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Lead
Poisoning – the undiagnosed epidemic
Why aren't more
lead poisoned kids being identified?
By Dr. Ben
Balzer, Elizabeth O’Brien and Michelle Calvert.
The LEAD Group
has become increasingly concerned that the extent of blood lead testing in NSW is so low.
Why aren’t more kids being tested?
We wish it was
because there are so few with high blood lead levels, but the truth is, there are more
than 75,000 lead poisoned kids in Australia, and more in NSW than in any other state or
territory. Children are simply not being tested. A blood test is all that is required but
a doctor's request is necessary.
So why aren't
doctors referring children for blood lead tests? We believe it's due to a lack of
awareness of the prevalence of elevated blood lead levels and not enough discussion of the
risk factors for elevated blood lead levels.
New LEAD
Group Policy
Questionnaire screening on
reproductive health
In order to
protect reproductive health and foetuses, pregnant women should be surveyed by
questionnaire to determine if their unborn baby has any risk factor for lead poisoning.
People planning a pregnancy should be surveyed to determine if their eggs or sperm has any
risk for lead poisoning. Risk factors will include those patients renovating pre 1970
homes (a common practice when a baby is due); those who work in a lead industry or
participate in a lead hobby or those who live in a point source community. Those people
with a current risk factor should be lead tested by venous blood sample. If blood lead
levels are elevated then the patient should be removed from the source OR the source may
be able to be moved away from the patient to prevent further poisoning.
Opportunistic
testing
Doctors should
always consider a blood lead test for any child who is having blood tests for any other
purpose.
Universal
questionnaire screening of children.
Without
exception, all children's parents should be surveyed by questionnaire to determine if
their child has any risk factor for lead poisoning. Children with a current risk factor
should be lead tested by venous blood sample. Children exposed to risk factors
historically can have their baby teeth assessed for lead.
Distribution
of Child Lead Risk Factor Questionnaire
The
distribution of the Risk Factor Questionnaire needs to be thoroughly investigated.
One option is
to include the Questionnaire in the Blue Book which the parent of every newborn
receives. However, a one-page addition to the Blue Book costs $75,000, and pages
can only be added when the Blue Book is being revised. The NSW Health Department has
apparently decided that this is not cost effective.
An alternative
is for the Questionnaire to be available for parents to fill out while waiting to see
their GP or Early Childhood Centre nurse.
The LEAD Group
will soon be asking for help from such groups as Rotary, in distributing bulk copies of
child lead risk questionnaires to Early Childhood Centres, especially in inner Sydney.
However,
clients of Early Childhood Centres are not perfectly aligned with the highest risk age
group (9-48 months old), due to the drop-out rate as children get older and for second and
subsequent children.
The best place
to catch the highest risk age group is at the GP surgery. The LEAD Group is investigating
the possibility of sponsorship for the printing of the questionnaire, which will have a
message for doctors on the reverse side.
The proposed child lead risk
questionnaire and the message to doctors is reproduced on the next two pages. If any
of our readers have any suggestions which may assist in raising the rate of blood lead
testing of "at risk" individuals, we would welcome a call on (02) 9716 0132 or
1800 626 086
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