Lead exposure remains an important environmental health issue in Minnesota, with occupational exposures serving as the primary source of lead exposure among adults. Blood Lead Screening Guidelines for Pregnant Women in Minnesota were created in 2004 and included recommendations for identifying and managing pregnant and breastfeeding women with elevated blood lead levels. Since this document was written, national guidelines were put into place, and more data came to light on the toxicity of lead at lower levels than previously established. To account for the new data, the definition of elevated blood lead levels in Minnesota was changed to 5 micrograms of lead per deciliter of blood (mcg/dL) in 2014.
METHODS:
The Minnesota Department of Health convened an interdisciplinary workgroup to assess available scientific evidence and make recommendations for testing and managing blood lead levels of pregnant and breastfeeding women. Website download data were analyzed to determine the number of persons accessing the updated guidelines.
RESULTS:
The workgroup created updated guidelines and a one-page quick reference guide that included a ten question risk screening questionnaire. The recommended action level of 5 mcg/dL for lead in blood of pregnant and breastfeeding women was set by the workgroup. Resources were identified to assist patients with concerns about their rights as employees with occupational exposures to lead, patients who need access to improved nutrition, and providers with questions about treatment and workplace restrictions. The guidelines were reviewed and approved by Local Public Health Association of Minnesota, Minnesota Affiliate of the American College of Nurse Midwives, Minnesota Medical Association, and Minnesota Section of the American Congress of Obstetricians and Gynecologists. During September–December 2015, the guidelines were downloaded over 550 times.
CONCLUSIONS:
The updated guidelines were widely accepted by professional medical associations in Minnesota. Future analyses will determine whether testing practices for pregnant women have changed following the release of the updated guidelines and whether additional women with elevated blood lead levels were identified. Tracking the source of exposure to lead of any additional pregnant women with elevated blood lead levels who are identified will provide additional data for future analyses.