Alaska

Data are necessary to make informed decisions. In late 2019, the Alaska Environmental Public Health Program (EPHP) switched from using an Access database for surveillance activities to the National Electronic Disease Surveillance System (NEDSS) Base System (NBS). This change resulted in substantial improvements with the quality, completeness, and accessibility of their childhood blood lead data. However, NBS did not allow EPHP to compile race and ethnicity data for analysis.

In 2019, EPHP attempted to establish a report that included race and ethnicity data during their onboarding phase for the NBS. However, the project was paused due to COVID-19 response activities.  Due to the delay, Alaska EPHP was unable to identify populations at higher risk for lead poisoning and could not develop focused strategies for testing and prevention activities.

In September 2021, the Alaska EPHP began working with their NBS vendor to develop a new report that would enable them to retrieve race and ethnicity data from NBS. After addressing some initial issues and completing quality assurance checks, the new report with race and ethnicity data became available for use in April 2022.

The enhanced data report significantly improved the completeness and quality of childhood blood lead data based on race and ethnicity. Using this report, Alaska EPHP had complete race and ethnicity data for 83% and 25%, respectively, of Alaskan children younger than 6 years old with a blood lead test in 2021. Because of this data, future data analyses will be better able to identify populations at higher risk of lead exposure and those with low testing rates. This will inform EPHP’s efforts to develop focused prevention activities.

Unlike most places in the United States, children in Alaska are less likely to be exposed to lead from paint in old homes. In Alaska, less than 10% of homes are built before 1960 and only one-third of homes were built between 1960 and 1977. Common sources of lead exposure in Alaska include products used for hunting and fishing, occupational take-home exposure through the mining industry, and leaded gasoline used in small airplanes. During telephone follow-ups for children with elevated blood lead levels (EBLLs) between 2011 and 2018, 50% of cases ate game meat hunted with lead ammunition and 54% of cases had a parent in the household that worked with lead compared with 39% of cases living in pre-1978 housing. However, few Alaskans realize the potential for lead exposure, especially for children.

From July to September 2018, the Alaska Environmental Public Health Program collaborated with the Alaska Department of Health and Social Services’ Public Information Office to conduct a public awareness campaign about sources of lead exposure specific to Alaska. The campaign included statewide radio announcements, thirteen promoted social media posts, and educational materials, including information cards and magnets, for health care providers and families. The campaign focused on the effects of lead on child health; the risk of bringing lead dust home from the workplace; and the presence of lead in ammunition, fishing weights, and aviation gas. Social media posts were targeted towards specific age groups, high-risk populations, and geographic areas known to participate in these activities, and radio announcements about risks of lead exposure from fishing and mining were targeted to radio stations in areas with those industries. All campaign materials encouraged parents to have their children tested for lead if they suspected exposure.

Through the public awareness campaign, thousands of Alaskans received information about sources of lead exposure and the hazards of lead exposure for young children. Four social media posts reached between 1,500 and 6,000 people, eight posts reached between 10,000 and 15,000 people, and one post reached over 40,000 people. Over 600 radio announcements were broadcast throughout the campaign, reaching the entire state.  Additionally, 5,000 information cards and 3,000 magnets were distributed at health centers, conferences, and health education events throughout the state.

In response to this campaign, as well as efforts from health care providers to test all Medicaid children under updated Medicaid lead testing requirements, the number of children in Alaska who received a blood lead test quadrupled between 2016 and 2018. Future awareness campaigns using these materials are planned to sustain awareness among Alaskans.