Middle GA Head Start to test students for lead poisoning

hduncan@macon.comMarch 15, 2012 

Middle Georgia Head Start agencies in 13 counties will be providing free testing for lead poisoning to enrolled children, because the area has the state’s highest incidence of lead poisoning in young children.

A grant of almost $100,000 from the U.S. Environmental Protection Agency will provide the testing in the North Central Health District next school year. The district includes Bibb, Houston, Crawford, Jones, Peach, Twiggs, Monroe, Baldwin, Putnam, Washington, Wilkinson, Jasper and Hancock counties.

Children found to have elevated blood lead levels will receive home visits to help identify and reduce lead exposure.

Although all children receiving Medicaid are supposed to be tested for lead poisoning, the district has the lowest testing rate in Georgia. Among those who are tested, the incidence of lead poisoning is almost four times higher than the state average in the rural counties and twice the state average in the urban counties, according to a summary of the grant application.

“We’re embarrassed and we’re going to try to fix it,” said Dr. David Harvey, director of the North Central Health District. “In Middle Georgia, we are not providing the care we should be.”

Breathing or ingesting lead can damage the brain and kidneys. In children, it can stunt mental and physical growth.

“If we don’t catch blood poisoning early, that child can be extremely developmentally delayed,” said Janice Haker, director for the Georgia Head Start Collaboration at the Georgia Department of Early Care and Learning. “And people die from lead poisoning.”

Deteriorating lead paint is the most common source of lead exposure. Although banned in 1978, it remains common in older homes. But lead exposure also comes from toys manufactured in countries such as China and in some Mexican candy and food products marketed to children, Harvey said.

The goals of the grant are to increase testing in the district’s 10 rural counties from 9 percent to at least 25 percent within a year; to educate primary care providers about lead risks and testing requirements; and to evaluate a geographic information system risk model in Bibb County that will identify high-risk neighborhoods and the children who live in them.

Dr. Anil Mangla, an adjunct professor in the Mercer University School of Medicine who helped design the grant proposal, said that neighborhoods’ age, predominant race, poverty level, and other risk factors will be used to build a new GIS database that will be integrated into the state’s immunization registry. The long-term goal would be that when a child goes to a pediatrician to receive a vaccine, that child’s address, race or other risk factors could immediately cause the pediatrician to be notified if they are at a higher risk for lead poisoning and need a blood test.

Higher risk for Bibb

For at least one risk factor, Bibb County may be at higher risk than the state average. Statewide, 20 percent of housing units were built before 1978. But almost 80 percent of Macon housing was built before that time, according to a 2010 Mercer University study.

Through the EPA grant, blood testing will also be available to some other young children in target areas served by participating Head Start agencies, Haker said. State officials have not yet determined how those will be selected. But testing could be offered, for example, to day cares that serve a high number of children who are eligible for Medicaid, she said.

Children whose initial test reveals blood lead levels of 15 micrograms per deciliter or higher -- a threshold set by the Centers for Disease Control and Prevention -- will receive a second test to confirm the results, said Margaret Gunter, healthy homes coordinator for the health district.

If the second test is higher than 10 micrograms per deciliter, then district health officials will follow up by offering testing to other family members, she said. The family will also receive a home visit to help them identify lead hazards in their homes. If no hazards are found there, health officials could look at other exposure routes such as a day care or the home of a relative where the child spends a lot of time, Gunter and Harvey said.

Children with very high lead levels, such as those exceeding 45 to 70 micrograms per deciliter, can be treated to reduce the lead load. Although this won’t reverse damage already done by lead poisoning, it can halt or reduce future damage, Harvey said. The therapy is called chelation. It uses a protein that attaches to lead in the blood, slowly removing it with the body’s wastes, he said.

Haker said, “At least if you can stop it when children are young, their bodies can develop new synapse paths” as they grow, so their own bodies can help them work around the damage.

Harvey said if developmental assessments, which are already supposed to be done by Head Start, can be correlated to the blood test results, that could provide valuable information about the damage caused by lead poisoning.

In 2010, 14 percent of Georgia children under age 6 with Medicaid who were tested for lead were found to have unsafe levels in their blood, according to the Georgia Department of Public Health.

The state estimates about 16,327 children under age 6 are at risk for elevated blood lead levels, based on poverty levels and the amount of housing built before 1950.

Carla Coley, district environmental health director, said that although old and historic housing is common in both high- and low-income neighborhoods, the paint is more likely to be deteriorating in low-income units.

“And often the money is not there to do the renovations or abatement to protect those kids in those homes,” she said.

There is no money for abatement in the EPA grant, either. But Coley said Gunter can help families with creative, no-cost changes that might reduce lead paint exposure. Examples might include positioning furniture in front of chipping areas or nailing a window shut so its lead paint is less likely to flake off or be released in dust when the window slides up and down.

Gunter noted that public housing and Section 8 housing is eligible to receive funding from the U.S. Department of Housing and Urban Development for repairs that reduce lead exposure.

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