How To Get Tested For Lead Poisoning – New Mexico is one of the worst states when it comes to identifying all children with lead poisoning.
That’s according to a study published last week in Pediatrics, a peer-reviewed journal of the American Academy of Pediatrics.
How To Get Tested For Lead Poisoning
Nationally, only 64 percent of lead-poisoned children under the age of five are diagnosed. In New Mexico, that number is much lower—just five percent.
Lead Testing & Removal
Lead paint and lead additives in gasoline were banned decades ago. But the ongoing Flint, Michigan emergency shows that lead poisoning is not a retrograde problem. It is estimated that 3.6 million homes in the United States today have lead-based paint, and 6.1 million have lead pipes.
In a study released by researchers from the Public Health Institute (PHI) using testing data from 1999 to 2010, they estimate that testing rates have decreased.
In fact, when we take a closer look at New Mexico’s own numbers, even though all Medicaid-eligible children between the ages of 12 and 24 months should be tested for lead levels, only 26 to 40 percent were tested in 2015.
According to the New Mexico Department of Human Services’ annual audit, these numbers vary by which health care organization performs the screening. In the year In 2015, Molina screened just 40 percent of the state’s Medicaid-eligible children with lead. The numbers go down from there: Blue Cross and Blue Shield of New Mexico and Presbyterian tested 33 percent each, and UnitedHealthcare tested just 26 percent.
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New Mexico Department of Health (DOH) spokesman Paul Rhine acknowledged concerns about the low testing rate in New Mexico.
“A low screening percentage means some children may miss out on the services they need. Currently, NMDOH’s Childhood Lead Poisoning Prevention Program is actively educating health providers, early childhood services and community programs about screening guidelines, testing requirements and ways to prevent lead exposure, he wrote for NM Politics. “These reports show that when we can find more children with elevated blood lead levels, we can help families eliminate sources of exposure and manage blood lead levels through case management.”
About 2.5 percent of American infants and children under the age of six have high levels of lead in their blood. In Flint, 5 percent of the children tested had elevated levels. As the NM Political Report wrote earlier this year, in more than 25 communities in New Mexico, those numbers were even higher.
In many places in New Mexico, less than 5 percent of children are tested for lead. And in some places there was no test data at all.
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“[High numbers] could mean there’s a serious problem with lead exposure in those communities. But you don’t know how high,” said Eric Roberts, a research scientist at PHI in Oakland, California.
If you are a clinician practicing in an approved environment, there must be many children with lead poisoning, you are encouraged to test more children. In other words, as tests continue to come back positive, it reinforces the need to continue testing in that community.
“But I can see that differently,” he said. “If, for whatever reason, the consensus is that there aren’t a lot of lead-exposed kids in a community, then clinicians aren’t going to have much use in testing.”
That’s why PHI wanted to look independently at how many children are exposed to lead in each state, he said.
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The National Health and Nutrition Examination Survey has been conducted by the Centers for Disease Control (CDC)’s National Center for Health Statistics since the 1960s. The study involved a random sample of Americans of all ages, studying each person carefully, including blood tests, physical exams, dietary analysis, and more.
Looking at the results of that survey, the PHI was an independent way to determine how common elevated lead levels are in the US population. Using that information, they created a predictive model for the prevalence of lead poisoning in children.
“The idea is that by knowing the socioeconomic, racial and housing characteristics of any given state, we can come up with a better estimate of how many lead-exposed children there may be,” Roberts said.
While the CDC is happy to tighten the way for lead exposure — cutting it in half from 10 to 5 micrograms per deciliter — Roberts said there is no safe level of lead in children’s blood.
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“Even at the lowest levels that people can measure, there are visible effects on behavior and there are losses of IQ points,” he explained. Testing that low number doesn’t capture children who are exposed to a “zero dose.”
This is a long-term public health problem, he said. And it can have serious implications not just for a family, but for an entire community.
“It’s very difficult because while I want to emphasize that the risk can affect anyone, there are clearly social justice issues at work here,” he said. “When we built that model to predict elevated blood levels, we knew what variables to use: race, housing, and poverty.”
The American Academy of Pediatrics may revisit its testing recommendations, he said. Or, states can mandate tests for all children.
Childhood Lead Poisoning
But, “Medicaid is needed for all of this. All the kids who signed up had to try, and it just doesn’t happen.
As of January, the New Mexico Department of Health has not responded to NM Political Report’s interview requests about lead testing in children. But in late April, the Department of New Mexico Epidemiology published an article about lead testing among New Mexico children from 2010 to 2014.
According to that article, last year, New Mexico implemented the CDC’s new reference level, lowering the level from 10 to 5 micrograms per deciliter to begin case management. The state also switched from testing all Medicaid-eligible children to “targeted testing of children determined to be at high risk when adequate data are available.”
According to the report, from 2010 to 2014, a total of 75,144 New Mexico children under the age of 6 had at least one blood sample tested for lead. At that time, 168 children under the age of 6 had high levels of lead in their blood.
How Lead Poisoning Is Diagnosed
Screening rates vary between counties. Five percent of children in Bernalillo, Catron, Cary, Harding, Lee, Sandoval, Taos and Union counties were diagnosed, according to that article. Meanwhile, 15 percent of children were diagnosed in Chavez, de Baca, Eddy, Grant, Hidalgo, McKinley, and Quay.
According to the report, screening needs to be improved in San Juan County, the Southwest and Northeast regions, and Bernalillo County.
Children are first given a finger stick test. If the test shows that the child has elevated lead levels, they will have a second, more accurate test. Ryan wrote that when retested several times, “blood lead levels were within the normal range.”
In response to questions about what happens after investigations identify a child or group of children, Rhien wrote that the DOH’s role varies depending on the situation.
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Health care providers must report elevated lead levels to the DOH. When the department’s Childhood Lead Poisoning Prevention Program learns of a child with elevated blood-lead levels, “providers can help identify the source of lead as quickly as possible and then prevent the child from further exposure,” Rhine wrote. He added that the department will work with the health professional to advise and educate the family on lead levels and the child will be retested until the blood lead test results decrease.
“In very rare cases when the lead level is greater than 20 ug/dL (micrograms per deciliter), when the health care provider and family have difficulty controlling the lead levels, or when the provider has difficulty locating the lead source, then we can go to the family’s home and assess lead hazards,” he wrote. No financial support is provided. EPA has a ‘Refresh, Repair and Paint’ program to help with education and indoor lead paint hazards.”
Risks vary by community, he wrote. Children may be exposed to lead if their parents work with metal or have hobbies such as stained glass or selling lead. Children may be exposed to Mexican cooking clay by cooking, eating clay, or coming into contact with black eye makeup (kajal).
“This is why data alone does not always accurately represent what is happening in individual communities in New Mexico,” he wrote.
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In response to questions about communities with large numbers of children exposed to lead, he wrote, “We have yet to find a case where many children in the same neighborhood have elevated blood lead levels that can be explained by a common lead exposure.”
Correction: In the original version of this story, we wrote from December that NMPR was seeking an interview with DOH. That’s when the lead test data was first released by Reuters; We reached out to the DOH in January. Testing children for lead exposure, explained: Shooting – Health News Multiple test options and false positives can leave parents confused about blood lead levels.
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