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LEAST Childhood Lead Program

For the last three years, the LEAST Lead Initiative has focused on improving health system improvements in the treatment of children with elevated blood lead levels in Galveston County. In late 2010, the CEHD in collaboration with CEHD Senior Fellows and others from the NIEHS COEC released a report called “Childhood Lead Exposure in Galveston, Texas, 2006-2008. Blood lead levels among young children, and local interventions to reduce environmental exposure and improve the health system response.” The report was developed in response to continued local concern about lead exposure among local children.

The LEAST Lead Initiative began with clear documentation of current local lead screening, testing and reporting processes, measures of turnaround times for running and reporting blood test results, implementation of improved tools such as reporting templates, and identification of potential improvements to the system at multiple entry points. Additionally, LEAST Lead was able to undertake a study on rates of EBLL’s among Galveston children presenting at the University of Texas Medical Branch (UTMB) which contradicted earlier studies that had found levels above state and national averages.

The study found the rate of elevated blood lead levels for children presenting at UTMB in 2006-08 to be at or below state and national averages of less than 2%. This finding contradicted studies conducted in 1999 and 2007, which claimed rates around 19%.

This study is also unique in looking at children with blood lead levels that fall below the threshold for action but could still harm their health. As scientific knowledge of the human harm from lead exposure has advanced, perceptions of “safe” levels of exposure have changed. Consequently, this study was designed to begin a process for monitoring lower levels of lead exposure that are still recognized to affect early child development and cause physical and cognitive harm, and which can be tracked over time to monitor exposure levels more carefully in Galveston. Our study documents, for instance, that the rate of blood lead levels at so-called “sub-threshold” levels that is, levels shown to cause health harm but that do not trigger automatic public interventions by local authorities is around 17% in the city and 9% in other areas of the county. But this rate is likely overestimated, as the health information system currently does not support highly accurate research on the issue, and we have opted to take a conservative approach in analysis.

The issue of sub-threshold blood lead levels is a concern in any city that has lead, and there is no precedent for what to do. This is the first study in Galveston to monitor this lower level of exposure, and likely one of few in the nation, but we hope it will serve as a model for other communities in demonstrating local commitment to protecting the health and safety of children from lead.

Click here to view the LEAST Lead Report and the Executive Summary.

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