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Childhood Lead Poisoning Prevention - Ricky Harrison

This is a full transcript of the online presentation. For the presentation itself, go here.

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Welcome to the Childhood Lead Poisoning Prevention Start-Me-Up Presentation!

 This presentation will help you become familiar with the problem of childhood lead poisoning in Florida. It has three specific objectives. The first objective is to introduce the causes and irreversible effects of childhood lead poisoning. The second objective is to provide you with an overview of at-risk populations in Florida and the lead poisoning statistics for the state. The third objective is to provide you with an overview of the Florida Childhood Lead Poisoning Prevention Program (the FL CLPPP) and encourage you to join us in our efforts to eliminate childhood lead poisoning in Florida.

 Let's start with the basics. Lead is a heavy metal. Its atomic number is 82, and its atomic mass is 207.20. Lead is indeed a poison and there is no natural level of lead in the blood.

 We must remember that lead is all around us. Lead may be found in older chipping or peeling paint inside or outside of your home. Lead may also be found in other places as well: jewelry, pottery, mini blinds, and even candy from other countries-just to name a few. 

Lead-based paint is the most common lead hazard in the United States. Homes built before 1978 may still contain lead-based paint hazards. Homes built before 1950 are even more likely to contain lead-based paint hazards. We learn about new sources of lead each year. Examples of lead-based paint hazards are shown below. 

What is childhood lead poisoning? There is no safe level of lead in blood; however, according to Florida's case definition of childhood lead poisoning: children age 72 months or younger with confirmed lead levels greater than or equal to 10 µg per deciliter are considered lead poisoned.

 This is in concert with the Centers for Disease Control and Prevention’s level of concern.

 There are two main pathways for lead to enter the body. These are termed: pathways of exposure. Ingestion is a pathway of exposure that usually occurs when one has hand to mouth contact. Inhalation is another pathway of exposure that includes breathing lead particles into your system. Usually, ingestion is the main pathway of exposure for children, but inhalation is the main pathway of exposure for adults. The diagram below shows many different sources and pathways of exposure.

Children under the age of six will always be especially at risk to sources of lead in the environment. Their developing bodies are more likely to absorb lead and their behaviors, such as frequent hand-mouth contact, serve as pathways for exposure.  

As discussed earlier, there is no safe level of lead in your body. However, characteristics differ between low-level and severe lead poisoning. Lowered IQ, hyperactivity, lack of concentration, behavioral problems, and learning disabilities are some affects of low-level poisoning. Hearing problems, headaches, anemia, neurological impairments, seizures, coma, and even death may be affects of severe lead poisoning.

This table shows the number of lead poisoned children under the age of six in Florida from the year 2001 to 2005.

Please note that data from 1997 through 2005 show more then 10,316 children less than 72 months of age identified in Florida with elevated blood lead levels.

 As we discussed before, homes built before 1978 are more likely to have lead-based paint. Homes built before 1950 are even more likely to contain lead hazards.

Children living in these older homes are high risk for lead poisoning.

There are approximately 433,564 homes in Florida built before 1950. 

If you notice the chart representing Florida to the right of this slide, you will see the percentage of pre-1950 housing by county.

 Older homes are usually grouped in the same neighborhoods and zip codes. Children who live in these high-risk zip codes are high-risk for lead poisoning.

 Children living in older neighborhoods live in close proximity to lead-based paint and soil hazards. It is recommended that these children receive a blood lead test at ages one and two.  

Refugees, immigrants and children adopted from foreign countries are high-risk for lead poisoning.

Industrial uses of lead are unregulated or under regulated in other countries. Some cultural practices involve the use of products containing lead. Almost 20,000 refugees aged 19 and under arrived in Florida in the past five years. If you notice the picture to the extreme bottom-left, you will notice pottery that contains lead, which came from a foreign country.  In addition, the fourth picture from the right shows a picture of candy that contains lead.  

We've all heard the saying, “don't take your work home with you.” However, sometimes it is inevitable. Children who have caregivers who have hobbies or jobs involving lead are high-risk for lead poisoning. Lead dust can be carried home from work or hobbies on clothes, shoes or equipment. Cottage industries remain prevalent in some parts of the state of Florida; these activities may also result in contamination of a child’s environment.  

Low-income children are high-risk for lead poisoning. Families with limited resources are more likely to reside in older homes that may have lead-based paint hazards. Low-income children are also more likely to have poor nutritional status, making it easier for them to absorb lead. Medicaid eligibility is used to target blood lead screening in this population across the United States.

 Minority populations are high-risk for lead poisoning. Statistics from the Miami-Dade CLPPP confirmed that minority populations are disproportionately affected by lead poisoning.

 The program reports that 90% of the 175 individuals with elevated blood lead levels in 2005 were either Hispanic or non-Hispanic black.

 The FL CLPPP manages lead prevention efforts in the state of Florida.

 Our mission is to protect the health and cognitive development of all children living in Florida by minimizing childhood exposure to all lead hazards.

 What do we do?

 We conduct statewide surveillance of blood lead screening; we provide case management and screening guidance; we fund four high-risk counties: Duval, Hillsborough, Miami-Dade and Palm Beach to lead local elimination efforts; and we coordinate the committee for the elimination of childhood lead poisoning.

 The Committee for the Elimination of Childhood Lead Poisoning is leading the way to a lead safe Florida. Our partners include: County Health Departments, the Advocacy Institute for Children, the Florida Chapter of the American Academy of Pediatrics, University of Florida's TREEO Center, Florida Children's Environment health Alliance, the Department of Community Affairs, the Agency for Health Care Administration, Local Housing Authorities, and various industry partners.

 Our committee created and works from Florida’s Strategic Plan for the Elimination of Childhood Lead Poisoning, “the elimination plan,” It is a statewide plan for meeting the healthy people 2010 goal of eliminating childhood lead poisoning.

The elimination plan has five sections: screening, surveillance, case management, protective policy, and primary prevention, which includes community outreach and education and housing.

 The committee has five committee working groups to ensure the activities defined in each section of the plan are completed. These workgroups are: screening and surveillance, protective policy, community outreach and education, housing, and case management.

 The screening and surveillance workgroup brings together two elements of our strategic plan; screening and surveillance. The screening and surveillance workgroup focuses on using surveillance data to monitor the number of at-risk children screened for lead poisoning. The data is used to develop target strategies to improve awareness of lead screening policies by the public and physicians. The group is also researching the most effective health care delivery systems for providing blood lead testing services and exploring opportunities to improve policies and management structures to increase screening rates. 

The protective policy workgroup focuses on educating policymakers, advocacy organizations, community leaders, public and private stakeholders and others in order to increase the effectiveness of state and local policies related to protecting children from lead poisoning in Florida.

 The community outreach and education workgroup takes a broader approach to ensure families, communities and other members of the general public are informed about traditional and nontraditional lead risks and prevention measures. The workgroup aims to establish viable and lasting partnerships with community organizations and state and local agencies already serving high-risk populations.

 The housing workgroup focuses on engaging new partners in efforts to ensure resources for creating and maintaining lead safe homes are available for high-risk families. Educating housing professionals in lead safety, working with existing agencies to improve enforcement of state and local lead safety requirements, and collaborating to leverage funding for lead hazard reduction are also key activities of this workgroup.

 The case management workgroup focuses on supporting County Health Department case managers, physicians, Children's Medical Services Program, HMOs and other partners in the coordination of follow up care for lead poisoned children. This workgroup will work together to develop guidelines, enhance current referral processes, and to ensure providers and partners are adequately informed of the proper medical follow-up care. 

What can you do to help prevent childhood lead poisoning?

 If you live in a home built before 1978 that has chipping or peeling paint, please take your child to get a blood lead test. You can also partner with the Florida childhood lead poisoned program by joining one of the five committee workgroups. You may also use the FL CLPPP’s educational materials and surveillance reports to heighten awareness and push lead poisoning prevention efforts in your area. In addition, you may contact your local policy makers and state legislators to convey the importance of lead poisoning prevention in Florida.

 Let the FL CLPPP help you protect Florida’s children!

The FL CLPPP can provide local data for building partnerships and for informing community stakeholders about lead hazards in your area. We can also provide technical assistance for local lead elimination efforts. We may also provide educational materials in Spanish, English and Creole.

 Thank you for viewing this presentation. I hope it has inspired you to help us address this completely preventable condition. If you have any questions, ideas or if you would like to join our efforts, please note the contact information on the following slide.

Julie Kurlfink is the Florida CLPPP Coordinator. She may be reached by email at Julie_Kurlfink@mail.DOH.state.fl.us.

 Ricky Harrison is the Environmental Policy Analyst for the Florida CLPPPP. He may be reached by email at Ricky_Harrison@mail.DOH.state.fl.us or by telephone at 850-245-4247.

 In Miami-Dade County, you may contact Alicia Camps Sotirescu MD, MSGPM. She is the Miami-Dade CLPPP Coordinador. Her email address is Alicia_Sotirescu@doh.state.fl.us, or you may contact her by phone at (305) 470-6872. 

In Duval County, you may contact Tiffany Turner, Ph.D. She is the Duval CLPPP Coordinator. Her email address is Tiffany_Turner@doh.state.fl.us, or you may contact her by phone at (904) 630-3289.

 In Hillsborough County, you may contact Cynthia O’Keeton. She is the Hillsborough CLPPP Coordinator. Her email address is cynthia_keeton@doh.state.fl.us, or you may contact her by phone at (813) 307-8015 x7108.

In Palm Beach County, you may contact Selva Selvendran. He is the Environmental Manager. His email address is Selva_Selvendran@doh.state.fl.us, or you may contact him by phone at (561) 355-3070.