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Published on: January 23, 2017
Non-treatment of screened children with intermediate blood lead levels
Insights
A nurse practitioner
Area of Science:
- Pediatric Environmental Health
- Clinical Nursing Practice
Background:
- Children at risk for lead poisoning require vigilant monitoring.
- Traditional approaches may involve aggressive treatment, even when not strictly necessary.
Purpose of the Study:
- To evaluate the effectiveness of a nurse practitioner-led screening and follow-up program for children at risk of lead poisoning.
- To assess the feasibility of monitoring lead levels without immediate chelation therapy.
Main Methods:
- Implementation of an aggressive screening and follow-up program by a nurse practitioner in a family practice setting.
- Monitoring of venous blood lead levels in at-risk children.
- Close observation of lead level trends in untreated cases.
Main Results:
- Untreated children showed a natural decline in blood lead levels over 12-18 months.
- Individualized care by a nurse practitioner allowed for monitoring without chelation, even in contaminated environments.
- Chelation was only required in the third summer when the city's abatement system failed.
Conclusions:
- Close monitoring by a nurse practitioner can effectively manage lead exposure in children without immediate chelation.
- Non-treatment strategies require a defined population, consistent follow-up, and community cooperation.
- Environmental factors, such as abatement system function, significantly impact lead exposure management.
Abstract:
An aggressive screening and follow-up program for children at risk for lead poisoning was conducted by a nurse practitioner in a small family practice unit. Subsequent venous blood lead determinations untreated cases show the natural fall in lead level over 12 to 18 months. Many of these children would have been chelated by others, yet individualized, specific, personalized care by a nurse practitioner permitted monitoring without treatment even in persistently leaded environments. No chelation therapy was necessary until the third summer, when coincident with a long, hot, dry season, the city's abatement system because nonfunctional. Non-treatment requires close follow-up, a relatively small population, and cooperation from the city.
