childhood lead poisoning risks and new initiatives for blood lead screenings

Childhood lead poisoning risks and new initiatives for blood lead screenings

Eric Frohmberg and Susan J. Lee

Maine Environmental and Occupational Health Program

Maine DHHS Public Health • Environmental and Occupational Health Program

Maine DHHS Public Health • Environmental and Occupational Health Program

Eliminating childhood lead poisoning

Maine DHHS Public Health • Environmental and Occupational Health Program

Focused efforts

Maine DHHS Public Health • Environmental and Occupational Health Program

Children with Blood Lead Levels > 20 ug/dL

0%

20%

40%

60%

80%

100%

20042005

20062007

20082009

20102011

year

Perc

ent >20 ug/dL Non-

MaineCare

> 20 ug/dL onMaineCare

MaineCare status as a risk factor

Maine DHHS Public Health • Environmental and Occupational Health Program

2004 2005 2006

2007 2008 2009

Trend of Cases of African Descent Lewiston

Not African African

Maine DHHS Public Health • Environmental and Occupational Health Program

High Blood Lead Levels often Chewers or Pickers

Maine DHHS Public Health • Environmental and Occupational Health Program

Children are poisoned by dust from lead paint

Maine DHHS Public Health • Environmental and Occupational Health Program

Children are poisoned by dust from lead paint

Maine DHHS Public Health • Environmental and Occupational Health Program

Maine DHHS Public Health • Environmental and Occupational Health Program

Rental vs. HomeownerPercent Private Residence or Rental Property for EIs

0%10%20%30%40%50%60%70%80%90%

100%

2003 2004 2005 2006 2007 2008 2009 2010 2011

% rental% private

Maine DHHS Public Health • Environmental and Occupational Health Program

Renovations causing poisoningsEBLL>15 ug/dL that report renovations in the last 6 months

0

10

20

30

40

50

60

2003

2004

2005

2006

2007

2008

2009

2010

2011

year

Perc

ent

% EBLL>15 ug/dL

Maine DHHS Public Health • Environmental and Occupational Health Program

Next frequent category of exposures

• Soil

• Take Home Dust

Maine DHHS Public Health • Environmental and Occupational Health Program

Maine DHHS Public Health • Environmental and Occupational Health Program

CLPPP calculated MaineCare Screening Rates

0

10

20

30

40

50

60

70

80

90

100

2003 2004 2005 2006 2007 2008 2009 2010

Year of Test

Perc

ent

12-23 months24-35 months

Maine DHHS Public Health • Environmental and Occupational Health Program

Maine DHHS Public Health • Environmental and Occupational Health Program

Upcoming

• New Risk Groups• Oral behavior• New Mainers

Maine DHHS Public Health • Environmental and Occupational Health Program

Feedback

• How are you currently screening?

• Why are MC screening rates not 100%?

• Proposed changes via Medicaid• Drop requirement for MaineCare universal

screening?

Maine DHHS Public Health • Environmental and Occupational Health Program

Barriers to screenings and solutions

• Knowledge of screening?

• Loss from office to lab?

Maine DHHS Public Health • Environmental and Occupational Health Program

In office blood lead screening law

• Critical parts are data transfer and addressing barrier of losing patients

• Rulemaking: AG review; public comment, review and approval.

Maine DHHS Public Health • Environmental and Occupational Health Program

Rules

• Use of portable testing device is a capillary screen. Confirmatory venous still needs to go to the state lab.

• Must use IMMPACT to be approved• Results to us w/in 48 hours• Provide work flow and CLIA Waiver

Certificate

Maine DHHS Public Health • Environmental and Occupational Health Program

In office portable testing devices: Plus

• Immediate results

• Removes barrier of testing at other location

• Families may be more motivated to get follow up venous

• PCP follow up easier

Maine DHHS Public Health • Environmental and Occupational Health Program

In office portable testing devices: Minus

• Staff time cost: Testing, recording, reporting

• Cost of machine – HETL will not provide supplies

• Reimbursement Rates

Maine DHHS Public Health • Environmental and Occupational Health Program

IMMPACT Lead Module

• Reporting

• Data and blood lead histories to users

• Data fields:• Sample date• Venous or Cap• Results

• Name, Address when tested

• Ordering Phys

• Flag for follow up visits if needed

Maine DHHS Public Health • Environmental and Occupational Health Program

Questions? Thoughts? Comments?

Eric FrohmbergEric.frohmberg@maine.gov

287-8141

Susan LeeSusan.j.lee@maine.gov

287-8671

www.maine.gov/healthyhomes

tracking.publichealth.maine.gov