Take the Lead on Lead: Feasibility of a Telemedicine-Based Clinic for Lead Poisoning Prevention and Management.

OBJECTIVE

Despite there being no safe amount of lead in the body, most public health and clinical interventions are focused on secondary prevention. A greater emphasis on early outreach may reduce cumulative lead exposure. Towards this end, we aimed to assess the feasibility of a virtual model for lead poisoning prevention and management among at-risk populations.

METHODS

We developed the Take the Lead on Lead (TLOL) clinic, a telemedicine-based program to facilitate educational visits, lead identification, and individualized resource allocation. We recruited patients aged 9 months-5 years with detectable, but low, BLLs (≥2 μg/dL and <10 μg/dL) from two urban academic medical centers in Boston, MA. Virtual visits featured a remote residential inspection to identify potential lead hazards and inform targeted counseling. Families also received a lead testing and temporary mitigation kit, community referrals, and follow-up BLL surveillance, as indicated.

RESULTS

Among 35 participants, most were Black, non-Latinx (51.4%) with residence in homes constructed before 1970 (60%). Potential lead hazards were visualized in the majority of homes that underwent a virtual home inspection (71.4%). On a post-participation survey, most families found that TLOL participation addressed their clinical concerns; provided actionable resources; and helped identify lead sources.

CONCLUSIONS

The TLOL program enabled detailed residential lead identification and early resource access with high levels of participant satisfaction. Further work is needed to assess the efficacy and cost-effectiveness of telemedicine-based care models applied towards lead poisoning prevention efforts.