childhood lead poisoning risks and new initiatives for blood lead screenings
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Childhood lead poisoning risks and new initiatives for blood lead screenings. Eric Frohmberg and Susan J. Lee Maine Environmental and Occupational Health Program. Eliminating childhood lead poisoning. Focused efforts. MaineCare status as a risk factor. - PowerPoint PPT PresentationTRANSCRIPT
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 [email protected]
287-8141
Susan [email protected]
287-8671
www.maine.gov/healthyhomes
tracking.publichealth.maine.gov