Report Urges Improved Lead Testing Of Children

Attorney General Spitzer today released a report urging improved testing of infants for lead poisoning. The report includes the Attorney General’s Top 10 recommendations to increase childhood lead testing in New York.

One of the key concerns raised in the new report is that one-year-olds in New York may not be getting tested, as required by law. The report specifically urges HMOs and state health officials to make concerted efforts to ensure these one-year-olds are tested in greater numbers.

"No child in New York should suffer from lead poisoning simply because he or she was not tested in time," Spitzer said.

Spitzer also called on the State Health Department to require that HMOs report lead testing results for both one- and two-year-old children. Spitzer’s office found that even though the law requires screening at both age one and two, the State Health Department currently only requires HMOs to report the number of two-year-olds that are tested. As a consequence, HMOs may not be testing one-year-olds as thoroughly.

Catching lead poisoning at an earlier age is essential to allow parents and doctors to determine how the child is being exposed to lead, protect the child from the lead exposure and provide medical attention before further damage is done. In order to meet the goal set by the federal Centers for Disease Control (CDC) of eradicating childhood lead poisoning by 2010, Spitzer is appealing directly to HMOs to immediately improve lead testing among their network physicians by using the guidelines contained in his report.

Children are exposed to lead primarily from chipping lead paint in their homes, air pollution and lead in various products. Currently, approximately 10,000 children are considered lead poisoned each year in New York State alone. New York has the largest number (3.3 million) and percentage (43%) of homes built before 1950, where lead paint is most likely to be present.

Lead poisoning can decrease children’s intelligence and affect their neuro-behavioral development, growth and hearing. Lead exposure can damage the central nervous system and kidneys and interfere with blood cell formation and development. Most lead-poisoned children will not have obvious symptoms, which is why testing at an early age is essential.

Spitzer’s report recommends that HMOs:

1. Ensure that lead testing starts at age one;
2. Offer incentives to parents who get their children tested on schedule;
3. Offer incentives to doctors who test a high percentage of children;
4. Regularly assess lead testing compliance strategies to help ensure deployment of the most successful strategies;
5. Make testing easier and more accessible at primary doctors’ offices by using less invasive lead testing methods;
6. Engage in early and regular member education, including reminders to expectant parents and attention-grabbing "Birthday Card" lead testing reminders before a child’s first and second birthdays;
7. Translate educational materials into multiple languages to adequately educate diverse member populations;
8. Educate doctors and other providers about the importance of lead testing;
9. Monitor and evaluate network providers’ lead screening practices and numbers; and
10. Conduct regular community outreach to engage and educate members.

Spitzer issued a report on lead poisoning in 2004, which sparked this inquiry and led to the development of these guidelines. The Attorney General’s Office tracked compliance with the lead screening law from 2000 to 2002, using information reported annually to the State Department of Health annually by the HMOs. The report demonstrated that many Medicaid and Child Health Plus HMOs have failed to test children for lead poisoning at an adequate rate, placing New York’s children at unnecessary risk of health impairment.

Lead screening at ages one and two is critical to the CDC goal of eliminating childhood lead poisoning by 2010. At these ages, children begin to explore areas of the house with high concentrations of lead paint chips and lead dust. Because they are still in the earliest developmental stages, they are far more vulnerable than adults to the mental and physical ravages of lead poisoning.

The report was prepared by Assistant Attorney General Paul Beyer of the Health Care Bureau, under the supervision of Troy Oechsner, Deputy Bureau Chief, and Joseph Baker, Bureau Chief.

Consumers and health care providers can call the Attorney General's Health Care Bureau Hotline at 1-800-771-7755. The full text of the report is available on the Attorney General's website: www.ag.ny.gov.

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