Christensen Krista, Coons Marjorie J, Walsh Reghan O, Meiman Jon G, Neary Elizabeth
Wisconsin Childhood Lead Poisoning Prevention Program, Wisconsin Department of Health Services, Division of Public Health, Bureau of Environmental and Occupational Health, Madison, Wisconsin.
Wisconsin Childhood Lead Poisoning Prevention Program, Wisconsin Department of Health Services, Division of Public Health, Bureau of Environmental and Occupational Health, Madison, Wisconsin,
WMJ. 2019 Apr;118(1):16-20.
In 2016, 4,353 Wisconsin children under 6 years of age were identified with elevated blood lead levels (≥ 5 μg/dL). There is no safe level of lead in the human body; extensive research shows that children with blood lead levels < 5 μg/dL may still be at risk for adverse health effects including developmental delays.
Physicians should follow current guidelines and consider factors such as the child's age, socioeconomic status, and housing situation when determining need for testing. In addition to Wisconsin's screening recommendations, federal requirements exist for testing Medicaidenrolled children. Under state statute, all blood lead test results and specified demographic information must be reported to the Wisconsin Childhood Lead Poisoning Prevention Program. To eliminate elevated blood lead levels, primary prevention is key. Physicians play an important role by educating parents, prospective parents, and caregivers about lead poisoning risks and prevention measures. Physicians are also vital in secondary prevention-mitigating the adverse effects in children already exposed to lead. Secondary prevention requires first identifying children with elevated blood lead levels through appropriate testing. Use of the Wisconsin Blood Lead Registry can alert providers about children with elevated blood lead levels and reduce duplicate testing. Recent surveillance data show current screening is inadequate; in 2015, only 32% of Medicaid-enrolled children received appropriate testing. Physicians should provide clinical management for children with elevated blood levels and their families.
Physicians are a vital partner in preventing, identifying, and mitigating the effects of elevated blood lead levels for Wisconsin's children.
2016年,威斯康星州有4353名6岁以下儿童的血铅水平升高(≥5μg/dL)。人体内不存在安全的铅含量水平;广泛的研究表明,血铅水平<5μg/dL的儿童仍可能面临包括发育迟缓在内的不良健康影响风险。
医生在确定检测需求时应遵循现行指南,并考虑儿童年龄、社会经济地位和居住情况等因素。除了威斯康星州的筛查建议外,对于参加医疗补助计划的儿童还有联邦检测要求。根据该州法规,所有血铅检测结果和特定人口统计信息必须报告给威斯康星州儿童铅中毒预防项目。要消除血铅水平升高的情况,一级预防是关键。医生通过教育父母、准父母和护理人员了解铅中毒风险和预防措施发挥重要作用。医生在二级预防中也至关重要——减轻已经接触铅的儿童的不良影响。二级预防首先需要通过适当检测识别出血铅水平升高的儿童。使用威斯康星州血铅登记处可以提醒医疗服务提供者注意血铅水平升高的儿童,并减少重复检测。最近的监测数据表明目前的筛查不充分;2015年,只有32%参加医疗补助计划的儿童接受了适当检测。医生应为血铅水平升高的儿童及其家庭提供临床管理。
对于预防、识别和减轻威斯康星州儿童血铅水平升高的影响,医生是至关重要的合作伙伴。