Texas Childhood Lead Poisoning Prevention Program Diana L. Salzman, MPH Adult Lead Surveillance Coordinator

1
Texas Childhood Lead Poisoning Prevention
ProgramDiana L. Salzman, MPHAdult Lead
Surveillance Coordinator
2
Reporting Authority

• Texas Health and Safety Code, Ch. 88 (June 2003)
  
• All blood lead levels (BLL) are reportable to the
  Texas Department of State Health Services (DSHS)
  - Children
• Texas Health and Safety Code, Ch. 84 (April 2003)
  Adults
• All BLLs are reportable to DSHS

3
Reporting Authority

• TX Administrative Code Title 25 Part 1
• Allows for case management of children with
  elevated blood lead levels (EBLLs)

4
Texas Childhood Lead Poisoning
Prevention Program

• Department of State Health Services Austin,
  Texas
• Data surveillance component
• Medical and environmental follow up component

5
Texas Childhood Lead Poisoning
Prevention Program

• Department of State Health Services Austin,
  Texas
• Process over 450,000 blood lead reports per year
• Receive blood lead reports from over 17,000
  healthcare providers and 70 laboratories per year

6
Texas Childhood Lead Poisoning
Prevention Program

• Department of State Health Services Austin,
  Texas
• From 1996-2004 received 117,453 blood lead
  reports with results 10 mcg/dL
• Receive 1400 cases per year 15 mcg/dL

7
Texas Childhood Lead Poisoning
Prevention Program

• Department of State Health Services Austin,
  Texas
• Refer EBLLs to local health departments (LHD) or
  public health regions (PHR) for follow up
• Develop educational materials for public and
  health care professionals
• Repository for blood lead reports and related
  information

8
Texas Childhood Lead Poisoning
Prevention Program

• Regional Health Departments 11 PHR
• Regional Lead Contact Case manager, Texas
  Health Steps coordinator (Medicaid),
  environmental inspector
• Triage children with EBLLS when no LHD exists in
  childs jurisdiction
• Refers to regional nurse, case manager or
  environmental inspector

9
Texas Childhood Lead Poisoning
Prevention Program

• Local Health Departments
• Tx CLPPP funds 6 LDHs Bexar County, Webb
  County, Travis County, El Paso County, City of
  Houston, City of Dallas
• Follow up children with EBLLs in respective
  jurisdictions
• Some LHDs have environmental inspectors
• Conduct environmental investigations for EBLL
  children (home, school, or daycare)

10
Texas Childhood Lead Poisoning
Prevention Program

• Additional Partners
• Federal Agencies
• Federal Drug Administration (FDA)
• Centers for Disease Control and Prevention (CDC)
• Housing and Urban Development (HUD)
• Environmental Protection Agency (EPA)

11
Texas Childhood Lead Poisoning
Prevention Program

• DSHS Food and Drug Safety
• DSHS Office of Border Health
• DSHS Medicaid/Texas Health Steps
• DSHS Laboratories (public and private)
• DSHS Environmental Lead Program

12
Texas Childhood Lead Poisoning
Prevention Program

• Plans
• Applying for CDC 5 year grant (FY 2006-2010)
• Fund additional local health departments
• Screening plan being reviewed for possible
  expansion

13
Texas Childhood Lead Poisoning
Prevention Program

• Data Approaches
• 97.5 of blood lead reports are received
  electronically
• 87 of the blood lead reports received are for
  Medicaid enrolled children
• Obtaining environmental inspection data

14
Texas Childhood Lead Poisoning
Prevention Program

• Testing Approaches
• Medicaid/Texas Health Steps guidelines (12 and 24
  months)
• State plan recommends testing all children at 12
  and 24 months

15
Texas Childhood Lead Poisoning
Prevention Program

• Mexico Related Issues
• Texas CLPPP coordinates directly with the Office
  of Border Health for all issues related to
  Mexico. The Office of Border Health works
  closely with the Texas Secretary of State on
  health related issues

16
Questions?