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331791
Does public health nurse consultation to families of children with blood lead levels (BLL) 5-9 ug/dL decrease risk of a subsequent BLL of 10+ ug/dL


Tuesday, November 3, 2015 : 8:30 a.m. - 8:50 a.m.

Kacie Kotnik, Mathematics and Statistics, NKU, Columbus, IN
Camille Jones, MD, MPH, CPH, Community Health and Environmental Services, Cincinnati Health Department, Cincinnati, OH
David Agard, Ph.D. Statistics, Department of Mathematics and Statistics, Northern Kentucky University, Highland Heights, KY
Audio (mp3) recording Recorded Presentation (mp4)
Lowering the CDC blood lead ‘level of concern’ (ug/dL) from 10 to 5 in 2012 resulted in a 3-6 fold increase in lead poisoned children.  However, lead risk assessment/case management is usually instituted only for BLL 10+.   Since 2007, the Cincinnati Health Department has provided nurse home visits to children with BLL 5-9, with education about diet, hand washing, house and toy cleaning, removing shoes when indoors, and recommendation to recheck BLL in 90 days; and measurement of height, weight, nutrition evaluation using the PEACH tool,  developmental evaluation, and testing dust wipes for lead.  When the nurse home visit could not be scheduled, literature was mailed.   Association of home visitation with incidence of a BLL 10+ was evaluated.

The Ohio Department of Health provided BLL results from 2007-2012 for 14,428 children in Cincinnati.  We followed children with first BLL 5-9 and at least one followup BLL result.  Average change in BLL/day was negative in all groups, but greater in the no intervention group than the nurse visit group.  Percent with BLL 10+ on next follow up blood test was similar for nurse visit and no intervention.  Nurse visit and no intervention groups had a similar average time between first and followup BLLs of 310 and 335 days, which was shorter than the literature group.  Public health nurse visits to families of children with BLL 5-9 are important, but may not be associated with decreased risk of BLL 10+.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Other professions or practice related to public health
Public health or related nursing
Public health or related research

Learning Objectives:
Compare the progression to blood lead level 10+ ug/dL in children with initial blood lead levels (BLL) 5-9 ug/dL, for children whose family received lead poisoning prevention literature and/or a public health nurse consultation and children whose families did not receive an intervention, prior to the recent lowering of the lead poisoning reference level to 5 ug/dL.

Keyword(s): Lead, Child Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the statistical analyses for the abstract, as part of my capstone project at the University of Northern Kentucky in the Department of Mathematics and Statistics.
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.

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