The DC Childhood Lead Poisoning Prevention Program

Dc Department Of Health, Washington DC

Investigators

Abstract

Childhood lead poisoning is an entirely preventable public health problem. In the District of[unreadable] Columbia, the estimated prevalence of lead poisoning in children ages 0 to 6, at 2.8% in 2005, is[unreadable] slightly higher than the 2.6% observed nationally. However, in poorly maintained residences in[unreadable] low income neighborhoods, this risk is multiplied. More than half of the city?s housing stock[unreadable] (51%) was constructed prior to 1950, when lead-based paint, the most common source of lead[unreadable] poisoning in young children, was used.[unreadable] While the District of Columbia has one of the highest per capita incomes in the United States, it[unreadable] also has some of the deepest pockets of urban poverty. The poverty rate for 2000, at 20.2%, was[unreadable] well above the 12.4% observed nationally. More than three-fourths of the District?s residents[unreadable] with incomes below the federal poverty line (77%) were African America. Almost three-fourths[unreadable] of the District?s children under age 18 (71%) are District are Medicaid recipients. It is these[unreadable] impoverished children and families that are most likely to live in deteriorating homes and[unreadable] apartments where lead-based paint poses the greatest risk. Other risks to these children include[unreadable] contaminated soil, lead pipes in the home, and parents who are exposed to lead at work.[unreadable] Additionally, children of immigrants, refugees and asylees may have been exposed to lead[unreadable] through cooking utensils, pottery, candy, toys, jewelry and other unsafe household items more[unreadable] commonly encountered in third world countries.[unreadable] To address the serious public health problem posed by environmental health, the District of[unreadable] Columbia Department of Health (DOH) seeks funding under a Cooperative Agreement with the[unreadable] Centers for Disease Control and Prevention (CDC) in support of its Childhood Lead Screening[unreadable] and Education Program (CLPSEP). Under the auspices of the Cooperative Agreement, the[unreadable] CLPSEP will undertake a series of activities designed to finalize an Elimination Plan for[unreadable] environmental lead hazard by 2010, which will be implemented by the CLPSEP pursuant to the[unreadable] approval of the inter-agency Lead Screening Advisory Committee (LSAC). CLSEP?s goal for[unreadable] 2010 is to reduce the incidence of new cases of childhood lead poisoning to 25 or fewer per[unreadable] year?a sharp decline from 2005, when there were 351 new lead poisoning cases.[unreadable] Under the Cooperative Agreement the CLPSEP will undertake a number of important activities[unreadable] designed to achieve this goal. Specifically, the CLSEP will expand its capacity to perform blood[unreadable] lead screening by hiring two new outreach investigators. The annual screening rate will be[unreadable] increased from 53% to 95% of Medicaid recipients ages 0 to 6 and from 39% to 0% of all[unreadable] District children in this age range.[unreadable] Targeted outreach will be conducted in neighborhoods in which residences are under Consent[unreadable] Decrees for lead-base paint abatement (n = 4,829) and/or replacement of lead pipes (n = 4,539).[unreadable] Home visits to these residences and surrounding homes will include blood lead testing, visual[unreadable] risk assessments, and tenant education on lead poisoning prevention. Referrals will be made as[unreadable] appropriate for environmental investigations by the DOH Environmental Health Administration,[unreadable] as well to the Department of Housing and Community Development for access to grants and[unreadable] loans for lead abatement.[unreadable] Under the Cooperative Agreement, the CLPSEP will continue to provide outreach, education and[unreadable] lead screening to tenants of all residences to CLPSEP by the DOH Environmental Health[unreadable] Administration for high environmental lead levels. In addition, the CLPSEP will collaborate[unreadable] with DC Water and Sewer Authority to provide these services to families occupying receiving[unreadable] services through the Lead Pipe Replacement Program. Finally, targeted outreach will be[unreadable] provided to immigrants, refugees, asylees, and culturally diverse populations.[unreadable] The CLPSEP will enhance its existing case management protocol to strengthen the coordination[unreadable] and delivery of environmental and medical lead remediation services and enhance the[unreadable] compliance of families with recommended procedures. The CLPSEP will also design and[unreadable] implement a database to track property owners whose properties violate federal standards for[unreadable] environmental lead. Repeated offenders will be referred to law enforcement officials. Finally,[unreadable] the CLPSEP will implement procedures for screening and referral of low-income children to the[unreadable] DC Medicaid Program.[unreadable] The Lead Screening Advisory Committee convened by DOH will continue to meet monthly. Its[unreadable] membership will be expanded to include additional representatives from the banking, lending,[unreadable] construction, and real estate industries, to enhance awareness of lead poisoning and provide[unreadable] education on legal requirements and effective methods for lead abatement. Partnerships with[unreadable] health care providers, child care providers, and other strategic partners will be strengthened, and[unreadable] CLPSEP will provide routine training and education to LSAC members to raise their awareness[unreadable] of childhood lead poisoning. Members will also be used as channels to increase the[unreadable] dissemination of lead poisoning educational materials to the general public.[unreadable] Importantly, negotiations to seek Medicaid reimbursement for blood lead screening, home[unreadable] assessments, and case management services will continue under the Cooperative Agreement.[unreadable] Year 1 funds are requested in the amount of $1,191,722.[unreadable]