North Carolina Childhood Blood Lead Surveillance Data. 10 micrograms per deciliter ( g/dl). Confirmation is g/dl within a six-

Transcription

1 North Carolina Childhood Blood Lead Surveillance Data 10 micrograms per deciliter ( g/dl). Confirmation is g/dl within a six-

2 2011 NORTH CAROLINA CHILDHOOD BLOOD LEAD SURVEILLANCE DATA, BY COUNTY Ages 1 and 2 Years Tested for Lead Poisoning Ages 6 Months to 6 Years Target Number Percent Tested Among Lead Percent Number Confirmed County Population* Tested Tested Medicaid** id** Tested ALAMANCE 3,740 1, , ALEXANDER ALLEGHANY ANSON ASHE AVERY BEAUFORT 1, BERTIE BLADEN BRUNSWICK 2,158 1, ,658 BUNCOMBE 5,243 3, ,628 4 BURKE 1,837 1, ,554 1 CABARRUS 4,893 2, ,285 CALDWELL 1,655 1, ,326 CAMDEN CARTERET 1, CASWELL CATAWBA 3,732 2, ,810 CHATHAM 1, CHEROKEE CHOWAN CLAY CLEVELAND 2,327 1, ,144 COLUMBUS 1, ,258 CRAVEN 3,384 2, ,481 1 CUMBERLAND 12,033 4, , CURRITUCK DARE DAVIDSON 3,616 2, , DAVIE DUPLIN 1,603 1, ,227 DURHAM 8,680 4, , EDGECOMBE 1,445 1, ,254 3 FORSYTH 9,527 6, , FRANKLIN 1, GASTON 5,330 1, , GATES GRAHAM GRANVILLE 1, GREENE GUILFORD 12,153 9, , HALIFAX 1,284 1, ,169 4 HARNETT 3,491 1, ,311 2 HAYWOOD 1, HENDERSON 2,254 1, ,748 1 HERTFORD HOKE 1, HYDE IREDELL 3,736 1, ,138 1 JACKSON JOHNSTON 4,678 2, ,798 2 *Target Population is based on the number of live births in 2009 and 2010 Prepared by Children's Environmental Health Unit **Includes ages 9-11 months Last updated 09/12/2013

3 2011 NORTH CAROLINA CHILDHOOD BLOOD LEAD SURVEILLANCE DATA, BY COUNTY Ages 1 and 2 Years Tested for Lead Poisoning Ages 6 Months to 6 Years Target Number Percent Tested Among Lead Percent Number Confirmed County Population* Tested Tested Medicaid** id** Tested JONES LEE 1,725 1, ,520 1 LENOIR 1, ,355 4 LINCOLN 1, MACON MADISON MARTIN MCDOWELL MECKLENBURG 28,348 9, ,454 2 MITCHELL MONTGOMERY MOORE 1,877 1, ,430 NASH 2,438 1, ,117 3 NEW HANOVER 4,575 3, , NORTHAMPTON ONSLOW 8,352 2, , ORANGE 2,509 1, ,199 1 PAMLICO PASQUOTANK 1, PENDER 1, PERQUIMANS PERSON PITT 4,451 1, ,228 1 POLK RANDOLPH 3,382 1, ,314 1 RICHMOND 1, ROBESON 4,232 2, ,329 1 ROCKINGHAM 1,991 1, ,344 ROWAN 3,224 1, ,105 2 RUTHERFORD 1, ,040 2 SAMPSON 1,781 1, ,556 2 SCOTLAND 1, STANLY 1,406 1, ,215 1 STOKES SURRY 1,672 1, ,263 SWAIN TRANSYLVANIA TYRRELL UNION 5,016 1, ,339 VANCE 1, WAKE 25,715 10, ,550 6 WARREN WASHINGTON WATAUGA WAYNE 3,284 2, , WILKES 1, WILSON 2,122 1, ,780 2 YADKIN YANCEY STATE 249, , , *Target Population is based on the number of live births in 2009 and 2010 Prepared by Children's Environmental Health Unit **Includes ages 9-11 months Last updated 09/12/2013

4 NORTH CAROLINA DIVISION OF PUBLIC HEALTH FOLLOW-UP SCHEDULE FOR DIAGNOSTIC / CONFIRMED BLOOD LEAD LEVELS FOR CHILDREN UNDER THE AGE OF SIX Blood Lead Level Response (Clinical and environmental follow-up is based on the rounded test result.) <5 µg/dl less than 4.50 µg/dl) Educate family about lead sources, environmental assessment & prevention of lead exposure Perform another blood lead test at age 2, earlier if risk of exposure increases All diagnostic (i.e., confirmation) tests should be performed as soon as possible within the time periods listed below. If diagnostic test result falls into a lower category - follow response for that risk category. If diagnostic or follow-up test result falls in a higher category conduct another (venous) diagnostic test based on the higher risk category & follow response for that risk category. 5-9 µg/dl µg/dl) within 3 months) µg/dl µg/dl) within 1 month) µg/dl µg/dl) within 1 week at µg/dl within 48 hours at µg/dl within 24 hours at µg/dl) >70 µg/dl greater than or equal to µg/dl) immediately as emergency lab test) Educate family about lead sources, environmental assessment & prevention of lead exposure If diagnostic test result is 5-9 µg/dl Take environmental history to identify lead sources & emphasize the importance of environmental assessment to identify and mitigate lead hazards Continue follow-up testing every 3 months until 2 consecutive tests are <5 µg/dl If diagnostic test result is µg/dl Refer to local health department for environmental investigation Continue follow-up testing every 1-3 months until 2 consecutive tests are <5 µg/dl If diagnostic test result is µg/dl Refer to local health department for required environmental investigation Provide clinical management Refer children to CDSA* Early Intervention or CC4C** as appropriate Refer to Social Services as needed for housing or additional medical assistance Continue follow-up testing every 1 month until 2 consecutive tests are <5 µg/dl If diagnostic test result is 70 µg/dl Hospitalize child and begin medical treatment immediately Refer to local health department for required environmental investigation Refer children to CDSA* Early Intervention or CC4C** as appropriate Refer to Social Services as needed for housing or additional medical assistance Continue follow-up testing every 1 month until 2 consecutive tests are <5 µg/dl *Children s Developmental Service Agency **Care Coordination for Children 3/24/16

5 Summary of Public Health Actions Based on Maternal and Infant Blood Lead Levels All Women of Child-Bearing Age Provide anticipatory guidance, provide health education materials, test workers according to established guidelines, and manage elevated BLLs according to adult lead guidelines (OSHA Medical Guidelines) Pregnant Women Confirm and referrals Environmental assessment & abatement of lead paint hazards Provide anticipatory guidance Notify health department Medical emergency Chelation therapy Medical removal from occupational exposure Lactating Women Lactation should be continued, but breast milk should be pumped and discarded until BLLs <40 Breastfeeding should be encouraged Breastfeeding may be initiated if infant s BLLs monitored Neonates (<1 Month of Age) 2 weeks 1 month 24 hours Follow local pediatric lead screening guidelines Infants (1-6 Months) 1-3 months 1 month 3 months 1-3 months 24 hours Follow local pediatric lead screening guidelines Micrograms/ Deciliter cs vi