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ARIZONA CHILDHOODLEAD POISONING
OFFICE OF ENVIROMENTAL HEALTH
Christine Cervantez Young
520-770-3124
PREVENTION PROGRAM
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
Arizona Childhood Lead Poisoning Prevention
ProgramOperates within the Arizona Department of
Health Services, Office of Environmental Health
Primarily CDC fundedMaintains Lead Poisoning RegistryProvides case management and
environmental investigationsPerforms health education activities
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM ADHS BLOOD LEAD REPORTING RULE
LABORATORIES REPORT ALL BLOOD LEAD TEST RESULTS
PHYSICIANS REQUIRED TO REPORT ELEVATED BLOOD LEAD LEVELS
– CHILDREN >10 ug/dL
–ADULTS >25 ug/dL
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM TARGETED SCREENING PLAN
All children living in targeted ZIP codes should have a blood lead test at 12 and 24 months of age. Children aged 36 to 72 months should be tested if they have not been previously tested.
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM TARGETED SCREENING PLAN
All Children covered by the Arizona Health Care Cost Containment System (AHCCCS) should be tested according to the Centers for Medicare and Medicaid Services (CMS) requirements, as follows: test all children at 12 and 24 months of age; test children at 36 to 72 months of age if they have not been previously tested.
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM TARGETED SCREENING PLAN
For children not living in a targeted ZIP code area, health care providers should conduct an individual risk evaluation in order to determine whether those children are at increased risk of having an elevated blood lead level (BLL).
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM CASE MANAGEMENT
10-19 ug/dLLead education materials mailed to parentsReminder letters encouraging follow-up
blood testing mailed to parents
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM CASE MANAGEMENT
Persistently 15-19 ug/dLLead education provided over the phone to
parentsEncouraged to schedule environmental
investigationReminder phone calls encouraging follow-
up blood testing
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM CASE MANAGEMENT>20 ug/dL Lead education provided over the phone to parents Encouraged to schedule an environmental
investigation Reminder phone calls encouraging follow-up blood
testing Physician and parents provided investigation results Parents provided recommendations to reduce and
prevent further lead exposure
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM ENVIRONMENTAL INVESTIGATION
CONDUCTED FOR CASES >20 ug/dL & PERSISTENT >15 ug/dL
SAMPLING OF PAINT, SOIL, DUST, WATER & OTHER SOURCES
QUESTIONNAIRE TO IDENTIFY OTHER SOURCES
SPECIFIC INTERVENTIONS PROVIDED TO PARENTS BASED ON FINDINGS
REPORT FINDINGS TO PHYSICIAN
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD EXPOSURES IDENTIFIEDIN CHILDHOOD LEAD POISONING
CASESLEAD-BASED PAINTFOLK REMEDIES- AZARCON &
GRETAIMPORTED POTTERYSOILDUST
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
OTHER EXPOSURES IDENTIFIED IN CHILDHOOD LEAD POISONING CASES
IMPORTED CRAYONS & CHALKIMPORTED TOYS & JEWLERYPLASTIC/VINYL WINDOW BLINDS
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
Healthy People 2010 ObjectiveEliminate Childhood Lead Poisoning
Arizona Elimination Plan Includes
–Addressing Lead Paint & Housing
–Addressing Lead Containing Home Remedies and Pottery Use
–Addressing Blood Lead Screening
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
PARTNERSHIPS
CITY OF PHOENX LEAD HAZARD CONTROL PROGRAM
HOUSING AUTHORIY OF COCHISE COUNTY LEAD HAZARD CONTROL PROGRAM
HEAD START & EARLY HEAD START IN SOUTHEASTERN ARIZONA
PROMOTORA GROUPS
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCE
175134
209 223 210
50 29 30 38 290
100
200
300
2000 2001 2002 2003 2004
Number of Lead Poisoned Childrenin Arizona 2000-2004
20 ug/dL or higher 10 - 19 ug/dL
Data Source: Arizona Lead Poisoning Registry
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCERace/Ethnicity of Lead Poisoned Children
in Arizona 2004
69%
14%
9%3% 2% 3% Hispanic
White Non-Hispanic
African American
American Indian
Asian
Unknown
Data Source: Arizona Lead Poisoning Registry
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCEAges of Lead Poisoned Children
in Arizona 2004
8%
55%
29%
8%
0-11 months
12-35 months
36-72 months
>72 months
Data Source: Arizona Lead Poisoning Registry
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCEBlood Lead Levels of Lead Poisoned Children
in Arizona 2004
70%
18%
5% 7%
10-14 ug/dL
15-19 ug/dL
20-24 ug/dL
>25 ug/dL
Data Source: Arizona Lead Poisoning Registry
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCE
Data Source: Arizona Lead Poisoning Registry
239
137
4418 15 25
0
50
100
150
200
250
StatewideMaricopa Pima Yuma Cochise OtherCountieswith <10
Cases
Number of Lead Poisoned Children by Countyin Arizona 2004
ARIZONA CHILDHOODLEAD POISONING
PREVENTION PROGRAM
LEAD POISONING SURVEILLANCE
Data Source: Arizona Lead Poisoning Registry
42
225
42
163
43
239
63
261
78
239
0
50
100
150
200
250
300
2000 2001 2002 2003 2004
Number of Lead Poisoned Childrenin Arizona Border Counties by Year
Border Counties: Cochise, Pima, Santa Cruz, Yuma Statewide