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Lead
Poisoning
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Increase
the number of high-risk 1- and 2-year-old children, enrolled in Medicaid,
screened for lead poisoning.
Target:
Total elimination. All Medicaid recipients will be screened.
Baseline, 1998-1999: 69,581 Medicaid enrolled children
were screened for Lead Poisoning.
Target Setting Method: Consistent with the targets set
by Division of Environmental Health, NC Department of Environment
and Natural Resources.
Reduce
the percent of 1 and 2-year-old children with blood lead levels
greater than or equal to 10 micrograms per deciliter.
Target:
< 0.5 percent.
Baseline, 1998-1999: 2.9 percent of children screened for blood
lead had blood lead level greater than or equal to 10 ?g/dL.
Target Setting Method: Consistent with the targets set
by Division of Environmental Health, NC Department of Environment
and Natural Resources.
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Environmental
Health - Lead Poisoning
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Lead poisoning is the leading environmentally
caused pediatric health problem today, even though it is entirely
preventable. Lead affects virtually every organ system and is particularly
harmful to the developing brain and nervous system of fetuses and
young children. Pre-school children are also at greater risk of exposure
because of normal increased hand-to-mouth activity and enhanced absorption
of lead. In the United States, elimination of lead in gasoline, household
paint, food and drink cans, and plumbing systems are cited as the
primary reasons for a 80 percent decline in mean pediatric blood lead
levels over the past two decades. Even so, 4.4 percent of U.S. children
are estimated to have potentially toxic levels of lead exposure. Remaining
sources of exposure to children include lead-based paint, lead-contaminated
soil and household dust, drinking water, parental occupations and
hobbies, industrial emissions, miniblinds and other vinyl products,
lead-glazed ceramic ware, and some traditional medicines and cosmetics.
In response to increasing evidence of
lead toxicity at low levels of exposure, the Centers for Disease
Control and Prevention lowered the blood lead action level to 10
micrograms per deciliter (g/dL) and, together with the American
Academy of Pediatrics, recommended screening all high risk one-
and two-year-old children. Recommendations also call for a multi-tier
approach to follow-up of children with elevated exposure with the
degree of intervention dependent on the level of exposure. Children
with elevated blood lead levels should receive a complete nutritional
assessment and parental education on the sources of lead and simple
measures to prevent exposure. In addition, more involved medical
and environmental interventions aimed at reducing absorption of
lead (e.g., treatment of calcium and iron deficiency, chelation
therapy) and identifying and removing sources of exposure (e.g.,
environmental investigation, lead hazard abatement) should be considered
for children with prolonged exposure or higher exposure levels.
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Disparities
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Although lead exposure has declined
dramatically for the entire pediatric population, there remains a
significant disparity between African American/Blacks and Whites with
the prevalence of elevated exposure among African American/Blacks
more than double that of Whites in North Carolina. Other minority
populations including Latino/Hispanics and American Indians are similarly
at elevated risk although screening data are more limited for these
groups. Likewise, low-income children, those from rural communities,
and children in North Eastern North Carolina, suffer disproportionately
from lead poisoning primarily as a result of greater exposure to deteriorated
lead-based paint in older rental housing. |
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Determinants/Risk
Factors
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Exposure to deteriorated lead-based paint,
age of housing (pre-1978), inadequate dietary calcium and iron, insufficient
handwashing, increased hand-to-mouth activity (e.g., pica) |
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Environmental
Health - Lead Poisoning |
