Lead poisoned child services
For lead poisoned children, also known as children with elevated blood lead or EBL, a public health nurse or case manager can assess the dwelling for obvious lead hazards, educate the family about how to reduce those hazards, and monitor the child’s blood lead levels. If the assessment identifies serious environmental lead hazards or if the child’s blood lead level continues to increase, a thorough environmental investigation should be performed.
For lead-poisoned children, a thorough environmental investigation of all possible sources of lead exposure for the individual child and possible intervention are needed to protect the child from further exposure and harm. Lead based paint or the lead-contaminated dust and soil it generates may or may not be the main source of the child’s exposure to lead. A visit with the public health authorities may improve the communication with the family, the collection of accurate information about the child’s exposure, and the success of any needed intervention.
Environmental Intervention Blood Lead Level
The level of lead in blood that requires intervention in a child under age six. This is defined as a blood lead level of 20 μg/dL (micrograms per deciliter) of whole blood or above for a single test, or blood lead levels of 15-19 μg/dL in two tests taken at least three months apart.
Public health case management consists of coordinating the child’s care and follow up, usually managed by a trained public health professional, such as a physician, public health nurse, other health care provider, or public health investigator. This management includes monitoring of medical care, education of the family, and coordination of services.
Care for lead-poisoned children often entails repeated blood lead level testing, psychological and mental development testing, and medical treatment that may include iron therapy and chelation treatment. Families should be educated about lead poisoning, including how to recognize warning signs and symptoms, how to reduce risks, and how to help their child get well. In addition, environmental investigation and intervention is required. Some families will need extensive case management and referral to social service providers. The public health investigator is the primary point of contact between the childhood lead-poisoning prevention program and the family.
If the child’s home is identified as a probable source of lead exposure, appropriate environmental sampling should be conducted. This should include the following samples:
- X-ray fluorescence (XRF) or laboratory paint-chip analysis of all defective paint on the dwelling, furniture, play structures, or on nearby buildings frequented by the child.
- XRF or laboratory paint-chip analysis of all chewable, impact, and friction surfaces.
- Dust samples from areas frequented by the child, including play areas, porches, kitchens, bedrooms, and living and dining rooms. Dust samples may also be collected from automobiles, work shoes, and laundry rooms (to assess the leaded dust on work clothes brought into the dwelling) if occupational lead exposure is a possibility.
- Soil samples from play areas, areas near the foundation of the house, and areas from the yard. If the child spends significant time at a park or other public play area, samples should also be collected from these areas, unless the area has already been sampled.
- First-drawn and flushed water samples from the tap most commonly used for drinking water, infant formula, or food preparation.
- Glazed dinnerware or ceramic cookware containing lead.
Elimination or control of other lead hazards
All lead hazards identified in the course of the investigation should be eliminated or controlled.
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