Prevent Childhood Lead Poisoning Research Articles

Childhood lead poisoning in Gaza Strip, the Palestinian Authority

PurposeTo assess lead poisoning among a pediatric population in Gaza Strip, the Palestinian Authority. MethodsA total of 1705 questionnaires and blood samples were collected from children aged 2–6 years, by the finger stick capillary procedure, for the assessment of blood lead level (BLL), using the LeadCare kits. The samples were collected from children living close to lead processing units (hotspots) and far 100–500 m away (general population). Management of elevated BLL was achieved by gavage of chelating agent d-penicillamine at a dose of 30 mg kg−1 body weight/day for two weeks for children having BLL above 20 μg/dl. Data were statistically analyzed using SPSS computer program version 22. ResultsDistribution of children in Gaza Strip by sampling process illustrated those 326 children (19.1%) living in lead processing units (hot spots) and 1379 children (80.9%) from location far away 100–500 m from host spot (general population). The mean BLL was 10.4 μg/dl. A total of 440 children (25.8%) were found to be having BLL ≥ 10 μg/dl while 1265 children (74.2%) have BLL < 10 μg/dl. BLL < 10 μg/dl was taken as a cut point due to CDC standards. The prevalence of BLL in hotspot areas in children who were exposed to lead and have BLL ≥ 10 μg/dl was 95.7% while in general population it was 9.3%. The difference between the study population was statistically significant (p < 0.01). Statistical significant differences between the study populations were found among several independent variables of risk factors such as household location and exposure sources, and occupational exposure. Gavage of d-penicillamine significantly reduced BLL to the acceptable level (BLL < 10 μg/dl). ConclusionsChildhood lead poisoning accounts for a substantial burden in Gaza Strip. Hotspots of lead-related industries are the high risk areas that contributing to high BLLs in children. d-Penicillamine was effective in the treatment of lead poisoning among children. Health education and treatment campaigns should be designed to minimize or prevent childhood lead poisoning in Gaza Strip.

Congress members seek data on lead poisoning

The public health crisis in Flint, Mich., has spurred four high-ranking Democrats in the U.S. House of Representatives to ask health departments in seven states for information about efforts to prevent childhood lead poisoning. Six of those states—Illinois, Massachusetts, New Jersey, New York, Ohio, and Pennsylvania—are identified as having the nation’s highest reported numbers of children with blood lead levels at or above an actionable level. “These children are at risk for serious intellectual, behavioral, and academic deficits, with lifelong and irreversible consequences,” the lawmakers say in letters to those six states and Michigan. They ask state health officials to provide details about their lead poisoning prevention strategies, including use of federal funds for these efforts and data collection methods. The information would be used to better understand how data are collected and whether current federal investments are “up to the task of addressing this public health challenge” as well

Peeling lead paint turns into poisonous dust. Guess where it ends up? A media campaign to prevent childhood lead poisoning in New York City.

Successful public health media campaigns promote messages, increase awareness, engage the public, and encourage behavior change. Between 2004 and 2006, the Lead Poisoning Prevention Program of the New York City Department of Health and Mental Hygiene conducted a media campaign grounded in social learning theory and the social marketing model to increase parents' awareness of childhood lead poisoning, ways to protect their children, and property owners' legal responsibility to fix peeling lead paint safely, and increase awareness of regulatory changes and encourage enforcement of New York City's Local Law 1 of 2004. Campaign materials were focus group tested and the campaign was refined annually. The campaign ran city-wide and in targeted high-risk neighborhoods. Neighborhoods and media venue (bus, train, kiosk, and store) changed annually, based on population risk factors and venue availability. Exposure to the campaign, campaign-related knowledge, and behavior were assessed using pre- and postcampaign street intercept surveys. Results showed that campaign reached the targeted population, and had an impact on knowledge of lead poisoning prevention measures as evidenced by increased knowledge of lead paint exposures sources in one year and increased knowledge of preventive behaviors in another year; these improvements were observed for both genders and most ethnic, primary language, educational attainment, and age groups in each year. Lessons learned indicate that well-targeted media campaigns, designed with audience participation, can reach parents through various venues, and improve key knowledge areas. Evaluation challenges faced include high levels of knowledge at baseline, competing media messages, and balancing between program needs and evaluation design.

Federal Agency Support for Healthy Homes

Numerous studies have demonstrated that housing interventions such as addressing structural deficiencies or lack of safety devices improve health. These successes, coupled with reports by health care and housing professionals of other health and safety issues in homes that they were unable to address, have renewed interest in promoting health by addressing unhealthy housing conditions--but with a holistic approach. The Centers for Disease Control and Prevention, US Department of Housing and Urban Development, and US Environmental Protection Agency fund programs to improve indoor air and drinking water quality and prevent childhood lead poisoning. All of these programs offer valuable lessons for designing more integrated programs. The federal agencies and their grantees have demonstrated that interagency collaboration is essential for successful outcomes. However, the Department of Housing and Urban Development, the Environmental Protection Agency, and the Centers for Disease Control recognize that no individual agency has all of the necessary resources or expertise to formulate national programs and policies and implement a national healthy homes agenda. Thus, they have come together with the US Department of Health and Human Services, the Department of Energy, the US Department of Agriculture, the National Institute of Standards and Technology, the National Institute of Environmental Health Sciences, and the Office of the Surgeon General to form an interagency working group to ensure that vigorous, healthy homes policies are implemented at federal, national, and community levels.

A Federal Agencyʼs Role in Fulfilling the Public Health Core Functions

The Institute of Medicine identified 3 core functions of public health: assessment, policy development, and assurance. Federal, state, and local public health agencies all have an obligation to provide these vital functions to ensure conditions in which people can be healthy. However, the few publications that provide core function applications only focus on applications at the local or state levels. The Centers for Disease Control and Prevention's Childhood Lead Poisoning Prevention Program uses a comprehensive public health approach. This article describes the Centers for Disease Control and Prevention's leading role in applying the core public health functions to prevent childhood lead poisoning.

Lead Prevention Knowledge Among Low-Income Urban Residents: The Chicago Lead Knowledge Test Revisited

ABSTRACTEfforts aimed at enhancing the knowledge of target populations constitute a widely used public health intervention strategy with the ultimate goal of improving health. However, integral to planning, implementing, and evaluating educational programs is identifying the knowledge base of the intended recipient. Improving health through educational interventions is a strategy commonly utilized in efforts to prevent childhood lead poisoning. However, few instruments have been validated for measuring lead knowledge, particularly among high-risk populations. We used factor analysis to evaluate the applicability of a previously developed lead knowledge assessment tool, the Chicago Lead Knowledge Test (CLKT), to a high-risk minority population in New Orleans and found that the structure of the CLKT did not accurately measure the knowledge of this population.

Costs and benefits of enforcing housing policies to prevent childhood lead poisoning.

Lead poisoning remains an important, yet entirely preventable disease among young children. This article compares the costs and benefits of strict versus limited enforcement of lead poisoning prevention housing policies in preventing additional cases of childhood blood lead elevation. The author conducted decision analysis using population-based data that compared recurrence of childhood lead exposure in 2 urban areas with different enforcement capacity, and cost data from a federal project and from medical and public health literature. Strict enforcement prevented additional cases, resulting in $45,360 savings from decreased medical and education costs and increased productivity for protected children. The model was robust to changing estimates of followup, housing repairs, relocation, and increases in lead levels over baseline. No cost savings were realized by strict enforcement if the probability of recurrence in limited units was 44 % lower than estimated, or if fewer children were identified in limited versus strict enforcement units. If the discount rate for future productivity losses was > or = 7.5%, strict enforcement did not lower costs. This analysis suggests that strict enforcement of housing policies to prevent childhood blood lead elevation results in decreased societal costs due to the avoidance offuture medical and special education and to increased productivity of resident children.

What do parents know about lead poisoning? The Chicago Lead Knowledge Test. Pediatric Practice Research Group.

To examine the extent of parental knowledge about lead poisoning and its prevention and to determine characteristics associated with accurate lead knowledge. Twenty-three pediatric practices and 1 family practice in Chicago, Ill, and its suburbs. A 24-question test regarding lead poisoning and its prevention (Chicago Lead Knowledge Test) was developed based on lead specialists' review and parental test-retest reliability. One point was assigned for each correct response. It was self-administered by a sample of 2225 parents of 0- to 6-year-old children visiting study practices. A 1-way analysis of variance (ANOVA) was used to determine the association of demographic descriptors with test scores. Respondents had a mean age of 33 years. Ninety percent were mothers, 49% were college graduates, and 80% were home owners. Fifteen percent lived in homes built before 1950, of which 36% were remodeled or renovated during the last 6 months. Respondents' youngest children were 80% white, 10% Hispanic, 5% African American, and 5% other. Ten percent received Medicaid and 86% had other medical insurance. Thirty-four percent recalled receipt of lead information from a health care provider, and 2.4% had had a child with a blood lead level of 0.48 micromol/L (10 microg/dL) or higher. The mean Chicago Lead Knowledge Test score was 12.2 (SD, 3.7). Questions related to lead exposure were more often answered correctly than those related to prevention and diet. In the ANOVA model, those who recalled receipt of lead information from a health care provider, college graduates, respondents aged 30 years or older, Hispanic respondents, and those living in homes built before 1950 had higher scores (all ANOVA P< or =.001). Parents do not have much knowledge of ways to prevent childhood lead poisoning. Information from a health care provider can aid parental knowledge. The Chicago Lead Knowledge Test is a new self-administered tool to help evaluate lead education programs.

Linking research and policy to ensure children's environmental health.

The U.S. Environmental Protection Agency (U.S. EPA) has made protecting children's environmental health its highest priority. Data on how and when children may be at risk are vital for accomplishing this goal. Recent examples of the link between research and policy include U.S. EPA actions to carry out the recommendations of the National Academy of Sciences on pesticides in children's food, reduce and prevent childhood lead poisoning, and revise national ambient air quality standards for ozone and particulate matter. Today, the Food Quality Protection Act (FQPA), which makes protecting children from pesticide residues in food a national priority, is contributing to the growing need for data for decision making. Further impetus comes from provisions in the FQPA and 1996 Safe Drinking Water Act Amendments for establishing a screening and testing program for potential risks from endocrine disruptors. Another factor is the analysis that will be required under President William J. Clinton's executive order directing all federal agencies, for the first time, to reduce environmental health and safety risks to children. Success of the U.S. international commitment to protect children is directly tied to the strength and availability of environmental data. To meet such challenges, the U.S. EPA is revising key science policies, expanding research opportunities, and adding to the public's right-to-know tools. In this dynamic climate, there are growing opportunities for the research community to play a greater role in helping ensure the well-being of children living today and in generations to come.

Preventing Childhood Lead Poisoning:: The Challenge of Change

Because of their rapid growth, immature biologic systems, and their developmental characteristics, children are uniquely vulnerable to exposure to environmental hazards. One of these is lead. Revised lead screening guidelines, published by the Centers for Disease Control and Prevention in Fall 1997, no longer advocate universal screening in some places. These guidelines will (1) require new policies from local public health agencies, (2) require new approaches for clinicians and managed care organizations, especially those with Medicaid-recipient enrollees, to conduct screening of children who may be at risk for exposure to lead, (3) offer new challenges for environmental follow-up to children identified with elevated lead levels, and (4) provide opportunities for collaboration between managed care and public health agencies.

Caregivers' knowledge and perceptions of preventing childhood lead poisoning.

Philadelphia is considered a high-risk area for lead poisoning. The Philadelphia Department of Public Health conducts education and outreach to screen children and promote prevention. Prior to this study there were no systematic data on the community's knowledge and perceptions of lead poisoning prevention. A 32-item questionnaire was developed to assess knowledge and perceptions of family caregivers of children younger than age 8. The survey was interviewer administered in pediatric clinics in two geographic areas of the city with documented severe and moderate lead poisoning rates. Eighty family caregivers were interviewed while waiting to see the pediatrician. Caregivers in the sample were connected to a health care system and resided in areas where lead community outreach was concentrated. Nevertheless, results suggest that even caregivers of children in high-risk areas do not mention lead poisoning as a health concern. About 61% of the sample identified eating paint chips as a cause of lead poisoning, whereas only 15% identified lead paint dust as a source of lead poisoning. Approximately 49% of the caregivers reported that they "never" or only "sometimes" perform recommended prevention activities. The Philadelphia Department of Public Health used these findings to review and modify education and outreach to prevent lead poisoning.

Preventing Childhood Lead Poisoning

Of all the neurotoxins, lead is the longest known and best understood. Because we know so much about what it does, where it is, and what is required to remove it from the presence of children, lead poisoning should also be one of the easiest diseases to eradicate. Despite this, progress in the primary prevention of childhood lead poisoning has been halting and erratic. In this paper, I outline the rapidly advancing state of knowledge on the epidemiology and toxicology of lead, examine some of the reasons for the gap between what is known and what has been accomplished, and outline the steps toward authentic primary prevention. Eradication of childhood lead poisoning is a realizable goal. Its importance is unquestioned; former Secretary of the Department of Health and Human Services Louis Sullivan declared in 1991 that it is the most serious environmental disease of North American children.

Statement on Preventing Childhood Lead Poisoning

Statement on Preventing Childhood Lead Poisoning