Online Program

Primary prevention for children with blood lead levels 5-9 ug/dl

Monday, November 4, 2013 : 5:30 p.m. - 5:50 p.m.

Camille Jones, MD, MPH, CPH, Community Health and Environmental Services, Cincinnati Health Department, Cincinnati, OH
Marilyn Goldfeder, RN, Childhood Lead Poisoning Prevention Program, Cincinnati Health Department, Cincinnati, OH
Stacey Watkins, RN, Division of Community Health and Environmental Health Services, Cincinnati Health Department, Cincinnati, OH
Rashmi Aparajit, RS, Cincinnati Health Department, Cincinnati, OH
Aalap Bommaraju, MPH, Reproductive Health & Wellness Program, Cincinnati Health Department, Cincinnati, OH
In August 2012, the Centers for Disease Control and Prevention improved national standards by lowering the lead poisoning level of concern from 10 ug/dL to 5 ug/dL, based on the 97.5th percentile in children. Local health departments are now deciding how to respond to this recommendation. In 2007, the Cincinnati Health Department's (CHD) Childhood Lead Poisoning Prevention Program was the first in the nation to implement a lead poisoning primary prevention program, providing home visitation to families of children with measured blood lead levels (BLL) between 5-9 ug/dL. From January 2008 to December 2012, 1510 children were referred to the program. The program consists of two home visits by a nurse who provides education about diet, hand washing, house cleaning, cleaning of toys, removing shoes when entering the home, and the recommended interval for repeat blood lead testing. During home visits, height and weight measurements are obtained, a nutrition evaluation is conducted using the PEACH tool, and the nurse discusses foods that the child likes to eat that are conducive to reducing the blood lead level. A developmental evaluation is obtained, as well as lead dust wipe samples for information and education. Analysis of developmental evaluations showed that BLL in the 5-9 ug/dL range is associated with developmental delay with language was previously published. During the visits, the nurse observes and discusses the family's challenges, and makes referrals for a variety of other issues including bedbugs, roaches, mold, structural issues in the home, applications for lead abatement grant funds, and applications to local and state programs that provide assistance to families with children. Data will be provided about the primary prevention program, including efficacy in preventing progression to a BLL of 10 ug/dL or higher.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related nursing

Learning Objectives:
Describe components of lead poisoning prevention intervention for children with blood lead levels 5-9 ug/dL.

Keyword(s): Child Health Promotion, Lead

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Assistant Health Commissioner for the Division of Community Health and Environmental Health Services in the Cincinnati Health Department. The Childhood Lead Poisoning Prevention and Healthy Homes Program is one of the major programs in my Division.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.