Tessa Miller, MPH; Joanna Balza, RN; Julia Kellis, BS; Heather Paradis, MD, MPH; John Meurer, MD, MBA; David Nelson, PhD, MS
WMJ. 2024;123(4):267-271.
ABSTRACT
Introduction: Every year, children are poisoned with lead with irreversible effects. This exposure most often occurs in older housing built before 1978 with chipping paint from windowsills where children play and ingest the lead particulates. Exposure to lead can cause neurological and psychological dysfunction, among other health issues.
Objective: This quality improvement study aims to evaluate our knowledge of at-risk children through a public health approach by analyzing the current public health data and possible barriers to lead screening, testing follow-up, and identifying at-risk children.
Methods: We received data on lead-poisoned children and inspected properties from the City of Milwaukee Health Department. We analyzed each child’s initial blood lead level, as well as follow-up tests recorded, ZIP code of residence, and family renter versus home ownership.
Results: Over 90% of children in the database had recorded follow-up blood lead testing following an initial elevated blood lead level. There was no difference in initial recorded blood lead levels between children with recorded follow-up blood lead levels and children without (21.40, SD = 11.26); t[1.17], P = 0.24). Most affected children were from economically disadvantaged ZIP codes (53206, 53208, 53215), and 94% lived in rented properties.
Conclusions: More work is needed to reduce lead in the environment and improve follow-up in affected children. ZIP code and rental data may indicate at-risk children. Although follow-up testing rates are high, the study revealed a wide range in lead levels with follow-up. Identifying at-risk children and reducing lead levels in children is vital to support health equity.