Lead poisoning-related case increase anticipated once reporting standards increase

LAFAYETTE, Ind. — Once an Indiana law takes effect this summer, a new position within the Tippecanoe County Health Department will address what could be a 400-percent increase in lead-poisoning cases.

Earlier this year, Gov. Eric Holcomb signed House Bill 1313 into law, effective July 1, that aims to bring state standards for children’s blood lead levels closer in line with the American Academy of Pediatrics’ standards and would require health care providers to screen every child under the age of 6 for lead.

In preparation, the Tippecanoe County Health Department requested county commissioners approve a state-funded position in the Tippecanoe County Health Department – the community health case manager.

The position will be responsible for managing the department’s cases relating to lead, fetal infant mortality  and communicable disease.

The American Academy of Pediatrics recommends that if a child is found to have a blood-lead concentration greater than 5 micrograms per deciliter (μg/dL), pediatricians and primary care providers should work with their federal, state and local governments to ensure a comprehensive environmental inspection is conducted in the housing units of children.

Prior to the new law, Indiana's standard was 10 μg/dL, which was the Centers for Disease Control and Prevention standard from 1991 to 2012. In 2012, the CDC adopted 5 μg/dL as the upper range of acceptable blood lead levels, although the CDC doesn’t believe that there is a safe blood lead level.

The county health department expects to see around a 200- to 400-percent increase in child-related lead poisoning cases in the upcoming year, said Amanda Balser, executive assistant at the Tippecanoe County Health Department.

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“Indiana is adopting what the CDC has had in place for a while. They’re doing case investigation now at 5 instead of 10, so that’s going to bring the case count up 200 to 400 percent for us. So, we needed to add another position for that, because we are already running around on an empty boat. We have to add back into that boat as things happen,” said Balser.

“Anytime time there’s legislation that brings about change and causes more work, we have to jump on that and add a new position to address the workload.”

With the new standard, the health department wants to address all lead-related cases whenever one is discovered. Lead is a neurotoxic that when exposed to young children can cause significant health concerns.

“Exposure to lead can seriously harm a child’s health, including damage to the brain and nervous system, slowed growth and development, learning and behavior problems, hearing and speech problems,” stated the CDC website.

“Protecting children from exposure to lead is important to lifelong good health. No safe blood lead level in children has been identified. Even low levels of lead in blood have been shown to negatively affect a child’s intelligence, ability to pay attention, and academic achievement,” stated the CDC website.

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Another caveat to the new law is its expansion on who needs to be tested for lead poisoning.

Prior to the law, Indiana only required children covered by Medicaid to be screened for lead poisoning, but as of July 1, all health care providers are required to screen every child under 6 for lead.

Funding for the Community Health Case manager

In preparation for the increase rise in testing across Indiana, the state has offered counties funding to create a new position to handle any new cases and investigations.

The state offered Tippecanoe County $88,000 to fund this new position for the next two years.

Commissioners expressed concern the amount might not be enough to fully fund the position.

The health department leaders said current funding will be a good starting point for the first two years and informed the commissioners that additional funding can be reimbursed if the case manager assists neighboring counties.

“So currently we’ll be getting around $88,000 as our max; however, there's smaller counties that will not be able to do their own investigation. And if our person has time, they will probably be given some of those smaller county cases, which we would get reimbursed for that. It’s not going to completely fund the position, but it’ll give it a good start for the first two years,” said Balser, at the recent meeting.

“We do have an environmentalist that has decided to step up and take the classes to be able to do those assessments. So, she will be going to school and we will get a lead machine to test it at homes. We will be testing individuals and homes and then working with the parents and any daycare centers we need to get those cases taken care of.”

Noe Padilla is a reporter for the Journal & Courier. Email him at Npadilla@jconline.com and follow him on Twitter at 1NoePadilla.

This article originally appeared on Lafayette Journal & Courier: Lead-poisoning case increase expected by Tippecanoe Co. Health Department