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Childhood Lead Poisoning Prevention Program

Logo graphic for the program which displays a red roof of a house with the acronym beneath it.

The New Mexico Lead Poisoning Prevention Program collects blood lead level data and provides case management services to Children and Adults with elevated blood lead levels. In an effort to prevent lead poisoning and decrease elevated lead levels in exposed children, the program provides:

Lead exposure in children can cause behavioral and learning problems, hearing loss, and at very high levels, seizures, coma, and death. Adults with elevated lead levels are most often caused by Occupational exposure. High lead levels can cause high blood pressure, reproductive problems, kidney damage, hearing loss, and neurological problems.

During case management, adults are warned about Carrying Lead Dust Home to their children and about the dangers of lead for an Expectant Mother and her unborn child. Developing fetuses and growing children are highly susceptible to lead’s toxic effects.

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Potential for Falsely Low Blood Lead Test

The US Food and Drug Administration (FDA) has issued a safety communication warning about the use of Magellan Diagnostics’ LeadCare analyzers (LeadCare®, LeadCare II, LeadCare Ultra and LeadCare Plus) with venous blood samples because they might result in falsely low-test results. FDA is now advising that Magellan Diagnostics’ LeadCare® analyzers should no longer be used with venous blood samples. The safety alert does not apply to capillary blood lead test results collected by fingerstick or heelstick.

More information about the May 17, 2017 warning can be found on the LeadCare Testing – FDA Safety Communication Warning page.

The purpose of this CDC Health Advisory is to notify state and local health departments, healthcare providers, and laboratories about CDC’s re-testing guidance in light of the safety alert. CDC is working with public health officials throughout the United States to determine where the analyzers were used and which blood lead test results might be affected. These are CDC recommendations regarding this safety alert.

CDC recommends that healthcare providers re-test patients who:

  • CDC recommends that healthcare providers re-test patients who are younger than 6 years (72 months) of age at the time of the alert (May 17, 2017)
  • CDC recommends that healthcare providers re-test patients who had a venous blood lead test result of less than 10 micrograms per deciliter (μg/dL) analyzed using a Magellan Diagnostics’ LeadCare® analyzer at an onsite (e.g., healthcare facility) or at an offsite laboratory.
  • CDC also recommends that healthcare providers re-test currently pregnant or lactating women who had a venous blood lead test performed using a Magellan Diagnostics’ LeadCare® analyzer.
  • CDC recommends parents discuss re-testing with their healthcare provider or health department to determine if their child’s blood should be re-tested.
  • CDC recommends for future blood lead testing, healthcare providers and public health officials should:
    • Send venous samples to Clinical Laboratory Improvement Amendments compliant laboratories using inductively coupled plasma mass spectrometry (ICP-MS) or graphite furnace atomic absorption spectrometry (GFAAS) (also known as electrothermal atomic absorption spectrometry ETAAS) instruments.
    • Send capillary samples to Clinical Laboratory Improvement Amendments compliant laboratories using any Clinical Laboratory Improvement Amendments compliant analyzer including ICP-MS, GFAAS, or LeadCare® analyzers

FDA’s Recalls and Investigations for Lead

Sirob Imports, Inc. Issues Recall Due to Elevated Lead in Spices

Sirob Imports, Inc of Lindenhurst, NY is recalling, Corrado, Orlando Imports, Nouri’s Syrian Bakery, Mediterranean Specialty Foods Brand and Butera Fruit Market Curry Powder because it contains elevated levels of lead.

The curry powder was distributed direct to Illinois, New Jersey, and New York. Please see the FDA Recall due to Elevated Lead in Spices page to learn more.

Lead Testing Issues with Magellan Diagnostics LeadCare Testing Systems

The US Food and Drug Administration (FDA) updated the LeadCare Testing Systems - Magellan Diagnostics webpage (March 22, 2018).

Based on data provided by Becton Dickinson & Company (BD), the FDA has concluded that one of the contributing factors to the inaccurate LeadCare test results is the chemical composition of the rubber stoppers of certain blood collection tubes.

Upon FDA’s request, BD conducted studies to assess the accuracy of Magellan’s LeadCare testing systems when used with venous blood collected into BD venous blood tubes. The FDA concluded that the studies performed by BD were robust and showed that there was a significant chance of incorrect results with Magellan’s LeadCare tests when used with venous whole blood collected in certain BD blood tubes. Upon further investigation, BD determined that the affected tubes' rubber stoppers contain a chemical called thiuram that can release reactive gases, carbon disulfide and carbonyl sulfide, which can dissolve into the blood sample and bind tightly to lead particles. This chemical reaction makes it difficult for the Magellan lead tests to detect the correct amount of lead in the sample.

There are several BD blood collection tubes that contain thiuram and that could be used with the Magellan lead tests including the BD Vacutainer® ethylenediamine tetra-acetic acid Lavender Top, Tan Top, Pink Top tubes and BD Vacutainer® Lithium Heparin Green Top tubes. At FDA’s request, BD is conducting testing to determine whether clinical laboratory tests other than the Magellan lead tests are affected by the thiuram chemical interference. Based on the results of BD’s studies to date and our understanding of the mechanism of the interference, the FDA does not believe there is evidence showing that other clinical laboratory test results are impacted by the thiuram chemical interference at this time.

Should children be tested for lead?

Children exposed to even small amounts of lead can suffer adverse health affects, most notably a lowered IQ, and may develop learning and behavior problems.

Both Federal and State Medicaid regulations require that all children enrolled in Medicaid be tested at 12 months and again at 24 months of age. Children between the ages of 36 months and 72 months of age must receive a screening blood lead test if they have not been previously screened for lead poisoning. No state is exempt from this requirement!

Children with blood lead levels below 10 micrograms per deciliter (µg/dL)

Even low levels of lead in blood have been shown to affect IQ, ability to pay attention, and academic achievement. Therefore, for levels between 5-9 µg/dL and if requested, the New Mexico Department of Health will work with parents and physicians to identify sources of lead exposure so the exposure may be reduced or stopped. This involves discussing potential sources of a child’s exposure and providing education about lead exposure prevention.

More Information

What steps should be taken if drinking water at home or school is above the Environmental Protection Agency action level of 15 ppb?

Households or Schools with Children Under Age 6 or Pregnant Women

Use bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead for cooking, drinking, and baby formula preparation. Because most bottled water does not contain fluoride, a fluoride supplement may be necessary.

Households or Schools without Children Under Age 6 or Pregnant Women

If you know lead pipes are in the home/building, flush cold water for 1-2 minutes before using. Then, fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).

If you learn that lead pipes are at the street, flush water lines with cold water for at least 5 minutes before using. Also, you can reduce your exposure by consuming bottled water or water from a filtration system that is certified by an independent testing organization to reduce or eliminate lead. If you do not know if lead pipes are at the street, you should contact your water utility.

These steps were based, in part, on the CDC's Lead in Tap Water web page.

Should adults be tested for lead?

In New Mexico, industries where lead exposure is common include public safety, radiator repair, mining and construction. However, non-occupational sources of lead exposure are also common in adults and include (but are not limited to) firearm hobbies, retained bullets, and the use of herbal remedies.

Adults should have a blood lead level test if:

  • Their employment exposes them to lead.
  • They are self-employed or work in small businesses.
  • They routinely use leaded products in their hobby.

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Should pregnant women be tested for lead?

The New Mexico Department of Health recommends following the medical case management guidelines developed by the CDC regarding pregnant and lactating women.

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Lead Renovation: Repair & Painting Rule

Requires the use of lead-safe work practices to ensure that common renovation activities like sanding, cutting and demolition, which can create hazardous lead dust, are conducted properly by trained and certified contractors or individuals.

It's federal law! If you are a Renovation Firm or Contractor, Training Provider, Property Manager, the General Public, or Member of the Press, you must follow the EPA Lead Renovation Repair and Painting Rule (RRP).

The rule includes the following:

  • Renovation firms must be certified under the RRP rule.
  • Individuals must be trained in lead-safe work practices.
  • Training providers must be accredited by the EPA.

For more information please visit the Lead Renovation Repair and Painting Rule web page.

Lead Surveillance Data Users

Statistics

Approximately half a million US children aged 1-5 years have blood lead levels greater than 5 micrograms of lead per deciliter of blood (µg/dL), the CDC Blood Lead Reference Level based on the 97.5th percentile of blood lead level distribution in US children aged 1-5 years. A child is considered to have an elevated blood lead level (EBLL) at a concentration of 5 µg/dL or greater.

Despite increases in New Mexico’s annual screening rates, only about 10% of children aged 1-5 years were tested for lead exposure in 2010. The rates of elevated blood lead levels among children aged 1-5 years have remained at relatively stable levels during the past few years. For example, from 2006 to 2010, the annual rates of elevated blood lead levels among children fluctuated between 1 and 2 children for every 1,000 children tested for lead exposure. From 2006 to 2010, 68 children under the age of 6 were found to have confirmed elevated blood lead levels among the 56,515 tested.

Fortunately, rates of elevated blood lead levels in New Mexican children are lower relative to US rates. However, since exposure to lead is known to have numerous adverse health effects and is a preventable exposure, these rates are still a concern. Despite the federal requirement that Medicaid-eligible children are to be tested for lead exposure, this testing does not always occur. Therefore, the rates of elevated blood lead levels may be unrealistically low.

From 2006 to 2010, 10,119 New Mexican residents aged 16 and older reported blood lead levels to the NMDOH. Of these, 31 adults had elevated blood lead levels (>25 µg/dL, 8 of which reported blood lead levels at 40 µg/dL or greater). Of the adults with elevated blood lead levels, 19 were due to occupational exposures.

Visit the New Mexico Public Health Tracking Environmental Health Data to access more data about lead in New Mexico.

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