LEAD MANUAL - Missouri Department of Health and Senior ...
Missouri Department of
Health and Senior Services
LEAD POISONING PREVENTION MANUAL
Missouri Department of
Health and Senior Services
LEAD MANUAL
Richard Dunn, Director
Missouri Department of Health and Senior Services and Senior Services
Bryant McNally, Director
Division of Environmental Health and Communicable Disease Prevention
Scott Clardy, Administrator
Section for Environmental Public Health
Revised December 2004
The Missouri Department of Health and Senior Services is responsible for protecting and
promoting the health of Missourians by assessing health status and needs, developing policies and priorities, and assuring that the state is responding appropriately.
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
Services provided on a nondiscriminatory basis
This lead manual was assembled by the Section for Environmental Public Health
Childhood Lead Poisoning Prevention staff to manage statewide lead poisoning prevention efforts.
Section for Environmental Public Health
Vision
Missouri public health agencies, through a universally recognized, comprehensive environmental health program, will eliminate negative human health effects to create a safe and healthy place to live.
Mission
We provide the citizens and guests of Missouri a safe and healthy environment through assessment, policy development, and intervention implementation to prevent unnecessary exposure to hazardous environmental conditions that cause illness, injury, and death.
Childhood Lead Poisoning Prevention Program
Mission
Assure the children of Missouri a safe and healthy environment through the detection, treatment, and primary prevention of lead exposures that may cause illness or death.
Missouri Department of Health and Senior Services
Lead Poisoning Prevention Manual
Table of Contents
1.0 Introduction
1. Purpose of the Lead Manual
2. Lead Poisoning
1.3 Exposure Sources
2.0 Missouri Lead Testing Plan/Procedures
1. Missouri Blood Lead Testing Statute
2. Regulations
3. Testing Areas Map
4. Lead Screening Guidelines and Risk Assessment Tool
5. Childhood Blood Lead Testing and Follow-Up Guidelines
6. Capillary Blood Sampling Procedure
7. Venous Blood Sampling Procedure
8. Laboratory Requirements and Reporting
9. Public Health Laboratories
3. Public Health System
3.1 Core Public Health Functions
2. Lead Surveillance
3. Local Public Health Agencies
4. Missouri Department of Health and Senior Services
5. Medicaid
6. Collaboration and Coordination for Children with an EBL
4.0 Public Health Nursing and Medical Management
4.1 Public Health Nursing Case Management
4.2 Periodicity Screening Guidelines for Medicaid Eligible Children/HCY
(Healthy Child and Youth) Screening Guide
3. Case Management Guidelines/Care Coordination Actions/Medicaid Guidelines for
Lead Case Management
4. MDHSS Nurse Care Manager Questionnaire
5. Anticipatory Guidance
6. Nutrition and Hygiene Measures for Preventing Lead Exposure/Absorption
7. Lead in Pregnancy
8. Parental Occupational Lead Hazards
9. Nursing Care Plans
10. Chelation Therapy
5.0 Environmental Management
5.1 Action Levels and Notification Referrals
5.2 Scheduling an EBL Risk Assessment
5.3 Conducting an EBL Risk Assessment
5.4 The Visual Assessment and Areas to Investigate
5.5 The EBL Risk Assessment Report
5.6 Reporting Assessment Results to the Occupant/Property Owner
5.7 Written Work Plan
5.8 Compliance and Re-Assessment Follow-Up
5.9 Non-Compliance Procedures and Letters
5.10 EBL Risk Assessment Procedure Summary
5.11 Environmental Sampling Methods and Procedures
5.12 EBL Risk Assessment Case Closure
5.13 Interim Control Methods and Procedures
5.14 Abatement Methods and Procedures
5.15 Post-Abatement Clearance Procedures
5.16 General Program Management
5.17 References
Lead Manual Forms
EBL Risk Assessment Report Part A1: Lead Hazard Identification
EBL Risk Assessment Report Part A2: Floor Plan
EBL Risk Assessment Report Part B: Lead Sampling Results
EBL Risk Assessment Report Part C1: Report of Lead in Dust and/or Water
EBL Risk Assessment Report Part C2: Report of Lead in Paint
EBL Risk Assessment Report Part C3: Report of Lead in Soil
EBL Risk Assessment Report Part C4: Report of Non-Paint Sources of Lead
Environmental Lead Analysis Request Form (Form #Lab.18)
HCY (Healthy Child and Youth) Lead Risk Assessment Guide
Lead Case Management Report
Lead Case Management Self Assessment Tool
Missouri Lead Poisoning Risk Assessment Tool
Nurse’s Lead Case Management Questionnaire
Nutritional Questionnaire
On Site Preliminary Lead Assessment Report
Private Water Supply Request Form - (Form # Lab.65)
Questionnaire for Lead Poisoning in Pregnant Women
XRF Quality Assurance/Instrument Performance Form
Appendices
A. Glossary
B. References
C. Lead Educational Materials
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