At a glance
CDC supports Alaska and other state and local health departments, or their bona fide agents, through cooperative agreements to support childhood lead poisoning prevention activities. Read about the program's successes.
About the program
The State of Alaska received $299,963 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in FY 2022. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2022, to September 29, 2023.
The strategies focus on:
- Ensuring blood lead testing and reporting
- Enhancing blood lead surveillance
- Improving linkages to recommended services
To learn more about these efforts in Alaska, contact the program below.
Alaska Division of Public Health
Section of Epidemiology
Environmental Public Health Program
PO Box 110610 Public Health
Juneau, AK 99811
Phone: 907-269-8000
Note:
Success story: funding year 3
Alaska trains community health aides on childhood lead poisoning prevention and testing
Challenge
Childhood blood lead testing rates in Alaska followed national trends and declined between 2019 and 2022. Testing rates in 2019 were at 11.82%, then decreased to 9%, 8%, and 7.6% for 2020, 2021, and 2022, respectively. The Alaska Lead Surveillance Program (ALSP) speculated that the decrease in testing in our state was due to
- A shift in focus during COVID-19 to infectious disease and immunizations in smaller communities
- Providers being unaware of Medicaid requirements for blood lead testing
- LeadCare II™ lead testing kits were unavailable in 2021 due to a nationwide recall.
Intervention
To address these challenges,ALSP partnered with the Region 10 Pediatric Environmental Health Specialty Unit (PEHSU) to provide training and increase awareness about childhood blood lead testing in Alaska during the Community Health Aide Program (CHAP) Forum in Anchorage on November 10, 2022. About 550 community health aides (CHAs) in over 170 rural Alaska villages make up the CHAP. CHAs provide emergent, acute, and chronic care to residents of their communities. CHAP convenes an annual forum to provide further education and training for CHAs.
The 90-minute training, titled Pediatric Lead Testing and Exposure in Alaska, provided information on
- How to identify sources of lead exposure in Alaska
- Why young children are more likely to have lead poisoning than other populations
- How lead exposure, even at lower levels, affects a child's learning and behavior
- Pediatric lead screening guidelines and reporting requirements
- Best practices for capillary blood lead collection for lead testing
- How to interpret blood lead test results.
Impact
More than 50 CHAs who attended the training gained knowledge and skills to identify and test children for lead toxicity. This training not only equipped them with the necessary tools but also empowered them to make a significant difference in their communities. CHAs work and reside in remote and rural Alaska, and they are among the first contacts community members have with the Alaskan healthcare system. Increasing awareness about childhood lead poisoning and testing to community-based healthcare providers during the CHAP Forum resulted in enhanced surveillance statewide and a decrease in lead poisoning among children in Alaska. Following the Forum, the rate of lead testing rose from 7.6% in 2022 to 10.3% in 2023.
Funding for this work was made possible in part by NUE2EH001437 the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Success story: funding year 2
Surveillance system reporting improvements help identify target population in Alaska
Challenge
Data are necessary to make informed decisions. In late 2019, the Alaska Environmental Public Health Program (EPHP) switched from using an Access database for surveillance activities to the National Electronic Disease Surveillance System (NEDSS) Base System (NBS). This change resulted in substantial improvements with the quality, completeness, and accessibility of their childhood blood lead data. However, NBS did not allow EPHP to compile race and ethnicity data for analysis.
In 2019, EPHP attempted to establish a report that included race and ethnicity data during their onboarding phase for the NBS. However, the project was paused due to COVID-19 response activities. Due to the delay, Alaska EPHP was unable to identify populations at higher risk for lead poisoning and could not develop focused strategies for testing and prevention activities.
Intervention
In September 2021, the Alaska EPHP began working with their NBS vendor to develop a new report that would enable them to retrieve race and ethnicity data from NBS. After addressing some initial issues and completing quality assurance checks, the new report with race and ethnicity data became available for use in April 2022.
Impact
The enhanced data report significantly improved the completeness and quality of childhood blood lead data based on race and ethnicity. Using this report, Alaska EPHP had complete race and ethnicity data for 83% and 25%, respectively, of Alaskan children younger than 6 years old with a blood lead test in 2021. Because of this data, future data analyses will be better able to identify populations at higher risk of lead exposure and those with low testing rates. This will inform EPHP's efforts to develop focused prevention activities.
Funding for this work was made possible in part by NUE2EH001437 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.
Success story: funding year 1
"Get the lead out, Alaska!" campaign increases awareness of lead exposure sources
Challenge
Unlike most places in the United States, children in Alaska are less likely to be exposed to lead from paint in old homes. In Alaska, less than 10% of homes are built before 1960 and only one-third of homes were built between 1960 and 1977. Common sources of lead exposure in Alaska include products used for hunting and fishing, occupational take-home exposure through the mining industry, and leaded gasoline used in small airplanes. During telephone follow-ups for children with elevated blood lead levels (EBLLs) between 2011 and 2018, 50% of cases ate game meat hunted with lead ammunition and 54% of cases had a parent in the household that worked with lead compared with 39% of cases living in pre-1978 housing. However, few Alaskans realize the potential for lead exposure, especially for children.
Intervention
From July to September 2018, the Alaska Environmental Public Health Program collaborated with the Alaska Department of Health and Social Services' Public Information Office to conduct a public awareness campaign about sources of lead exposure specific to Alaska. The campaign included statewide radio announcements, thirteen promoted social media posts, and educational materials, including information cards and magnets, for health care providers and families. The campaign focused on the effects of lead on child health; the risk of bringing lead dust home from the workplace; and the presence of lead in ammunition, fishing weights, and aviation gas. Social media posts were targeted towards specific age groups, high-risk populations, and geographic areas known to participate in these activities, and radio announcements about risks of lead exposure from fishing and mining were targeted to radio stations in areas with those industries. All campaign materials encouraged parents to have their children tested for lead if they suspected exposure.
Impact
Through the public awareness campaign, thousands of Alaskans received information about sources of lead exposure and the hazards of lead exposure for young children. Four social media posts reached between 1,500 and 6,000 people, eight posts reached between 10,000 and 15,000 people, and one post reached over 40,000 people. Over 600 radio announcements were broadcast throughout the campaign, reaching the entire state. Additionally, 5,000 information cards and 3,000 magnets were distributed at health centers, conferences, and health education events throughout the state.
In response to this campaign, as well as efforts from health care providers to test all Medicaid children under updated Medicaid lead testing requirements, the number of children in Alaska who received a blood lead test quadrupled between 2016 and 2018. Future awareness campaigns using these materials are planned to sustain awareness among Alaskans.
Funding for this work was made possible in part by NUE2EH001358 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.