Take the Lead on Lead: Feasibility of a Telemedicine-Based Clinic for Lead Poisoning Prevention and Management

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-04-17 DOI:10.1016/j.acap.2025.102844

Ryan CL Brewster MD , Keith Acosta BS , Diane Story MPH , Frehiwot Bayuh , Shalini Shah DO , Alan Woolf MD, MPH , Noah Buncher DO , Marissa Hauptman MD, MPH

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引用次数: 0

Abstract

Objective

Despite there being no safe amount of lead in the body, most public health and clinical interventions are focused on secondary prevention. A greater emphasis on early outreach may reduce cumulative lead exposure. Towards this end, we aimed to assess the feasibility of a virtual model for lead poisoning prevention and management among at-risk populations.

Methods

We developed the Take the Lead on Lead (TLOL) clinic, a telemedicine-based program to facilitate educational visits, lead identification, and individualized resource allocation. We recruited patients aged 9 months-5 years with detectable, but low, BLLs (≥2 μg/dL and <10 μg/dL) from two urban academic medical centers in Boston, MA. Virtual visits featured a remote residential inspection to identify potential lead hazards and inform targeted counseling. Families also received a lead testing and temporary mitigation kit, community referrals, and follow-up BLL surveillance, as indicated.

Results

Among 35 participants, most were Black, non-Latinx (51.4%) with residence in homes constructed before 1970 (60%). Potential lead hazards were visualized in the majority of homes that underwent a virtual home inspection (71.4%). On a post-participation survey, most families found that TLOL participation addressed their clinical concerns; provided actionable resources; and helped identify lead sources.

Conclusions

The TLOL program enabled detailed residential lead identification and early resource access with high levels of participant satisfaction. Further work is needed to assess the efficacy and cost-effectiveness of telemedicine-based care models applied towards lead poisoning prevention efforts.

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带头处理铅：基于远程医疗的诊所预防和管理铅中毒的可行性。

目的：尽管人体铅含量不存在安全标准，但大多数公共卫生和临床干预措施都侧重于二级预防。更加强调早期推广可能会减少累积的铅接触。为此，我们旨在评估在高危人群中预防和管理铅中毒虚拟模型的可行性。方法我们开发了以远程医疗为基础的“带头治疗”（TLOL）诊所，以促进教育访问、铅识别和个性化资源分配。我们从马萨诸塞州波士顿的两个城市学术医疗中心招募了年龄为9个月至5岁的可检测但较低的bll（≥2 μg/dL和≤10 μg/dL）患者。虚拟访问的特点是远程住宅检查，以确定潜在的铅危害，并告知有针对性的咨询。如所述，家庭还收到了铅检测和临时缓解工具包、社区转诊和后续BLL监测。结果在35名参与者中，大多数是黑人，非拉丁裔（51.4%），居住在1970年以前建造的房屋中（60%）。在大多数进行虚拟房屋检查的家庭（71.4%）中，潜在的铅危害都是可视化的。在参与后的调查中，大多数家庭发现参与tll解决了他们的临床问题；提供可操作的资源；并帮助确定铅的来源。结论：TLOL项目能够详细地识别居民铅线，早期获得资源，参与者满意度高。需要进一步开展工作，以评估应用于预防铅中毒工作的基于远程医疗的护理模式的功效和成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.