Lead Poisoning Prevention
Publications and Reports
2010 Childhood Lead Poisoning Elimination Plan
The 2010 Childhood Lead Poisoning Elimination Plan was released
in June 2004. This plan is designed to collaboratively create a lead-safe
Minnesota where no children have elevated blood lead levels by the year
2010. It is the result of the hard work and dedication of the Advisory
Work Group, whose attention to detail and willingness to examine the complex
and diverse issues underlying childhood lead poisoning has led to a comprehensive
approach to eliminate lead as a pediatric health threat in Minnesota.
Historically MDH has been involved in efforts to enhance the early identification
of children who have been exposed to lead, and to increase and improve
the follow-up services these children need. Although these secondary prevention
activities will retain a vital role in the 2010 Elimination Plan,
the main focus of the plan is primary prevention (preventing children
from ever being exposed to lead). This will be accomplished through the
reduction or elimination of sources of lead in the childhood environment.
2010 Plans:
2010 Progress Reports
2010 News Release
(August 25, 2004)
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Blood Lead Screening Guidelines
for Minnesota (March 2000)
The Blood Lead Screening Guidelines for Minnesota were officially
released in March 2000. They recommend physicians order blood tests for
1) children residing in specific geographic areas that have a high rate
of elevated blood lead cases, and 2) children matching specific demographic
groups that have a high rate of elevated blood lead. The guidelines are
endorsed by the Minnesota Medical Association (MMA), the Minnesota Chapter
of the American Academy of Pediatrics (AAP), the Minnesota Academy of
Family Physicians (MAFP), and BlueCross BlueShield BluePlus of Minnesota.
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Blood Lead Screening Guidelines
for Pregnant Women in Minnesota (June 2004)
In June 2004, MDH developed Blood Lead Screening Guidelines for Pregnant
Women in Minnesota. They are designed for OB/GYN physicians, nurse practitioners,
and midwives to assist them in screening and treating pregnant women for
elevated blood lead levels, thus ensuring that both the women and their
children receive intervention to reduce their lead exposure. They are
endorsed and supported by the Minnesota Chapter of the American College
of Obstetricians and Gynecologists (ACOG). The guidelines have been sent
to all OB/GYN physicians, nurse practitioners, and midwives in Minnesota.
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Blood Lead Testing Methods Report to the Legislature (February 2008)
The 2007 Legislature directed MDH to conduct a study to evaluate blood lead testing methods used to confirm elevated blood lead status. This report is the response to that legislative directive. Specifically, it contains an examination of the false positive rate of capillary tests for children who are younger than 72 months old, current protocols for conducting capillary testing, including filter paper methodology, and existing guidelines and regulations from other states and federal agencies regarding lead testing. As required, the report also includes recommendations on the use of capillary tests to initiate environmental investigations and case management, and reducing the state mandatory intervention level to ten micrograms of lead per deciliter (μg/dL) of whole blood.
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Childhood Blood Lead Case Management Guidelines
for Minnesota
(June 2001/Revised July 2006)
The Childhood Blood Lead Case Management Guidelines for Minnesota
were officially released in June 2001. In 2006, the guidelines were revised
to reflect current state statute, and the knowledge gained in the previous
five years of implementation. As part of the revision, the full
report title was changed to, Childhood Blood Lead Case Management Guidelines
for Minnesota -
Reference Manual to more accurately reflect the document's purpose,
while the condensed version's title (Appendix C below) did not
change. The documents are intended as tools that case managers can
use to provide consistent and comprehensive case management.
Appendix C can be used for quick
verification of what interventions are recommended for each blood
lead level. The reference manual is more comprehensive and includes
recommended qualifications for the case manager, protocols for the home
visit, a list of referrals for services and information, action plans
for various blood lead levels (ranging from non-detect to emergency medical
situation), a review of case closure thresholds, and a glossary of commonly
used lead terms. The guidelines were endorsed in 2001 by the MMA, the
Minnesota Chapter of the AAP, the MAFP, and the Minnesota Nurses Association
(MNA).
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Childhood Blood Lead Clinical
Treatment Guidelines for Minnesota (July 2001)
The Childhood Blood Lead Clinical Treatment Guidelines for Minnesota
were officially released in July 2001. They represent the consensus opinion
of eight physicians experienced in treating patients with an elevated
blood lead level. The issue discussed the most in the work group was the
efficacy of chelation therapy, and the blood lead level above which chelation
is appropriate. The guidelines are endorsed by the MMA, the Minnesota
Chapter of the AAP, the MAFP, and the MNA.
- Full
Report Without Appendices
(PDF: 111KB/26 pages)
- Full
Report With Appendices
(PDF: 403KB/30 pages) This
version contains all appendices so that it will be more convenient
to print—however,
the appendices may not be updated as they become outdated. Please
see the links above for the most current version of appendices.
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Elevated Blood Lead Levels in the
Minnesota Medicaid Population
These reports present the results of a joint effort between the Minnesota
Department of Human Services (DHS) and the Minnesota Department of Health
(MDH) to examine the lead testing and elevated blood lead level rates
for Minnesota children. This project, known as the Minnesota Lead Data
Match Project, links MDH Blood Lead Surveillance System data with DHS
data for children under age 6 enrolled in Minnesota’s Medicaid programs
(referred to here as Minnesota Health Care Programs, or MHCP).
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Medical Management for Lead-Poisoned Adults created
collaboratively by the Association of Occupational and Environmental Clinics (AOEC)
The purpose of this document is to provide useful advice to clinicians
caring for adult patients
who have been exposed to lead, whether at work, at home, through hobbies,
in the community,
through consumer products, retained bullets, or other sources. This document
is derived, in
part, from the input of an expert panel convened by the Association of
Occupational and
Environmental Clinics (AOEC). However, three clinical scholars then considered
the medical
evidence submitted by the expert panel and incorporated many of the conclusions
reached by
this panel. This paper, therefore, reflects the clinical views of AOEC
members, not necessarily
the expert panel, particularly in areas where the expert panel had been
unable to come to
consensus. The following points are emphasized:
1) Medical care serves as an adjunct to public health and industrial
hygiene exposure control.
Clinicians who evaluate patients with potential lead exposure should
have appropriate referral
mechanisms in place for prevention of further exposure to lead. Although
one goal of health
care is to remove the patient from exposure, the social consequences
of potential disruption of
housing or of income may be important and must be considered by the clinician.
2) Current occupational standards are not sufficiently protective and
should be strengthened.
Although the federal Occupational Safety and Health Administration’s
(OSHA) lead standards
have provided guidance that has been beneficial for lead-exposed workers,
these regulations
have not been substantially changed since the late 1970s and thus are
primarily based on health
effects studies that are well over three decades old. There is an urgent
need to revise them.
3) The clinical guidelines presented here are appropriate for
adults, recognizing that younger
adults, particularly those in workplace settings, may share developmental
risks that place them
closer to pediatric populations, and that maternal exposure, whether
in the workplace or in the
general environment, places the developing fetus at risk for exposure.
4) Clinicians should feel free to contact any of the member AOEC clinics
for additional telephone advice, and are encouraged to refer patients when appropriate.
See: Medical
Management Guidelines for Lead-Exposed Adults (PDF: 200KB/15 pages) Attention: Non-MDH link
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Minnesota's Lead Poisoning Prevention Programs:
Report to the Legislature (February 2009)
This report provides a brief overview of public health concerns associated
with lead exposure, documents activities related to characterizing and
preventing lead poisoning by the Minnesota Department of Health, presents
the status of current funding sources, and evaluates likely future directions
for state-level lead programs. This report addresses work conducted since
the previous legislative report (February 2005 to January 2009).
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Protecting Families from Lead: The
Lead Poisoning Prevention Workshop Manual
The "Protecting Families from Lead: The Lead Poisoning Prevention
Workshop" manual was prepared to assist lead case managers and health
educators in spreading the word about childhood lead poisoning prevention.
The target audiences for the workshops are professionals/groups that work
with families with young children, e.g. rental property owners and day
care providers. The manual describes the workshop strategy and provides
basic information on the preparation, implementation, and evaluation of
a lead prevention workshop. The manual includes a set of seven appendices
which provide support materials for workshop hosts, including frequently
asked questions and answers about lead, a draft workshop agenda, sample
demonstrations that can be performed during a workshop, and sample evaluation
tools.
The PDF documents listed below are large. If you have problems downloading
the report or questions about the manual or the workshop strategy, please
contact the Minnesota Childhood Lead Poisoning Prevention Program
Manager (see list on the Contact
Us web page).
For more information about Lead Training go to HUD's
training site.
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Surveillance Database Reports
These reports are an overview of the blood lead testing data on Minnesota
residents as reported to the Minnesota Department of Health. The MDH maintains
an extensive blood lead surveillance system for the purpose of monitoring
trends in blood lead levels in adults and children in Minnesota. The data
are used to help identify populations at risk for elevated blood lead
levels. The surveillance system then uses this information to help ensure
that screening services are provided to groups identified as having the
highest risk of lead poisoning and that environmental and medical follow
up is provided to children with elevated blood lead levels. The following
reports are in PDF format.
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For questions about this page, please contact the Lead
Program at health.lead@state.mn.us
or 651-201-4620. For specific lead questions, please use the contacts listed
on our Contact Us page.
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