Page 19 - Delaware Medical Journal - January/February 2020
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PUBLIC HEALTH
preventable. Lack of resources and political will has hampered too many states and cities from addressing the root causes.
As David Jacobs, Chief Scientist at the National Center for Healthy Housing
and a former Director in charge of lead hazard control at the U.S. Department
of Housing and Urban Development, said recently, “We’ll never test our way out of this.” It is time for Delaware policymakers to integrate this fact into the state’s approach to the health of some of its most vulnerable children.
LEAD-POISONING PREVENTION POLICIES
Although children are exposed to
lead from many sources, including water from leaded pipes and some consumer products, lead-based paint and lead-contaminated dust are the most widespread and dangerous sources of high-dose lead exposure for young children. There are two public policy approaches to reducing children’s exposure to lead-based paint and dust:
Primary prevention, or policies
that require housing (and other environments) to be safe from the dangers posed by lead paint and lead-contaminated dust. Experts agree these policies have the most promise
for reducing lead poisoning, but most states and municipalities have not made part because of limited resources and authority.
Secondary prevention, or policies
management, and treatment of children with elevated blood lead levels (BLL). Because lead exposure
does not cause obvious symptoms
occurred, blood lead screening is used to identify exposed children. In Delaware,
or venous blood lead test at 12 months. A Medical Risk Assessment (MRA)
via a questionnaire administered by the provider to the parent is also mandated to identify children at risk of lead poisoning at 24 months of age, although the U.S. Preventive Services Task Force (USPSTF) has determined that these instruments are inaccurate.
consists of medical and developmental follow-up as well as nutritional recommendations and environmental interventions, if possible. According
to the Centers for Disease Control and Prevention (CDC), “evidence suggests provision of services to children with elevated BLLs remain components of a comprehensive lead poisoning prevention program.”2
CHILDREN AT RISK
Delaware has collected lead levels on approximately 20%-25% of children 12-month-old children at risk has been hampered by a number of factors:
machines are available, many
families to a local laboratory.
Families may not follow through with the laboratory visit.
2. Although licensed child care facilities require that families enrolling a child obtain sign-off from a health care provider that their child has received a lead test at 12 months of age (as part of the child health appraisal), only about half of Delaware’s young children attend licensed child
care. Therefore, for about half of Delaware families, there is no check point to ensure that the 12-month lead test has been completed.
Del Med J | January/February 2020 | Vol. 92 | No. 1
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