Lead poisoning remains a serious public health concern, particularly for children. Even in small amounts, lead can cause irreversible damage to a child’s cognitive development, learning abilities, and behavior. As Dr. Louie Olive of Elliot Primary Care at Londonderry rightly states, “Preventative care is the most important kind of medicine.” In line with this belief, the state of New Hampshire requires that all one- and two-year-old children are screened for lead. Elliot Health System has undertaken significant efforts to increase the number of children in our community who are properly screened for lead poisoning, helping to safeguard their futures.

Why lead screening is critical

Lead is a potent neurotoxin that can cause lifelong harm to children. Lead exposure can significantly impact a child’s brain development. The damage from lead poisoning is permanent, making early detection through screening crucial. Even tiny amounts of lead dust can cause:

  • Delays in speech, learning, growth and development
  • Hyperactivity and behavior challenges
  • Lower IQ and lower achievement in school
  • Damage to a child’s body, including brain, kidney, and nervous system
  • Hearing loss
  • Death

Identifying elevated lead levels in children allows parents and healthcare providers to take immediate steps to prevent further exposure and lessen potential harm to the child’s health.

How does lead poisoning happen?

Lead poisoning occurs when lead is ingested, inhaled, or absorbed through the skin. Common sources of lead exposure include lead-based paint, which was widely used in homes before it was banned in 1978, and contaminated well water and soil. In older homes, particularly those in low-income areas, lead may still be present in the paint, dust, pipes, faucets, and other plumbing fixtures. Children living in these environments are at a particularly high risk.

Young children, especially those under six years old, are the most vulnerable to lead poisoning. Their bodies are rapidly developing, making them more susceptible to absorbing lead. Additionally, because young children often put their hands or objects in their mouths, they can easily ingest lead dust found in their environment.

The dangerous decline in lead screening

Unfortunately, lead screening rates have been declining. Since 2019, New Hampshire has seen a 25% drop in lead screening rates for children aged 72-months and younger. At Elliot Health System, we recognized this trend and identified an opportunity to improve care for some of our most vulnerable patients—infants and young children.

Elliot Health System’s commitment to lead screening

In response to this critical need, Elliot Health System set an ambitious goal: to achieve an 85% lead screening rate for 1-year-olds. We formed a multidisciplinary lead workgroup comprised of physicians, nurses, patient service representatives, medical assistants, continuous improvement specialists, data analysts, IT specialists, and office managers. When our workgroup began its efforts, the screening rate for this age group was 68%. Understanding the importance of early detection, the team collaborated to identify the reasons why children might miss their screenings and developed practical solutions to overcome these challenges.

Key initiatives included working closely with our IT department to set up automatic reminders for providers and ensuring that lead screening is prioritized during well-child visits. Additionally, nurses and medical assistants received training to collect testing samples directly in the office, streamlining the process and making it more convenient for families.

These efforts have already shown significant progress, with our screening rates improving by 20%–exceeding our goal. This success reflects the dedication of our staff and the effectiveness of our approach in ensuring that every child receives the preventative care they need.

Moving forward

Elliot Health System is committed to protecting the health and well-being of our community’s children. We can help prevent the devastating effects of lead poisoning by prioritizing screening and continuing to improve our processes. Following our success with one-year-olds, our focus now shifts to include increasing rates of two-year-old screening. Through our ongoing efforts, we are working to ensure that every child can grow, learn, and thrive in a safe and healthy environment.

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