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Preventing Lead Poisoning In Virginia A training module for primary health care providers

Preventing Lead Poisoning In Virginia A training module for primary health care providers

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Preventing Lead Poisoning In Virginia A training module for primary health care providers

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  1. Preventing Lead Poisoning In VirginiaA training module for primary health care providers Virginia Partnership for Lead Poisoning Prevention Education Virginia Institute for Developmental Disabilities Virginia Commonwealth University Funded by: Virginia Department of Health United States Environmental Protection Agency

  2. Lead Poisoning is... • Number one environmental hazard for children • Preventable with early screening and environmental intervention • Common with an estimated 890,000 children affected nationwide

  3. Epidemiology of Childhood Lead Poisoning in Virginia 25,000 Affected At least 500 new cases per year* Affects 4.4% of children overall Affects 15% of children in poverty * 95% of cases are asymptomatic

  4. Virginia’s Highest Risk Metropolitan Areas Richmond Norfolk Petersburg Roanoke Portsmouth Lynchburg 1.6 million homes in Virginia may have lead paint

  5. Who’s At Risk? EVERYONE

  6. … Especially Children • Living/visiting homes built before 1978 • Low-income families • 6 to 36 months (Hand to mouth activity) • Abused or neglected • Iron deficient or anemic • Minority or ethnic background • Parent with occupational exposure or hobby

  7. Primary Sources of Lead TODAY • Dust • Floor, Window sills, Frictional Surfaces, Home renovations • Paint • Chipping,Cracking,Peeling • Soil • Paint Chips, Exhaust from Leaded Gasoline

  8. Water Vinyl Miniblinds Bullets Car batteries Folk Remedies Lead Smelters Ethnic Cosmetics Leaded Crystal Occupational Old Toys Furniture Ceramic Ware Fishing Sinkers Secondary Sources of Lead

  9. Lead Enters the Body Through... • Ingestion • Tastes sweet • Hand to mouth activity • Inhalation • Dust particles • Transplacental Transfer • Passes from exposed mother to fetus via placenta

  10. Physical Effects of Lead Poisoning • Central Nervous System • Interferes with normal brain development • Auditory Damage • Language Delays • Muscular and Skeletal System • Poor Coordination • Decreased Growth • Renal System

  11. Social and Educational Effects of Lead Poisoning • Aggressive and Antisocial Behavior • Learning Disabilities • Attention Deficient Hyperactivity Disorder • Disorganization • Juvenile Delinquency

  12. Pathophysiology of Lead Poisoning In Children • Absorption • GI tract: primary site • Lungs: rapid • Distribution • Blood • Soft tissue • Bone • Elimination • 60% absorbed excreted immediately • Renal system: primary mode of excretion

  13. Physical Constipation Persistent Tiredness Nausea/Stomach Aches Anemia Appetite Loss/Anorexia Headaches Psychological Irritability Insomnia Hyperactivity Reduced Attention Span Symptoms of Lead Poisoning Or No Symptoms

  14. Who’s at Risk? Targeted Screening Questionnaire 1. Eligible for Medicaid, VACMSIP or WIC? 2. Living in a ZIP CODE determined to be high risk? 3. Living in or regularly visiting a house or day care center built before 1950? 4. Living in or regularly visiting a house built before 1978 with chipping paint or renovations within the last 6 months? 5. Living with or regularly visiting a sibling or playmate with lead poisoning? 6. Living with an adult whose job or hobby involves lead exposure? 7. Living near an active lead smelter, battery recycling plant, or other industry likely to release lead? IF YES TO ANY OF THE ABOVE --- Draw for a blood test

  15. Preventing Lead Poisoning Is As Easy As... 1. Assess Risk 2. Screen via Blood Test 3. Manage

  16. What Can Physicians Do?The American Academy of Pediatrics Supports... • Anticipatory Guidance and Education • Screening Awareness • Lead Hazards • Proper Nutrition • Housekeeping/Safe Home Renovations • Increase Screening and Screening Efforts • Children 12 to 24 months • Children 3-5 years old (if not screened previously) • Universal vs. Targeted • Advocacy

  17. Diagnostic Testing of Elevated Blood Lead Levels

  18. Medical Management • Chelation Therapy • Succimer • 10mg/kg • Recommended for elevated blood lead levels of 45ug/dL or greater • Consult with Regional Treatment Center

  19. Lead Regulations 1979 - Ominbus budget reconciliation act 1992- Residential lead based paint hazard reduction act (title x) 1993 - All blood test levels are reportable to the Virginia Department of Health 1999- Lead screening accountability for early-intervention act pending

  20. Regional Treatment Centers

  21. Insurance Coverage For Lead Screening

  22. Want More Information? Virginia Partnership For Lead Poisoning Prevention Education Phone:(804) 827-0942 Lead Hotline::1-800-523-4019 Email:kllewis@vcu.edu Website:www.vdh.state.va.us/fhs/child/lead