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Preventing Lead Poisoning In Virginia A 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

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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


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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


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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


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Virginia’s Highest Risk Metropolitan Areas

Richmond

Norfolk

Petersburg

Roanoke

Portsmouth

Lynchburg

1.6 million homes in Virginia

may have lead paint



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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


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Primary Sources of Lead

TODAY

  • Dust

  • Floor, Window sills, Frictional Surfaces, Home renovations

  • Paint

  • Chipping,Cracking,Peeling

  • Soil

  • Paint Chips, Exhaust from Leaded Gasoline


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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


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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


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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


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Social and Educational Effects of Lead Poisoning

  • Aggressive and Antisocial Behavior

  • Learning Disabilities

  • Attention Deficient Hyperactivity Disorder

  • Disorganization

  • Juvenile Delinquency


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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


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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


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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


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Preventing Lead Poisoning Is As Easy As...

1. Assess Risk

2. Screen via Blood Test

3. Manage


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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


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Diagnostic Testing

of Elevated Blood Lead Levels


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Medical Management

  • Chelation Therapy

    • Succimer

    • 10mg/kg

    • Recommended for elevated blood lead levels of 45ug/dL or greater

  • Consult with Regional Treatment Center


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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



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Insurance Coverage For

Lead Screening


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Want More Information?

Virginia Partnership For Lead Poisoning Prevention Education

Phone:(804) 827-0942

Lead Hotline::1-800-523-4019

Email:[email protected]

Website:www.vdh.state.va.us/fhs/child/lead


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