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Wisconsin physicians have new recommendations to test all children for elevated levels of lead in their blood.
The State Department of Health Services is calling for universal lead testing for all one and two-year-olds and up to age five if not previously tested.
The number of Wisconsin children who were tested dropped 75% from April 2019 to April 2020 according to DHS.
Dr. Beth Nieri is a retired pediatrician, adjunct assistant clinical professor of pediatrics at the UW School of Medicine and Public Health,
and co-president of the Wisconsin Environmental Health Network.
She joins us to detail why these recommendations are needed, and Dr. thanks very much for being here.
Thank you for inviting me.
How important is it that young children be tested for blood lead levels?
It is critical, and I'm really so proud of our state for taking this step.
Right now we have what's called targeted testing, and as a result of that we miss a lot of children.
I don't think we have a good handle on how many children in the state are being poisoned by lead.
How concerning is it as the DHS reports that the number of children being tested has fallen off?
That's extremely concerning.
I mean, part of it was COVID because children weren't going in to see their doctors.
But when you have targeted screening, you're going to miss some children.
When we go to Universal, we'll be able to find all the children who are affected by lead.
And what is targeted screening?
Targeted means you have a questionnaire, and if any of the answers to the question are positive, then you do a lead screen.
And our previous targeted testing was based on the age of the housing.
So we would capture, hopefully, children who were lead poisoned by paint.
But we would miss children if it was lead pipes.
If it was other things, such as living near a small airport that still uses leaded gasoline and small aircraft,
we might miss children who had food that was contaminated.
As with this last case, we saw in November 2023.
What happens to a child if they have lead in their blood?
Well, lead is a toxicant.
It affects every organ in the system, but it is awful for the human brain.
And if we think of children from the ages of zero to five, that brain is still developing.
It's creating these pathways, and it's their future.
So what happens is that it interrupts these circuits in the brain.
So the result is we see children who have lower IQ.
It affects what we call executive function, and that means the ability to sit still in class to regulate your emotions,
to reason through things.
So when you think about a child who can't do that, and in kindergarten, maybe they can't sit still,
and they can't focus, they can't learn.
And so what we discovered is that if we had elevated lead levels in children,
it affected their third grade reading and math scores.
It affected high school graduation rates, and it's linked to incarceration.
So it's awful for the child, but it has societal implications for all of us.
Is there any way to treat it if a child has elevated levels?
That's a very difficult question.
So once it's in the body, the body sees lead as calcium, and so it gets stored in the bones.
The only time we actually treat a child for lead poisoning is if their level gets up to 45 micrograms per deciliter.
That's very high.
And then they go through a process of what's called chelation.
They have to be hospitalized.
It's quite extreme, but the damage has already been done.
It's already hit the brain.
Everything we should be doing is to prevent children from being lead poisoned.
Speaking of doing things, should Wisconsin be doing more particularly in Milwaukee
where two thirds of elevated lead levels are found?
Absolutely.
So what we do with blood testing is what's called secondary prevention.
What we really want to do is primary prevention.
And what that means is prevent the child from ever being exposed to lead.
So what we should be doing is taking the lead out of the environment.
And we are doing some of those things.
Getting rid of the lead service lines across this state, across the country,
making sure that we have what we call lead safe homes.
Maybe not lead free, but lead safe.
The paint is in good repair.
We have done wonderful things.
We took the lead at a residential paint in 1978.
We took it out of automotive gasoline in the 70s, and that was the biggest drop in lead levels
for this country for children.
What I would love to see is Milwaukee to say to all the landlords,
show me that your property is lead safe before you rent it.
Do you know what we do now?
We wait until a kid is poisoned, then we go into the house and say,
okay, now clean it up.
That's backwards.
We should be preventing those children from being exposed,
but we have a state law that limits it.
Rochester, New York has legislation like that.
We need to do that in Milwaukee.
Dr. Beth Nary, thanks very much.
Thanks for your passion.
Thank you.
In other health updates, the JN1 variant of COVID has taken hold
as the most prevalent strain having been first detected in August.
This, along with cases of influenza and RSV,
have been swirling this season.
Health officials are hoping the worst is over, but still caution getting tested and vaccinated.
Really what you're seeing is evolution in action with these viruses.
Mutations happen viruses adapt and they change over time.
So the fact that we're seeing a new viral strain shouldn't be surprising.
And I would enforce that discussion with your provider.
There's a lot of misinformation out there about vaccines,
what they do and what they don't do.
Absolutely.
There's a lot of overlap in terms of symptoms between RSV, COVID and influenza.
So I think it's going to be really difficult for patients to figure out
which one of the three they have and how to encourage them if they're not feeling well
to reach out to their provider and get tested.
For more on this and other issues facing Wisconsin,
visit our website at pbswisconsin.org and then click on the News tab.
That's our program for tonight. I'm Frederica Fryberg.
Have a good weekend.
Thank you.