Delaware

Since 1994, Delaware’s Childhood Lead Poisoning Prevention Act has required all children to have a blood lead test at or around the age of 12 months. Additionally, using a standardized risk questionnaire, healthcare providers were to decide if a second blood lead test should be performed at 24 months of age. The Delaware Division of Public Health (DPH) determined through correspondence with healthcare providers that the questionnaire was underused. Therefore, more than 1,000 children at high risk of lead poisoning were potentially not being tested at or around 24 months of age.

Through efforts by the DPH, the Childhood Lead Poisoning Advisory Committee, and local advocacy groups, Delaware revised the Childhood Lead Poisoning Prevention Act in October 2021 and its subsequent regulations. The Act mandates that all children be tested for lead at ages 12 and 24 months of age regardless of risk. The risk questionnaire was removed from the Act as it was no longer needed. A Health Alert was mailed to healthcare providers informing of the change and reiterating that the CDC Blood Lead Reference Value (BLRV) was updated from 5.0 µg/dL to 3.5 µg/dL. Delaware is using the current CDC BLRV as the level for follow-up testing, beginning outreach to families regarding ways to reduce exposures, and providing case management. DPH case investigators become involved if the blood lead level (BLL) is at or above 7.0 µg/dL by venous sample and will schedule a lead risk assessment. They will also encourage property owners to address any hazards identified.

The approximate birth rate in Delaware is 11,500 babies annually. With blood lead testing now required at 24 months of age for all children, those who are at higher risk have a greater likelihood of being tested then instead of relying on the previously mandated questionnaire. The increased testing rate is expected to identify 1,200 more children with higher BLLs as results above the BLRV are reported to the Delaware surveillance system. Families of children whose BLL are at or above the CDC BLRV will receive information on exposure reduction and case management, and they will be referred to intervention programs to monitor for and address developmental delays. Also, if BLLs are at or above 7.0 µg/dL, an environmental investigation and lead risk assessment will be performed. Preliminary data indicates that from July through December 2022, 137 referrals were made for developmental services.

Funding for this work was made possible in part by NUE2EH001422 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

The city of Wilmington has the highest rate of children with elevated blood lead levels (BLLs) in Delaware, with three zip codes (19805, 405 elevated BLLs; 19802, 310 elevated BLLs; 19801, 205 elevated BLLs) in the city of Wilmington having the highest number of children with elevated BLLs between 2010 and 2017.

Delaware’s Lead Poisoning Prevention Program developed a partnership with the Latin American Community Center (LACC), which serves New Castle County, the county in which the City of Wilmington is located, to conduct a lead poisoning prevention outreach and awareness campaign targeting households with young children in New Castle County. LACC arranges for specially trained staff to contact New Castle County, families with children to encourage lead testing. From 2016 through 2018, in partnership with the LACC, Delaware’s Lead Poisoning Prevention Program raised awareness of the dangers of lead poisoning and the need for childhood lead screening with the following activities:

• Setting up a booth at 84 community events.
• Engaging over 11,000 parents in one-on-one consultations.
• Distributing over 4,000 lead awareness information pamphlets to parents.
• Giving 29 presentations with over 315 attendees.
• Conducting over 150 phone consultations.
• Distributing 414 lead test kits to families.
• Conducting 556 home assessments.

LACC also created radio and print ads in English and Spanish to raise awareness of blood lead testing. The print ads were placed in four local Hispanic publications that have a combined readership of 85,000. One of the publications also put the ads on their Facebook page, which was liked by over 3,000 people in September 2017. The radio ads played on two radio stations in English and Spanish, with a combined listenership of 40,000. In September 2017, LACC organized and promoted a lead poisoning prevention awareness event at its Early Development Center.

These efforts resulted in 40 children getting blood lead level screening from the Delaware Lead Poisoning Prevention Program.

Funding for this work was made possible in part by NUE1EH001256 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.