Lead Testing: What Family Physicians Can Do

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Michigan Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines require children to be tested for blood lead poisoning at 12 months and 24 months, and between the ages of 36 and 72 months if not previously tested. Due to the enhanced public health issue of an increased risk for lead exposure in the City of Flint, Michigan Chief Medical Officer Eden Wells, MD, MPH, FACPM recently sent out an advisory to providers to follow enhanced guidelines for lead testing in children.

Healthcare providers should screen ALL children (regardless of Medicaid/insurance status) aged 0-6 years of age exposed to Flint city drinking water after April 2014. Note: this includes all children younger than 1 year and children between the ages of 3 and 6 years.

If a child has already been screened within the time period of April 2014 to the present by a capillary test, healthcare providers should follow-up on any elevated levels >5mcg/dl to ensure confirmatory venous testing is conducted.

Utilize the standard Blood Lead Level (BLL) Quick Reference for Primary Care Providers.

All patients with blood lead levels greater than 5mcg/dl should be referred for case management coordinated through Genesee County Health Department. Providers can make referrals for case management at 810-257-3833.

Providers should inquire about use of a drinking water filter and/or bottled water in all clients residing in city limits. Clients and providers can call 2-1-1 for locations for filter distribution.

All people with Flint water should be advised to eat regular meals with a diet high in calcium, iron and Vitamin C to decrease lead absorption, mitigate the effects of lead exposure, and to enhance the excretion of lead.

Healthcare providers should inquire about other potential sources of lead in the household per current recommendations.

For more information, click here.

To read about Governor Snyder's focus on the Flint water crisis during his 2016 State of the State adress on January 21, and his call for the legislature to commit to more than $28 million in supplemental funding for crisis intervention in Flint, click here.