Virginia

In 2021, the Virginia Department of Health (VDH) recorded 21 risk assessors across Virginia’s 35 health districts. The maximum number of risk assessors in any health region was five; most had two or fewer. The VDH Childhood Lead Poisoning Prevention Program (CLPPP) frequently receives anecdotal reports that this number of personnel is insufficient for the required assessment workload. Due to this lack of trained certified personnel, lead risk assessments are often delayed, and certain health districts must lend risk assessors to districts with fewer personnel.

In collaboration with the state Department of Housing and Community Development’s Lead Hazard Reduction Program and the Virginia Community College Workforce Alliance, VDH CLPPP funded a risk assessor training class for 15 staff members from various health districts across the state in October 2021.

This risk assessor training increased the amount of certified risk assessors employed by VDH by approximately 71%. Though the course reached maximum capacity, many health districts expressed interest in sending additional staff members to any future training opportunities. After the risk assessor course was completed, participants answered a 15-question evaluation. On a scale of 1 (poor) to 5 (excellent), 60% of participants rated each course component at a “5,” with the remaining answers averaging at a “4.” By increasing risk assessment capacity in Virginia, this intervention supports the VDH CLPPP’s goal to strengthen connections between lead-exposed children and recommended remedial services.

Virginia has generally relied solely on medical providers and local health departments to identify children in need of blood lead testing, manage cases of children with elevated blood lead levels (BLLs), and link children with health effects from lead exposure to services. Lack of staff time, awareness of lead poisoning, and prevention protocols and resources have resulted in undiagnosed and untreated cases of children with elevated BLLs―particularly in populations with a higher risk of lead exposure, such as low-income and immigrant/refugee children in Virginia’s cities and rural areas like Appalachia, the Eastern Shore, and Southwestern/South-central Virginia.

To increase the number of children tested, Virginia’s Department of Environmental Epidemiology (DEE) used CDC funding to convene a diverse group of stakeholders and establish the state’s first Childhood Lead Task Force to gather input and identify opportunities for collaboration. On February 25, 2019, 25 individuals from various organizations, divisions, and sectors met for the Task Force’s first meeting. Topics discussed included common sources of lead exposure in Virginia, guidelines for lead testing, and how lead case management and lead surveillance are conducted. Participants shared goals, proposed activities and roles, and provided examples of collected lead data metrics. Participants also had an open discussion about existing childhood lead poisoning prevention initiatives and how they could collaborate to increase testing and strengthen surveillance and educational outreach.

Twenty-one meeting participants expressed interest in joining the Task Force and holding quarterly meetings. There was also interest in forming subcommittees to strengthen childhood lead poisoning education and childhood lead data.

Overall, this meeting served as an important first step for increasing blood lead level testing in children and reducing childhood lead cases in Virginia. DEE received robust programmatic feedback from 14 participants on best practices for disseminating lead education materials, identifying new partners for engagement, and forming collaborations with WIC and the Office of Family Health Services. DEE also received feedback on program objectives and suggestions for additional activities and resources.