNWN_enUS274US286&q=pictures+of+lead+poisoning&um= • 1&ie=UTF-8&ei=YTtjSpziGaWvtgfYk_z0Dw&sa=X&oi=image_result_group&ct=title&resnum=1 Lanphear BP, Hornung R, Ho M, Howard CR, Eberle S, Knauf K. 2002. Environmental lead exposure during early childhood. J Pædiatr 140:40-47. • Retrieved July 11, 2009 from http://www.ehponline.org/members/2004/6941/6941.html Lewis R.L. (1997). Metals. In: Occupational and Environmental Medicine, 2nd ed. (LaDou J, ed). Stamford, CT:Appleton and Lange, • 405-439. Retrieved July 12, 2009 from http://www.ehponline.org/members/2004/6941/6941.html

  18. References-continued- Lidsky TI, Schneider JS. 2003. Lead neurotoxicity in children: basic mechanisms and clinical correlates. Brain 126:5-19. Retrieved July 11, 2009 from http://www.ehponline.org/members/2004/6941/6941.html Meyer PA, McGeehin MA, Falk H. 2003b. A global approach to childhood lead poisoning prevention. Int J Hyg Environ Health 206:363-369. Retrieved July 12, 2009 from http://www.ehponline.org/members/2004/6941/6941.html Michigan Department of Community Health (MDCH). 2007. Children with elevated blood lead level. Retrieved July 10 from http://michigan.gov/documents/mdch/1129_02_01_07_186280_7.pdf Michigan Department of Community Health / Childhood Lead Poisoning Prevention Statewide Lead Testing/Lead Screening Plan. (2008). Retrieved July 10, 2009 from http://www.michigan.gov/documents/ScreenPlan_11223_7.pdf Michigan Government. (2002). What is a HEPA vacuum and how do I use it? Retrieved July 11, 2009 from http://www.michigan.gov/printerFriendly/0,1687,7-132-2940_2955_2983-19755--,00.html Moeller, D.W. (2005). Environmental health (3rd ed.). Cambridge, MA: Harvard University Press U.S. Environmental Protection Agency (2008). Quotes. Retrieved July 7, 2009 from http://www.epa.gov/Region2/library/quotes.htm • U.S. Environmental Protection Agency (2008). Quotes. Mohandas K. Gandhi quoted in EF Schumacher, Small is Beautiful. Retrieved July 12, 2009 from http://www.epa.gov/Region2/library/quotes.htm • U.S. Environmental Protection Agency (2008). Quotes. Fujio Cho, President of Toyota Motors, North American International Auto Show, 2004. Retrieved July 12, 2009 from http://www.epa.gov/Region2/library/quotes.htm • World Health Organization. (1995). Recent Developments in Low-Level Lead Exposure and Intellectual Impairment in Children. Retrieved July 12, 2009from http://www.ehponline.org/members/2004/6941/6941.html • Ziegler EE, Edwards BB, Jensen RL, et al. 1978. Absorption and retention of lead by infants. Pediatr Res 12:29-34. Retrieved July 11, 2009 from http://www.ehponline.org/members/2004/6941/6941.html

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