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Environmental Health > Lead Poison Prevention > Flashcards

Lead Poison Prevention Flashcards

1
Q

What are some sources of lead exposure?

A
  • GASOLINE
  • PAINT (HOUSING 27 MILLION UNITS BUILT BEFORE 1940, WATERBURY 85% HOUSES BUILT BEFORE 1978),
  • DUST/SOIL,
  • WATER (NATURAL, PLUMBING),
  • Air,
  • Food Containers (now BPA)
  • Hobbies (solder, pottery, glass, shells)
  • Home remodeling
  • Occupational (Mining, construction)
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2
Q

There are two methods of exposure to lead, which is most common?

A

There is ingestion and inhalation. Inhalation of lead dust is the most common exposure. (Ex. most of the exposure from lead paint is not from children eating paint chips, but from the dust that comes off of old paint)

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3
Q

Where in the body does lead concentrate (specifically in children)?

A

Lead can effect all organ systems, but will concentrate in the developing bones of exposed children…re-leeching back into the blood stream long after exposure is an issue

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4
Q

History of lead as a disease causing substance

A
  • Effects known pre BC - Roman Sweetener
  • 1700s well known occupational disease impact
  • 1897 observed as disease in children in Australia
  • 1904 Australia, Gibson pinpointed lead paint as source of childhood illness
  • First Case Childhood Disease Report in US 1914 Disease known elsewhere prior to that. Australia and Europe banned the use of lead in paint
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5
Q

What are some of the symptoms of lead exposure (low to moderate levels)?

A

Extremely vague symptoms that are identical to many other conditions:

ABDOMINAL PAIN
HEADACHE
VOMITING
LETHARGY

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6
Q

Health Effects of Lead Exposure

A
  • Primary target: CNS
  • KIDNEY Damage
  • HEARING LOSS
  • IMPAIRED MENTAL PERFORMANCE
  • PREMATURE BIRTHS LOW BIRTH WEIGHT
  • IMPAIRS VITAMIN D METABOLISM
  • Anemia, elevated BP in middle-to-old age
  • Very high lead levels in children can cause severe neurologic problems such as coma, convulsion, and death
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7
Q

Two primary forms of treatment for lead poisoning

A

CHELATION - treatment involving the IV injection of a chemical that binds to lead in the body, allowing it to be excreted

NUTRITION -
DIET RICH IN CALCIUM AND IRON

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8
Q

What is the reportable threshold of blood lead level for Connecticut children?

A

5 ug/dl or greater is reportable to the DPH

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9
Q

Disparities in lead exposure

A
  • CHILDREN
  • BLACK population >24.5% Have BLL >25 ug/dl

(General Population = 5%)

  • CT 2 to 6.5% of children < 6 have EBLL in larger cities
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10
Q

What are some occupations with greater risk of lead exposure?

A

STEEL Workers
PAINTERS
CARPENTERS, CONSTRUCTION
MINING
SMELTING
RECYCLING
Take Dust Home to Families

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11
Q

What was one method of lead control that CT used that avoided legislation?

A

Control through contracts…DPH told DOT to require its contractors to take procautions and reduce the use of leaded (?) products

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12
Q

What are some issues with home lead abatements?

A
  • Who performs the work?
  • Issues of Certifications and training,
  • Cost to customers
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13
Q

Universal lead screening in CT…who?

A
  • Kids under 6 years (3 tests before 6yo)
  • Not federally mandated
  • FINGER STICK VS CONFIRMED (VENOUS, Gold Standard)
  • Lowering of reportable standard…down from 70ug/dl - 5 today
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14
Q

What are the target areas for lead pollution?

A
  • URBAN Areas
  • PRE 1960 HOUSING
  • Highways
  • Near INDUSTRY (SMELTING, BATTERY RECYCLING)
  • USE OF CENSUS DATA to identify low SES areas
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15
Q

Who are target populations in lead control?

A
  • CHILDREN <6
  • MINORITY (BLACK, HISPANIC populations)
  • WIC, EPSDT PROGRAMS, WELL CHILD CONFERENCES
  • DISPROPORTIONATELY AFFECTS THE POOR
  • SINGLE FEMALE HEAD OF HOUSE ( NORTH CAROLINA STUDY)
  • SCREENING BEST DONE DOOR TO DOOR
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16
Q

Lead control federal funding story…

A
  • Categorical funding from the feds originally…
  • Post 1980, the funding was rolled into a block grants. Hartford, Waterbury and New Haven kept funding their lead prevention programs while other departments diverted the money elsewhere
  • Funding has returned to categorical as per CDC
17
Q

Agencies involved with Lead Control…pretty obvious

A

FEDERAL
EPA, HUD, FDA, CDC, CPSC
STATE
DPH, DEEP, DCP, DOH
LOCAL
HEALTH, HOUSING, POLICE

18
Q

Lead Sampling Sources

A

PAINT CHIPS
DUST
SOIL
AIR
XRF (X-RAY FLUORESCENCE) - Caleb

19
Q

Major issues of Lead abatement/remediations

A
  • COST (FORECLOSURE, INCREASED RENT)
  • RELOCATION (MOVE TO HOUSE WITH INTACT LEAD PAINT ??)
  • CONCERNS FOR LOCATION OF SCHOOL, FAMILY, SHOPPING, TRANSPORTATION, NEIGHBORHOOD, ETC.
  • TRAINED WORK FORCE (TRAINING COURSE APPROVAL)
20
Q

What methods of remediation can and cannot be use?

A
  • NO DRY METHODS (NO SCRAPING, SANDING)
  • NO BURNINGCAN USE
  • REMOVAL
  • WET STRIPPING
  • ENCAPSULATION
  • HEPA VACUUMING
21
Q

Talk to me about lead exposure prevention

A
  • APPROPRIATE CLEANING METHODS
  • REMOVAL FROM GASOLINE (Complete around 1980)
  • REDUCTION OF LEAD IN PAINT
  • REDUCTION IN FOOD (ESPECIALLY BABY FOOD)
  • BAN LEAD SOLDER (PLUMBING [1983 IN DRINKING WATER LINES ENFORCED 1986 SDWA] AND FOOD CONTAINERS [1983])
22
Q

Aspects of 1992 lead prevention legislation

A

TITLE X October 1992

  • TARGET HOUSING PRE 1978
  • HUD TO ABATE PRE 1950, INSPECT ALL PRE 1978, MANAGEMENT PLANS
  • DISCLOSURE REQUIREMENT PRE 1978 HOUSES, RENTAL UNITS
  • ALL STATES GETTING HUD FUNDS MUST HAVE LEAD ABATEMENT REGS. AS PROTECTIVE OF PUBLIC HEALTH AS EPA…
  • IF NOT EPA RUNS PROGRAM and STATE LOSES HUD FUNDS
23
Q

Billick Article

A

Reduction of lead in gasoline stemming from HUD studies that demonstrated seasonal variations BLL of NYC children corresponding to season variations in gasoline use.

Very complex issue to solve due to confounders (many other sources of lead, unsure if control of gasoline would have a significant effect) and lack of inter-agency communication at the federal level among those that have authority over sources

Environmental Health (4 decks)

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