Using a group of 3,682 Michigan Medicaid-enrolled children under the age of 6 with an elevated blood lead level screening, Kemper and his team set out to determine if children were receiving the necessary follow-up testing within 180 days of their screening. The six-month interval following an elevated screening is critical to determine if blood lead levels are increasing and if the child is responding to any medical intervention.
The study was based in Michigan since the state has a reporting mechanism for all blood lead levels, and compared to other states, Michigan has a higher number of children with lead poisoning.
Most children in the study were Hispanic or non-white, lived in urban areas and had a high risk of lead exposure. More than half in the study were 1-year-old and 2-year-old children.
The study found that a little more than half (53.9 percent) of the children received follow-up testing. Of those who had follow-up testing, testing occurred an average of 69 days after screening revealed the elevated blood lead level, and 47.5 percent continued to have an elevated blood lead level.
But the children initially at the highest risk for lead poisoning or exposure were the least likely to get follow-up testing after a blood lead level screening.
In fact, the study showed the likelihood for follow-up testing was lower for Hispanic or non-white children, children living in urban areas, and children with a high risk for lead exposure.
Most revealing is that among those children who did not have follow-up testing, 58.6 percent had at least one medical encounter during the 180 days following the elevated screening blood lead level.
While the majority of these visits were for evaluation and medical care management, more than 13 percent had at least one visit for preventive care and more than 26 percent had an emergency department visit all of which account for missed opportunities for follow-up testin