Krista Christensen, PhD, MPH; Marjorie J. Coons, RN, MS; Reghan O. Walsh, BS; Jon Meiman, MD; Elizabeth Neary, MD, MS
WMJ. 2019;118(1):16-20.
Abstract
Introduction: In 2016, 4,353 Wisconsin children under 6 years of age were identified with elevated blood lead levels (≥ 5 µg/dL). There is no safe level of lead in the human body; extensive research shows that children with blood lead levels < 5 µg/dL may still be at risk for adverse health effects including developmental delays.
Discussion: Physicians should follow current guidelines and consider factors such as the child’s age, socioeconomic status, and housing situation when determining need for testing. In addition to Wisconsin’s screening recommendations, federal requirements exist for testing Medicaid enrolled children. Under state statute, all blood lead test results and specified demographic information must be reported to the Wisconsin Childhood Lead Poisoning Prevention Program. To eliminate elevated blood lead levels, primary prevention is key. Physicians play an important role by educating parents, prospective parents, and caregivers about lead poisoning risks and prevention measures. Physicians are also vital in secondary prevention—mitigating the adverse effects in children already exposed to lead. Secondary prevention requires first identifying children with elevated blood lead levels through appropriate testing. Use of the Wisconsin Blood Lead Registry can alert providers about children with elevated blood lead levels and reduce duplicate testing. Recent surveillance data show current screening is inadequate; in 2015, only 32% of Medicaid-enrolled children received appropriate testing. Physicians should provide clinical management for children with elevated blood levels and their families.
Conclusion: Physicians are a vital partner in preventing, identifying, and mitigating the effects of elevated blood lead levels for Wisconsin’s children.