MetroHealth Takes Additional Steps to Curb Greater Cleveland's Lead Crisis

Lead Coalition

Even a small amount of lead in a child’s body is dangerous and can slow healthy development, which is why The MetroHealth System is strengthening its efforts to address the ongoing lead crisis.

With Greater Cleveland’s only dedicated pediatric lead clinic, MetroHealth has a long history of addressing lead exposure in the community. But more needed to be done. The first steps include screening as many pediatric patients as possible and making it easier than ever for families to have their children tested.

Testing for elevated levels is nothing new. Still, far too many children in Greater Cleveland go without this critical screening. It’s one thing for a physician to order a lead test – young children covered by Medicaid or who live in areas at high-risk for exposure are required to be screened. The challenge is ensuring those tests happen.

Late last year, MetroHealth providers started collecting blood samples for testing right in the exam room during routine pediatric visits at main campus – a move that would eventually become standard practice at all MetroHealth pediatric sites. No longer are patients and their caregivers forced to wait in line at a lab or return later for the blood draw.

It seems like a simple change, but it’s already shown remarkable progress. The rate of lead tests completed on the day of the visit climbed from 49% last year to 72% in 2021.

“A lot of parents and caregivers aren’t cognizant of the risks lead can pose, and this gives us an opportunity with a captive audience to stress the importance of testing every child – no matter where they live – and making it happen,” says Matthew Tien, MD, a MetroHealth pediatrician and one of the leaders of the System’s new Lead Coalition.

Lead is an invisible danger. It can live in paint used in old houses and apartments, dust, soil and even cosmetics. Children with elevated lead levels are at risk for serious health issues including delayed development, learning and behavioral issues, inattention, hyperactivity, irritability and more.

MetroHealth’s pediatric lead nurse ensures all patients with elevated levels and their caregivers are notified of test results and connected with the appropriate provider for follow-up care. A community health worker also connects patients with resources that can assist with any sorts of lead abatement work. That might include, for example, connecting a family with the Legal Aid Society of Greater Cleveland to work with an unresponsive landlord.

“We can treat the patients but putting them back into the environment that’s harming them in the first place isn’t going to help,” says Jennifer Conti, RN, another leader of the coalition. "With this coalition, we want to better leverage community resources to help our patients. That’s the only way we’ll get to the root of this problem."

Despite the success with screening, Conti and Dr. Tien say that is a downstream approach to a systemic issue. Prevention must take center stage to achieve of the coalition’s goal of having zero pediatric patients with elevated lead.

One way MetroHealth will approach this challenge is to start screening expectant mothers for lead and educating them about the risks lead can pose for their families.

"We don't want to use our children as lead detectors,” Tien says. “Our goal with the coalition isn't just to increase screening. We want to address the big picture of lead exposure, the housing issues and to educate parents on how to prevent lead exposure in the first place."

If you have questions about testing your child, consult your pediatrician. For more information, visit metrohealth.org/pediatrics.