Kentucky

In May 2022, there were reports of children in Kentucky being exposed to Surma, a traditional eye or facial cosmetic used in Africa, Asia, and the Middle East. A case of childhood lead poisoning in Daviess County was directly related to the use of Surma. Outreach materials on Surma provided by Western States Pediatric Environmental Health Specialty Units were in English which presented a language barrier for some families. Additionally, these materials were not readily available for all local health departments. An estimated 10,000 Kentucky residents fluently speak Afghan languages, creating the potential for this population not being reached by outreach messaging.

The Kentucky Childhood Lead Poisoning Prevention Program (KYCLPPP) provided information to local health departments and communities to reach families at risk of using Surma in July 2022. KYCLPPP focused on Daviess County and populations of refugees from Afghanistan. The materials recommended asking clinicians about lead testing and provided alternative lead-free products for culturally significant activities and contact information for those with additional questions. To meet demand, 150 fact sheets each were printed in Dari and Pashto.

The information provided to local health departments is intended to change practices related to Surma usage and improve childhood blood lead testing. Since the materials were distributed, there have been no reports of lead poisoning from Surma. As of March 15, 2023, Kentucky surveillance data has not detected a significant increase in testing among Afghan children.

Funding for this work was made possible in part by 6 NUE2EH001380-02-02 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.

Upon meeting with 120 local health departments in the state, Kentucky’s Childhood Lead Poisoning Prevention Program (KYCLPPP) became aware that nurses were often relying on outdated educational materials to support lead poisoning prevention outreach.

Each of Kentucky’s 120 health departments was contacted and offered free educational materials about lead poisoning prevention. During 2018, KYCLPPP disseminated 5,639 childhood lead poisoning prevention brochures to 37 interested local health departments to facilitate consistency in lead poisoning prevention outreach across the state. Local health departments could incorporate community-specific knowledge into these materials to find the best fit for lead education and create a sense of ownership for their outreach efforts.

Health departments shared educational materials that provided anticipatory guidance to parents. These were provided during lead screenings (59%), after identifying children with elevated blood lead levels (18%), at various outreach events (such as health fairs, community partner meetings, environmental health conferences, etc.) (13%), and during clinical visits (mostly Special Supplemental Nutrition Program for Women, Infants, and Children [WIC] clinic visits) (10%).

KYCLPPP increased lead poisoning prevention outreach at the community level, which is viewed as a more approachable, appropriate setting. Additionally, local health department nurses indicated that they could supply accurate education and guidance to high-risk families. For example, Lake Cumberland Health District staff members added education on childhood lead poisoning prevention to parenting classes they teach to soon-to-be-released incarcerated individuals with young children.

Funding for this work was made possible in part by NUE1EH001264 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.