Alabama

The State of Alabama received $350,000 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in the third funding year 2023. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2023 to September 29, 2024.

The strategies focus on

  • Ensuring blood lead testing and reporting
  • Enhancing blood lead surveillance
  • Improving linkages to recommended services

To learn more about the efforts in Alabama, contact the program below.

Alabama Department of Public Health
Childhood Lead Poisoning Prevention Program
The RSA Tower
201 Monroe Street, Ste 1050
Montgomery, AL 36104
Phone: 334-206-3883

Success Story 2023

Alabama Increases Services to Hundreds of Children Exposed to Lead

Challenge

In 2020, tests showed that 13,984 Alabama children younger than 6 years of age had lead in their blood. To qualify for a public health intervention, children must have a blood lead result of 5 µg/dL or higher. Only 759 (5%) children qualified to receive the intervention. Because childhood lead poisoning can have serious physical and social consequences, the ACLPPP needed to increase the number of children who qualified for public health intervention.

Intervention

The Alabama Childhood Lead Poisoning Prevention Program (ACLPPP) sought to increase linkages to services for more children affected by lead exposure. In January 2022, ACLPPP aligned its guidance with CDC’s updated blood lead reference value (BLRV). As a result, children with a blood lead test result of 3.5 µg/dL or higher qualified for public health interventions. Interventions include parent education, case management, and environmental testing. As the primary referral source for developmental evaluation and services in Alabama, the Alabama Early Intervention System (AEIS) adopted the updated criteria in April 2022.

In addition, the Alabama Department of Public Health updated its case management protocol. They began to refer children younger than age 3 years to AEIS for interventions. They also began referring children aged 3 years and older to local departments of education for evaluation and developmental services, based on individual needs.

Impact

By incorporating the protocol and procedure changes above, ACLPPP increased the number of children referred for case management. From 2020 to 2022, referrals increased by 103%. As of December 16, 2022, a total of 1,540 children met the new criteria for case management services. This increase in children eligible to receive services allowed more families to receive one-on-one education about lead poisoning prevention. In addition, more homes were evaluated for sources of lead exposure. By working with AEIS to align criteria, more children can now be referred to receive evaluation and establish developmental services.

Funding for this work was made possible in part by NUE2EH001413 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Success Story 2021

Alabama Increases Blood Lead Testing in Children through Provider Outreach

Challenge

The Alabama Department of Public Health Childhood Lead Poisoning Prevention Project’s (AL CLPPP) data showed many providers were either not testing for lead or not reporting blood lead levels (BLLs) as required by the Alabama Department of Public Health Administrative Code 420-4-1. Additionally, data indicated that many children were not receiving appropriate follow-up testing when there was an elevated BLL.

Intervention

To increase awareness of the state’s blood lead testing and reporting requirements, AL CLPPP launched a campaign to educate Alabama pediatric medical providers. AL CLPPP also issued new state blood lead guidelines, which aligned with CDC’s Recommended Actions Based on Blood Lead Level, to address common blood lead screening and follow-up testing issues identified in the pediatric healthcare community including state BLL reporting requirements and testing kit recalls.

Impact

There is evidence of increased BLL reporting since the development and initial distribution of the guidelines and educational campaign. From 2017 through 2018, the number of BLL results provided to AL CLPPP increased by 6.6%, from 43,806 blood lead results to 46,683 results. In addition, the number of children tested, as reported to AL CLPPP, increased by 3.1%, from 38,218 in 2017 to 39,404 in 2018. This increase in blood lead testing and reporting is expected to continue as the guidelines are shared with more providers and one-on-one education and other technical assistance are provided. Through testing, providers and families alike can monitor and address lead exposure, even at low levels, before a child has potentially permanent life-altering neurological damage. In addition to providing important information for individual children’s follow-up care, accurate and complete reporting of BLLs helps the AL CLPPP identify and address geographical areas and populations most at risk for lead exposure in the state.

Funding for this work was made possible in part by the Cooperative Agreement Number [NUE2EH001358] from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.