Success Stories: Environmental Health Clinic

“Maggie” is a 2-year-old child from Frederick County who received routine blood lead screening from her pediatrician and was found to have a fingerstick blood level of 62 ug/dL. She was referred immediately to Kennedy Krieger Institute’s Environmental Health Clinic for admission for chelation therapy, and was brought in by her parents. A venous blood sample was taken and same-day blood lead analysis performed. During the clinic visit, comprehensive environmental history by the nurse clinician and physician revealed multiple potential sources of lead exposure in the child’s home and at her secondary address, her grandmother’s house. The parents received a demonstration of lead-specific housecleaning and nutritional recommendations from the nurse, and were given informational pamphlets to take home. These pamphlets were also provided to them in Spanish, to be shared with Maggie’s grandmother, who is originally from South America. The parents also met with the social worker to discuss the multiple concerns about housing, financial issues, and educational services for Maggie’s sister, who has special needs. The family prioritized their needs, with assistance from the social worker, and linkages were facilitated with appropriate resources in their community. A blood lead level was also recommended for the sister; this was done the next day by the primary health care provider, and was found to be 4 ug/dL.

Maggie’s blood lead level was confirmed at 60 ug/dL by Kennedy Krieger Institute’s blood test, and she was admitted to the inpatient floor for chelation therapy. A multidisciplinary team meeting was held among the Environmental Health Clinic professionals and the inpatient team. A plan of management was discussed and reviewed with Maggie’s parents. Summaries of the clinic visit and multidisciplinary meeting were faxed to Maggie’s primary health care provider, local health department, and Maryland Department of the Environment (MDE). Environmental inspections were arranged for the primary and secondary addresses. The primary health care provider, local health department, and MDE were kept apprised of Maggie’s progress during chelation therapy. At the time of discharge, Maggie and her family went to stay temporarily at a cousin’s lead-safe home while lead abatement was carried out at the primary and secondary addresses. Maggie continues to attend the Environmental Health Clinic for periodic monitoring of her blood lead level and environmental status, and the social worker continues to assist with issues of concern to the parents. Consultant management will be continued until the Kennedy Krieger Institute specialist and the primary health care provider are comfortable that Maggie will not require another course of chelation, and her blood lead level is low enough.

Bradley L. Schlaggar, M.D., Ph.D., Named President and CEO of Kennedy Krieger Institute

We’re thrilled to welcome Bradley L. Schlaggar, M.D., Ph.D., to the Kennedy Krieger family as our next President and CEO.

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