|, 2001, ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News ( ISSN 1440-0561)
The Journal of The LEAD (Lead Education and Abatement Design) Group Inc.
Case Lead Poisoning and
Elizabeth O'Brien, Manager, Lead Advisory Service
Information Gathered and Ignored
Adrian Oates' 1st blood lead test result was 31.7 µg/dL. The repeat result was 33.3 µg/dL. Lead concentrations equal to or greater than 15 µg/dL are a notifiable disease. In opposition to the NHMRC guidelines listed previously, Adrian was not referred to a paediatrician on the basis of this blood lead result and no environmental assessment was carried out.
According to John Devlin, Environmental Health Officer at West Coast Council, the Director of Public Health did not notify the West Coast council of this blood lead result (pers comm. with E O'Brien 28 Sep 2000). The lower of the two results was later reported in the Menzies Centre study but the summary of the study presented to the West Coast Council on 21 June 2000, did not specifically mention this result or give the number of children with a notifiable blood lead level.
Makayla Oates' 1st blood lead test result was 9.5 µg/dL. Denise's grandson (her daughter's son) Alex had a blood lead level of 18 µg/dL according to Denise but Denise's daughter was not notified or given any information on lowering the blood lead level. Alex was required to have another blood lead test in three months time.
Denise Oates says that the 1st blood lead test on Adrian was so high that a second test was carried out. Adrian was re-tested (March 1998) but she was apparently not notified of the result or telephoned with advice. Adrian Oates 2nd blood lead test result was 32.1 µg/dL. In opposition to the NHMRC guidelines listed above, Adrian was not referred to a paediatrician on the basis of this blood lead result and no environmental assessment was carried out.
On the 2nd April 1998, Dr Mark Jacobs, Director of Public Health issued Public Health Act 1997 Guideline No. 1 "Notifiable Diseases, Human Pathogenic Organisms and Contaminants" which listed "Lead poisoning (whole blood lead level greater than 15 µg/dL or 0.72 µmol/L, not related to an occupational exposure)" as a disease to be notified by a laboratory within one working day.
Adrian was referred to a paediatrician because Adrian's mother was concerned about his difficult behaviour. The paediatrician was concerned about Adrian's delayed speech and ordered some blood tests. He included a lead test after Denise told him that Adrian had had high blood lead levels in 1997. Adrian's 3rd blood lead (PbB) test was on the 20th January 1999 and the result was 41.7 µg/dL. The paediatrician ordered repeat blood lead tests for Adrian every 3 months after this. The results of the familys subsequent blood lead tests are summarised here and appear in the graph.
Apr 1999 Adrian's 4th PbB result = 35.6
As required by regulation, a copy of the results of all the above tests (except for Denises acceptably low result) were apparently sent to the Director of Public Health. According to John Devlin, Environmental Health Officer at West Coast Council, the Director of Public Health did not notify the council of any of these blood lead results (personal comments 28 Sep 2000 and 16 Oct 2000).
According to Denise Oates, Adrian and Makayla and her grandson Alex were blood lead tested in December 1997 for a survey carried out by the Menzies Centre for Population Health Research. She says that her son Tyler was said to be too young to be included in the survey - he was 10 months old.
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