Primary prevention for children with blood lead levels 5-9 ug/dl

In August 2012, the Centers for Disease Control and Prevention improved national standards by lowering the lead poisoning level of concern from 10 ug/dL to 5 ug/dL, based on the 97.5th percentile in children. Local health departments are now deciding how to respond to this recommendation. In 2007, the Cincinnati Health Department's (CHD) Childhood Lead Poisoning Prevention Program was the first in the nation to implement a lead poisoning primary prevention program, providing home visitation to families of children with measured blood lead levels (BLL) between 5-9 ug/dL. From January 2008 to December 2012, 1510 children were referred to the program. The program consists of two home visits by a nurse who provides education about diet, hand washing, house cleaning, cleaning of toys, removing shoes when entering the home, and the recommended interval for repeat blood lead testing. During home visits, height and weight measurements are obtained, a nutrition evaluation is conducted using the PEACH tool, and the nurse discusses foods that the child likes to eat that are conducive to reducing the blood lead level. A developmental evaluation is obtained, as well as lead dust wipe samples for information and education. Analysis of developmental evaluations showed that BLL in the 5-9 ug/dL range is associated with developmental delay with language was previously published. During the visits, the nurse observes and discusses the family's challenges, and makes referrals for a variety of other issues including bedbugs, roaches, mold, structural issues in the home, applications for lead abatement grant funds, and applications to local and state programs that provide assistance to families with children. Data will be provided about the primary prevention program, including efficacy in preventing progression to a BLL of 10 ug/dL or higher.