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COVID-19 Pandemic Resulted in Significant Decline in Children Tested for Lead

The New Jersey Department of Health today announced a partnership with the New Jersey Chapter of the American Academy of Pediatrics on approaches to improve lead screening rates. The number of New Jersey children tested for lead exposure declined 20 percent last year, consistent with a Centers for Diseases Control (CDC) study that found COVID-19 adversely affected identification of children with elevated blood lead levels due to the closure of many medical offices, schools and day care centers last spring.

Nearly 179,000 children under the age of 17 were screened for lead exposure in 2019, when nearly 4,000 children—or 2.2 percent-- had elevated blood lead levels, defined by the CDC as 5 micrograms per deciliter (mcg/dl) or higher. Preliminary 2020 data indicates 144,000 children were tested of whom 4,032 , or 2.8 percent, had elevated blood levels, an increase of 29 percent. In addition, 11 children had to be hospitalized for elevated blood lead levels of 45 mcg/dl or more. In 2019, only three children required hospitalization for elevated blood lead levels of 45 mcg/dl or more.

“Children spent significantly more time at home last year, increasing their risk of exposure to lead paint and contaminated dust,” said Health Commissioner Judith Persichilli. “Even low levels of lead in blood can affect a child’s health, behavior, ability to pay attention, and achieve milestones at school. It is critical that families reschedule any previously cancelled pediatric visits so young children can be tested for lead exposure.”

“Pediatricians are working across the state to help children get caught up with the vital well-child visits that may have been delayed due to the profound effects of the COVID-19 pandemic on our communities,” said Dr. Jeanne Craft, FAAP, President, New Jersey Chapter, American Academy of Pediatrics. "Offices are open now, with measures in place to ensure that infants, children and adolescents are seen safely."

“We encourage families to resume their regular checkups for their children, to get the lead screening that may have been delayed as well as additional preventative care, vaccines, and screenings that will help them get back on track for the healthiest childhood possible,” Dr. Craft said.

Dr. Craft said the Academy is “concerned about the decrease in child blood lead testing as a result of the disruptions to well childcare brought on by the COVID 19 pandemic. NJ saw a 20 percent drop in lead testing in 2020 which mirrors the national trend.  Lead is still the most common environmental toxin for children and even very low blood levels can cause permanent, irreversible neurologic damage. All children in New Jersey are at risk.

Children living in older housing stock tend to be most at risk.

The NJAAP will partner with the Department of Health and its childhood lead program on approaches to improve screening rates by connecting with the pediatric medical community, preschool services and families. State law mandates that all physicians, registered nurses, and licensed health care facilities that provide services to children less than 72 months of age perform blood lead screening for all children, regardless of potential risk or geographic location. Blood lead screenings should be conducted according to the following schedule: All children should be screened for lead at ages 1 and 2 years of age, or if not previously screened at these ages, at least once before their 6^th birthday.

The Department’s efforts to increase screening rates will be enhanced by the assistance of Dr. Meg Fisher, a pediatrician and member of the board of the national American Academy of Pediatrics who joined the Department as an advisor during the pandemic.

“Pediatricians are working across the state to help children get caught up with the vital well-child visits that may have been delayed due to the profound effects of the COVID-19 pandemic on our communities. Offices are open now, with measures in place to ensure that infants, children and adolescents are seen safely,” the Academy said.

In addition, the Commissioner is sending a letter to health care providers across the state urging them to contact parents to reschedule missed well-visits. “Ensuring all children are screened for blood lead at ages one and two ensures early identification and removal of lead exposures to children,” Commissioner Persichilli said.

When children are found to have been exposed to lead, there are services available to assist the child and remove lead from their environment. Early detection and early intervention are critical, as the impacts of lead on children’s developing bodies can be permanent.

There is no safe level of childhood lead exposure, according to the CDC. Lead-based paint and lead-contaminated dust in older homes (built before 1978) are the most common sources of lead exposure in children. Children are exposed to lead dust in the home through opening and closing of doors and windows that have lead paint, outside sources being tracked into the home through shoes, entering through open windows during and after power washing of homes with exterior lead paint, and through home renovations disturbing lead-based paint. Other sources of lead exposure in children include water from leaded pipes, and imported toys, candy, spices, jewelry, cosmetics, herbal remedies, and pottery that may be contaminated with lead.

“Through Governor Murphy’s comprehensive statewide plan to address lead exposure, we are working to protect New Jersey’s families from the dangers of lead,” said Jane Cohen, Director, Office of Climate Action and the Green Economy. “Together with our cabinet members, stakeholders, and advocates, we will continue our efforts to prevent exposure from lead in new Jersey’s water infrastructure, lead-based paint in older homes, and contaminated soil in our communities.”

The New Jersey Poison Control Center at Rutgers New Jersey Medical School, Department of Medicine, also assists the Department with a call center where medical questions about lead can be answered in multiple languages 24/7 at 1-800-222-1222.

“Lead exposure in early childhood can have lasting effects on development which are difficult to reverse, and prevention really is the best medicine,” said Dr. Diane P. Calello, executive and medical director of the NJ Poison Control Center. “Removing lead hazards from older housing stock, and eliminating contaminated food, toys, and folk remedies are the most important things we can do to make a difference.”

Over the past 20 years the number of children with elevated blood levels has declined dramatically.

To learn more about preventing childhood lead poisoning please visit: https://www.state.nj.us/health/childhoodlead/prevention.shtml To download posters, educational materials, and other resources, please visit: https://www.state.nj.us/health/childhoodlead/

Follow the New Jersey Department of Health on Twitter @njdeptofhealth, Facebook /njdeptofhealth, Instagram @njdeptofhealth and Snapchat @njdoh.