Lead Poisoning Prevention
Special Projects

Blood Lead Testing at WIC Clinics

In an effort to increase blood lead testing for high-risk children in Minnesota, staff from the Minnesota Department of Health (MDH) Childhood Lead Poisoning Prevention Program (CLPPP) conducted a blood lead testing pilot project at WIC clinics in four Minnesota counties: Blue Earth, St. Louis, Stearns and Winona. To determine testing locations, statewide blood lead surveillance data and Minnesota census data were analyzed using lead risk criteria (the number of young children living in the county, the percent of children living in poverty and the percent of older housing). The four counties chosen were among those that ranked between high and medium for these risk criteria.

The CLPPP received funding from the Centers for Disease Control and Prevention (CDC) for the project, which included staff time and laboratory analysis fees for those children without insurance. Ultimately, the goals for the project were to determine the percent of children tested during WIC clinics who had elevated blood lead levels (EBLLs) and to demonstrate the efficacy of performing a blood lead test during WIC clinics utilizing a filter paper protocol.

For each child aged 9-36 months whose parent or guardian was willing to participate, an informed consent was completed, a filter paper lead test was performed, and the parent or guardian completed a risk factor survey containing six questions. For the four counties combined, 812 children were tested (Table 1), and 809 of these also had completed risk factor surveys (Table 2). Of the tested children, none had lead levels of 20 ug/dL or greater, and two had a lead level of 10 ug/dL or greater. Fifty-six children (7%) had lead levels of 5 ug/dL or greater.

Table 1. Blood Lead Test Results

Lead Level

Duluth

Winona

Mankato

St. Cloud

Total

< 5 μg/dL

167 (87%)

96 (93%)

215 (96%)

278 (94%)

756 (93%)

5.0-9.9 μg/dL

23 (12%)

6 (6%)

8 (4%)

17 (6%)

54 (7%)

10.0-14.9 μg/dL

1 (0.5%)

1(1%)

0 (0%)

0 (0%)

2 (0.3%)

Total

191

103

223

295

812



Table 2. Survey Questions and Responses

#

YES

NO

DK

(%)
(%)
(%)

1

Has the child moved from a major metropolitan area or another country within the last twelve months?

48

752

9

(6)
(93)
(1)

2

During the past 6 months has the child lived in or regularly visited a home, childcare, or other building built before 1950?

265

394

149

(33)
(49)
(18)

3

During the past 6 months has the child lived in or regularly visited a home, childcare, or other building built before 1978 with recent or ongoing repair, remodeling or damage (such as water damage or chipped paint)?

244

422

142

(30)
(52)
(18)

4

Has the child, or his/her sibling or playmate, had an elevated blood lead level?

18

607

184

(2)
(75)
(23)

5

Does the child receive services from Minnesota Care (MnCare) or Medical Assistance (MA), which includes the Prepaid Medical Assistance Program (PMAP)?

501

286

22

(62)
(35)
(3)

6

Has your child had a lead test before?

88

576

144

(11)
(71)
(18)

The two children who had an elevated lead level above 10 ug/dL answered YES to questions which indicated that the children received Medicaid services and lived or spent time in a home built before 1950, two of the primary risk factors for childhood lead poisoning. When combined, the first five questions on the survey indicated that 95% of the tested children met the criteria for blood lead testing according to Minnesota screening guidelines. The federal Medicaid program requires blood lead testing for children at ages one and two, and most children in the WIC program are also enrolled in a Medicaid-funded program.

The MDH WIC clinic blood lead screening project was a successful collaboration between the state health department and four local public health agencies, even though it did not identify a high number of children with elevated blood lead levels (10 ug/dL or higher). Some of the children attending WIC clinics do not receive routine health prevention services, and are therefore not likely to receive blood lead testing at a medical clinic. This would indicate that WIC clinics appear to be an efficient way to screen children at risk for lead poisoning who would not otherwise be tested. If a local WIC program would like assistance with implementing blood lead screening at their WIC clinics, you may contact the MDH Lead Program's State Case Monitor, found on the Lead Poisoning Prevention Contacts web page.

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Legislative Study Work Group

During the 2004 legislative session, the following enabling text, as included in the Laws of Minnesota 2004 Ch 288, Section 31 was passed:

The commissioner of health, in consultation with the Department of Employment and Economic Development, the Minnesota Housing Finance Agency, and the Department of Human Services, shall develop and evaluate the best strategies to reduce the number of children endangered by lead paint.

The Legislative Study Work Group was the direct result of that legislation. The following agenda, handouts, and summary are from the work groups first meeting on September 2, 2004.

The group met again on October 7, 2004. The following agenda and summary are from that meeting.

The group met a final time on November 18, 2004. The following is the agenda from that meeting.

A summary of all three meetings will be included in the Biannual Report to the Legislature, which will be released in February. The Legislative Study Work Group will have completed it's charge after they have commented on the final draft of that report. A link will be provided when the report is released.

Please contact Daniel Symonik at 651-201-4928 or daniel.symonik@state.mn.us if you have any questions.

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Countryside Lead Study

Countryside Public Health Service (CPHS), and the Minnesota Department of Health (MDH) conducted a study of lead poisoning in Chippewa, Swift, and Yellow Medicine Counties. The project goal was to test every child up through 3 years old in those three counties for blood lead. Two dino's talkingThe Countryside Lead Project ran for one year starting September 1, 2001. Funding was provided by the Centers for Disease Control and Prevention (CDC,) and UCare Minnesota. In addition to CPHS and MDH, eight local health clinics, (ACMC-Benson, Granite Falls, Marshall, Willmar, Appleton Medical Clinic, Family Practice of Willmar, Montevideo Clinic, and Sioux Valley Canby Campus), were actively involved in recruiting participants and conducting blood lead tests for this study.

The three counties of Chippewa, Swift and Yellow Medicine were chosen because they have one community health service agency (CPHS) that serves all three counties and because they have a high proportion of homes built prior to 1950. This is a significant risk factor for lead poisoning. In addition, very few children have been tested for blood lead in these counties. The Countryside Lead Project is especially important because most of the attention to the problem of lead poisoning has been focused on urban areas. This study will help rural areas of the state receive equal protection from the potentially hazardous effects of lead.

Children under six years of age who spend time in homes built before 1978 with chipping or peeling paint are at greatest risk for lead poisoning. Younger children are susceptible because their bodies are still growing, their nervous system is still developing, and they are the most likely to put things in their mouths. The good news is that lead poisoning can be prevented through blood testing and elimination of lead from the home environment. The Countryside Lead Project will help estimate how much lead poisoning there is in rural Minnesota. The study results will allow us to find out which things in the child's environment cause elevated blood lead levels. This will help our agencies and physicians to focus screening activities in all of Minnesota toward those children most at risk for elevated blood lead levels. The study will also help prevent future lead poisoning by telling us where to focus our efforts at removing sources of lead.

Countryside Lead Prevalence Study (PDF: 162KB/14 pages)

The findings from this study were published in the Journal of Environmental Health, September 2005 issue as the featured article. You must be a current subscriber to download the article:

Zabel, EW, MC Falken, M Sonnabend, M Alms, DM Symonik. 2005. Prevalence of elevated blood lead levels and evaluation of a lead risk screening questionnaire in rural Minnesota. J. Env. Health 68(2)9-16.

For further information contact —

Erik Zabel, PhD, MPH
Minnesota Department of Health
651-201-4931
erik.zabel@state.mn.us

Liz Auch, CHS Administrator
Countryside Public Health Service
320-843-4546 or 1-800-657-3291
lauch@countryside.co.swift.mn.us

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Child Dies of Lead Poisoning from Metal Charm

Reebok charms have been recalled by the Consumer Products Safety Commission. Consumers who have purchased shoes with heart-shaped metallic charm bracelets should keep the charm bracelet away from children, especially infants and toddlers who often place items in their mouths. The charm bracelet should be disposed of by throwing it away in the trash or bringing it to a household hazardous waste collection site.

Health care providers should consider lead poisoning as a possible diagnosis if young children present with symptoms of increased intracranial pressure, unexplained gastric symptoms, and a history of eating or mouthing non-food objects.

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MDH studies Contractor RRP Compliance

The Minnesota Department of Health recently conducted a statewide survey of renovation contractors to determine compliance with the EPA's Renovation, Repair and Painting Rule. An executive summary of this survey and the post card used in this survey can be found on the links below.

2012 Survey of Lead Paint Regulatory Compliance Among Minnesota Renovators (PDF: 104KB/ 2 pages)

Lead Poisoning Postcard (PDF: 3720KB/ 2 pages)

Lead Enforcement Postcard (PDF: 3650KB/ 2 pages)

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Updated Thursday, 23-Jan-2014 08:10:03 CST