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Description:Because case management of children with elevated blood lead levels varies markedly among states, cities, and other jurisdictions, the Advisory Committee on Childhood Lead Poisoning Prevention developed these nationally applicable recommendations. Based on recently published studies and augmented with opinions of experts, this report defines the elements of case management and offers assessment and management guidelines for health departments, case managers, primary care physicians, and other professionals. Not all recommendations are appropriate for any individual child because of variations in age, blood lead level, housing status, and—most important—the ability of caregivers to respond to recommendations without being overwhelmed.
The report contains five chapters in addition to the introduction: home environment investigation and interventions, medical evaluation and treatment, nutritional assessment and dietary modification, developmental surveillance and interventions, and education for caregivers. At the beginning of each chapter is a summary table of specific management recommendations. (The remainder of the tables, the figures, and the references are at the end of each chapter.) The text of the chapters provides the detailed information and references upon which most recommendations are based. Each chapter concludes with suggestions for further research.
This report, in addition to addressing the case management of individual children, also discusses the importance of state laws, regulations, and financing related to lead abatement efforts and the provision of appropriate services for affected children. Finally, the authors of this report recognize that case management is involved with the secondary prevention of elevated blood lead levels and that primary prevention by the removal of ongoing lead exposure sources should be promoted as the ideal and most effective means of preventing elevated blood lead levels.
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