At a glance
CDC supports Oklahoma 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 Oklahoma received $350,000 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 Oklahoma, contact the program below.
Oklahoma State Department of Health
Oklahoma Childhood Lead Poisoning Prevention Program
123 Robert S. Kerr Ave.
Oklahoma City, OK 73102
Phone: 405-426-8311
Note:
Success story: funding year 3
Oklahoma improves compliance among providers using LeadCare II™ testing devices
Challenge
Compliance in blood lead testing and reporting for providers who use point-of-care devices, such as the LeadCare II™ device, is difficult to manage. Oklahoma's Childhood Lead Poisoning Prevention Program (OCLPPP) is responsible for surveillance, case management, education, and outreach activities for the entire state. As a result of the program's limited resources, OCLPPP staff members do not always know where all these devices are physically located or if they are being used. Those who have the devices might not know proper results reporting requirements. In addition, the manufacturer recalled some devices due to issues with falsely low results in 2017 and 2023. These issues caused confusion, and some clinics stopped using the devices temporarily or permanently. Since about 28% of the state's total reporting volume comes from users of these devices, it is important to ensure that users are kept informed of changes and that reporting occurs in a timely manner.
Intervention
OCLPPP updated a list of users who have purchased a LeadCare II™ device from the manufacturer. Program staff contact each new purchaser with reporting instructions and offer technical assistance on how to upload results to OCLPPP's electronic portal. Staff emails or calls any user who fails to report test results in a timely manner with a reminder to report. OCLPPP contacts local daycares, Head Starts, and local event organizers to encourage increased testing in areas with low testing and reporting rates.
Impact
As a result of OCLPPPs efforts, about 84% of LeadCare II™ device users reported blood lead results in fiscal year 2022. That proportion increased to 94% during fiscal year 2023. During January–March 2023, all providers reported results. OCLPPP will continue its work to contact new LeadCare II™ device buyers to continue this progress and ensure all users keep reporting results.
Funding for this work was made possible in part by [RFA-EH21-2102] from 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.
Sucess story: funding year 2
Ensuring blood lead testing in Oklahoma through data linkage challenge
Challenge
All blood lead level (BLL) results reported in Oklahoma are contained in the Healthy Homes Lead Poisoning Surveillance System (HHLPSS); however, only state Childhood Lead Poisoning Prevention Program (CLPPP) personnel have access to these results. Oklahoma has 68 health departments that serve 77 counties. Historically, approximately 20% of Oklahoma children receive blood lead testing through a county health department. Staff members at the county health department must contact the CLPPP staff for results, which takes additional time and may result in failure to obtain follow-up testing or unnecessary testing if a child has already had a recent test. This approach has made it challenging to ensure universal testing for children at ages 1 and 2 years.
Intervention
In 2022, the Oklahoma CLPPP worked with the Oklahoma State Health Department's information technology (IT) program to create a data linkage to allow county health department personnel access to blood lead test results from HHLPSS through the Public Health Oklahoma Client Information System (PHOCIS). PHOCIS is used to track Women, Infants, and Children (WIC), child health, and child guidance appointments and demographic information. This new data linkage allows county personnel instant access to blood lead test results without having to consult the Oklahoma CLPPP staff. County personnel already use PHOCIS to enter all encounters for county health visits and do not require additional access or steps to view a child's blood lead test results.
Impact
Improvements to PHOCIS, with the added linkage of HHLPSS lead results, has enabled county health department personnel to more quickly know which children require additional follow-up tests and which children have not received required testing. All 672,239 distinct child records are available and may be queried on demand. Since any PHOCIS user can view lead test records, WIC and county personnel (when WIC clinics are housed in the county health departments) may also view test results in advance for WIC clinic rosters. CLPPP personnel now have more time to focus on other lead poisoning prevention activities since they no longer receive requests for information on test results from local health departments.
Funding for this work was made possible in part by RFA-EH21-2102 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
Increasing capillary confirmatory testing for kids in Oklahoma
Challenge
Each year, approximately 900 Oklahoma children 6 months through 6 years of age have a higher blood lead level (BLL). If initial capillary BLL test results are 5 micrograms per deciliter (µg/dL) or greater, the child should receive a confirmatory test within 12 weeks. A confirmatory test is necessary because capillary blood lead tests can produce false positives due to contamination. Before Fall 2017, the only acceptable confirmatory test for Oklahoma children was a venous blood draw (venipuncture) from the child's arm, which can be a traumatic experience for both children and parents.
Intervention
Effective October 2017, the Oklahoma Childhood Lead Poisoning Prevention Program (OCLPPP) amended its rules to allow a second capillary confirmation for children with an initial capillary BLL of 5–9 µg/dL. OCLPPP developed a handbook detailing the new rules for confirmatory testing and mailed the handbook to 2,100 pediatric healthcare providers in September 2018.
Impact
Following the rule change and dissemination of the handbook, 130 children have received a second capillary confirmation instead of a venipuncture. Additionally, confirmatory testing for initial BLLs of 5–9 µg/dL increased by 6.4% from 2017 through 2018.
Funding for this work was made possible in part by NUE2EH001391 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.