Today's Health With CMT, Beyond Flint: A Healthcare Moment of Truth...

​Although the recent “outbreak” of lead exposure in Flint, Michigan has captured widespread attention, the problem of lead intoxication is hardly new or limited to Flint, MI.  At least as far back as World War II, it was recognized that lead can be ingested from a variety of sources including paint, soil and water drawn from lead pipes.  Other recent articles [1][2] show that lead intoxication is a widespread community health concern as well.

With the reignited public light on this population health concern, Care Management Technologies (CMT), a North Carolina-based leader in population health management and data analytics, quickly developed new measures to assist health care systems and municipalities in identifying children at high risk for lead exposure. CMT used its nimble and expert clinical and data protocols to incorporate guidelines from the CDC and the American Academy of Pediatrics and added the ability to incorporate local guidelines for immediate use.   When elevated blood levels are detected, the CMT measures assist health care managers to ensure that children at risk of exposure, or those who have already been exposed, do not “fall through the cracks.”  The guidelines also make sure that schedules are maintained for recommended repeat tests and assessments for the elevated risk population.  The CMT measures assist the health care system by providing a registry of high risk children for easy identification and follow up with evidence-based assessments and interventions.

It is clear that no amount of lead exposure is benign.  Lead is a neurotoxin and exposure to it can lead to a variety of neuropsychological problems.  In 2012 the CDC reduced its lower blood lead level of concern from 10 •g/dL to 5 •g/dL, but even lower blood lead levels in children have been associated with long-term consequences.  These consequences, which may not become evident until years later, include reduced IQ scores, impaired academic achievement, problems with attention and impulsivity and even risky behaviors in adolescence like smoking and drinking.  Catching elevated lead levels early is critical for the use of chelating drugs for treatment of very high lead levels (usually defined as greater than or equal to 45 •g/dL) although, even with their use, these drugs may not reverse the brain damage leading to these problems.

Health Care Homes and other health systems can utilize the lessons and painful reminders of Flint, MI to get in front of this public health concern by putting in place the practice protocols for identifying those at risk of lead exposure.  For example, children who live in homes built before 1978, have siblings or playmates with elevated blood levels, or live in geographic areas with documented history of raised lead levels in water.  This has also been found to be true for recent immigrants, refugees or foreign adoptees and their access to clean, lead-free water.  As such, aggressive steps should be taken to test for increased lead levels.  When these levels are then found to be high, the use of CMT measures to monitor and track can assist greatly in the testing and evaluation for other complications of lead exposure such as iron deficiency anemia.  It should finally be noted that ongoing neuropsychological evaluation may also be required in various instances.

For further information about CMT's lead measures and other analytic supports and solutions, please contact Carol Clayton, PhD, CEO at 919-674-2547 and visit CMT online at: www.cmthealthcare.com

Sources

[1] Shumway, J. (2016, February 4) Report: 18 Cities In Pennsylvania, Including Pittsburgh, Have Higher Lead Exposure Than Flint. Pittsburgh KDKA, Retrieved from http://pittsburgh.cbslocal.com/2016/02/04/report-18-cities-in-pennsylvania-with-higher-lead-exposure-than-flint/

[2] Wines, M. and Schwartz, J. (2016, February 8) Unsafe Lead Levels in Tap Water Not Limited to Flint. The New York Times, Retrieved from http://p.nytimes.com/email/re?location=InCMR7g4BCKC2wiZPkcVUgd/tOj0oVEs&user_id=1e6509a56f47f6a14ef6738040c06913&email_type=eta&task_id=1455028501854372&regi_id=0