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Improving Lead Screening In A Pediatric Practice: A Quality Improvement Project, Audrey Myers

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Background: Detectable lead levels in children’s blood have been associated with increased cognitive difficulties, attention deficits, and poorer academic performance. Children enrolled in Medicaid have higher rates of elevated blood lead levels, yet requirements to test all children at age 1 and 2 who are enrolled in Medicaid are not being met. Nationally, 34% of children enrolled in Medicaid do not undergo proper blood lead level screening. The aim of this project was to increase required blood lead level screening rates for children with Medicaid insurance at a private pediatric practice in the Shenandoah Valley in Virginia.

Methods: The …

Accumulation Of Lead By Biofilms In Drinking Water Distribution Systems, Kaleb Oren Belcher

Graduate Theses and Dissertations

Recent crises, such as the one in Flint, MI, indicate that lead exposure from drinking water is a major health concern in the United States. Over six million lead service lines are still in use in the United States, and a universal protocol to safely remove these lead service lines from drinking water distribution systems has not yet been established. This paper calls to attention the potential hazard that biofilms pose as a source of lead in distribution systems, even after the removal of lead pipes. This study used a simulated water distribution system containing a lead source pipe and …

Establishing Baseline Lead Levels Found In Swiss Chard Grown Near The Hillsboro Airport, Amber A. Lee

University Honors Theses

Samples of Swiss Chard were collected from four community gardens within a three-mile radius from the Hillsboro Airport in Hillsboro, Oregon. Samples were also collected from a site within a two-mile radius of the airport, as well as a removed site in McMinnville, OR. Samples were analyzed using Anodic Stripping Voltammetry (ASV) to quantify the lead content from each site. The highest concentration of lead was from the site within a two-mile radius of the airport with a value of 8.9 X 10-4 micrograms of lead per gram of sample. The lowest site concentration was 3.9 X 10-5 micrograms per …

The Invisible Crisis: Framing The Remediation Of Milwaukee's Lead Laterals, Isabella Rieke

Theses and Dissertations

When Milwaukee’s municipal water system was developed in 1874, one-half-inch lead pipes were used to convey water from the mains in the street to a customer’s home; the City has since acknowledged that nearly 100,000 such lead pipes are still in use today, a revelation which has opened for debate whether or not these pipes pose a galvanizing public health risk with far-reaching policy and infrastructure implications. This study explores the community response to Milwaukee’s lead laterals through the efforts of the Freshwater for Life Action Coalition (FLAC). How do Milwaukeeans understand the risks posed by the lead laterals? In …

Spatial And Temporal Trends Of Mining-Related Lead-Zinc Sediment Contamination, Galena River Watershed, Sw Wisconsin-Nw Illinois, Dylan Alexander King

MSU Graduate Theses

Alluvial sediments within the Galena River Watershed were severely contaminated with heavy metals by historical zinc (Zn) and lead (Pb) mining operations during the early 1800s until 1979. Since the mines closed, there have been efforts to remediate on-site mine waste. However, the effectiveness of these efforts to reduce metal concentrations in stream sediments is unknown. This study compares present-day (2017) contamination trends in the Galena River Watershed to trends reported 25 years ago. A total of 415 sediment/soil samples were collected and analyzed using X-ray florescence spectrometry to determine sediment metal concentrations. The highest concentrations of zinc measured were …

Decreasing Environmental Health Risks In The Philippines: Implementation Of A Culturally Appropriate Screening Tool, Alyssa Samson

Doctor of Nursing Practice (DNP) Projects

Objectives: The purpose of this DNP project was to increase the knowledge of environmental health risk factors in the Philippines among nurses and doctors located within that healthcare system. The overall goal was to educate providers on local environmental health risks, provide training for the use of a screening tool (Tagalog Environmental Health and Safety Assessment Tool [TEHSAT]), and provide resources aimed at increasing screening of at risk populations and provide opportunities for education and health promotion.

Methods: This project included a two-part educational training session. The first part included a preliminary presentation on environmental health and the use of …

Three Essays On Public Policy And Health, Jessica E. Sauve-Syed

Dissertations - ALL

This dissertation is comprised of three essays on health and public policy. My research examines how regulations and targeted programs impacted health outcomes.

The first two chapters use the unexpected shock of water borne lead in Flint Community Schools’ classrooms to estimate the causal impacts of lead on students’ cognitive and behavioral outcomes. The first paper focuses on the short-run academic achievement of elementary school children. At the average level of lead exposure, conservative estimates find that the share of students scoring proficient on statewide standardized exams drops by 6 to 9 points in math and drops by 12 to …

Effect Of Lead Contaminated Soils On Lycopene And Mineral Contents Of Tomatoes (Solanum Lycopersicum), Andrea T. Amati

Theses

Eating fruits and vegetables is beneficial to human health, not just because they provide essential nutrients and vitamins, but also because phytochemicals scavenge free radicals and can reduce the risk of developing cancer and other diseases. However, not all people have access to affordable fresh fruits and vegetables. People who live in “food deserts” often are limited to smaller stores where prices are higher and the quality and variety of fresh fruits and vegetables are scarce. Urban gardens have been proposed as a potential solution to the issue of food deserts and as a way to promote nutrition in low …

Assessment Of Metals In Tissues Of Marine-Associated Birds In South Florida, Caitlyn A. Nay

HCNSO Student Theses and Dissertations

Seabirds – broadly defined as any bird species associated with the marine environment – are exposed to a wide range of environmental contaminants. Vectors of exposure to metal pollution include by external contact, inhalation, and most often ingestion of food and incidental seawater. Seabirds are often considered marine ecosystem bioindicators due to their high trophic position, relatively long lifespan, and wide geographic ranges. We examined the concentration of total mercury (THg), lead (Pb), and cadmium (Cd), in the kidney, liver, breast muscle, and feathers of seven species of juvenile and adult seabirds commonly found in South Florida: brown pelican Pelecanus …

Lead, Copper, And Iron In University Tap Water, Alison Mclendon

Honors Theses

This study observed concentrations of lead, copper, and iron in university tap water over an eight-week span during and between the summer and fall semesters. First draw and 30s flush samples were taken after overnight stagnation from the Honor House, College Hall, J. B. George Building, and International Center bathrooms and analyzed with an inductively-coupled plasma mass spectrometer (ICPMS). There was no obvious correlation between time in the semester and metal concentrations. Relative iron levels rose and fell at the same time in all buildings, but there was little correlation between buildings for lead and copper concentrations. The Honor House …

Surface Soil Metal And Metalloid Contamination Within The Urban Environment Of Atlanta, Georgia, Lanier Henson

Geosciences Theses

Previous research from urban cities around the world have found elevated soil lead concentrations in many of the cities because of anthropogenic deposition of lead from industrial, transportation, and residential applications. Children, impoverished populations, and pregnant women all experience increased adverse health risks when exposed to land with elevated soil lead concentration. The project tested the following hypotheses concerning soil lead within the Atlanta urban environment; soil is enriched from transportation sources and deteriorating lead paint, soil lead is not sourced from the weathering of the bedrock or soil, and enrichment is heterogeneous. The hypotheses were tested through the geochemical …

Bioaccessibility Of Lead From Contaminated Soil Using Phosphate Treatment -- Physiologically Based Extraction Test And In Vitro Gastrointestinal Method Test, Austin Charles Doss

Masters Theses

"Phosphate treatments are used to immobilize lead in soil by forming pyromorphite. Soil from Bonne Terre, Mo was collected to study whether such treatment decreases the bioaccessibility of lead. The soil was treated using 0.5 soil wt% of phosphate. Treatments were: none, phosphoric acid, triple super phosphate, and organic bone meal. Each sample was studied after one, four, sixteen, and twenty weeks; during this time span, water was added approximating the average rainfall rate. Percolated water was collected to test the leached phosphate concentrations. Phosphate was below the detection limit in that leachate. Remediated soil samples were used in Physiologically …

Lead In Tap Water From The City Of Dayton, Ohio, Kayla Marie Haman

Browse all Theses and Dissertations

Lead (Pb) in public tap water is a national health concern and is the main pathway of human exposure to Pb. The City of Dayton has verified Pb pipelines and homes with Pb plumbing; thus, residents are at risk to Pb leaching into their tap water. I sampled water from 130 residential and 24 public water taps and measured Pb and copper (Cu). Five percent of samples exceeded the action level for Pb (> 15 [micro]g/L) and none exceeded the action level for Cu. The City of Dayton's lead pipeline map identifies potential Pb exposure from Pb distribution pipes. However, …

Microscale Controls On Lead Speciation In Soils: A Framework For Sustainable Remediation, Grant Reeder

Graduate College Dissertations and Theses

The potential of a soil to immobilize heavy metal ions is dependent on the presence of adsorption sites, and the stability of metal species over the range of geochemical conditions present in the soil over time. Lead (Pb) is a cumulative toxin that is enriched in much of the urban pedosphere due to historical use of Pb-based paint and Pb-amended gasoline. Because in-situ remediation of Pb is possible if the bioavailable fraction can be rendered inert, understanding Pb-sorbent interactions is necessary to accurately and efficiently alter Pb speciation in soils. The objectives of this study are to 1) determine efficient …

Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown

Walden Dissertations and Doctoral Studies

Lead exposure during childhood is a significant global public health concern as the potential effects of exposure can result in the need for long-term treatment, diminished productivity in society, and financial strain on the health care system. There is strong evidence of a relationship between lead exposure and attention-deficit/hyperactivity disorder (ADHD); however, there is a gap in the current literature regarding the relationship between lead exposure and specific symptoms of ADHD and the strength of that relationship. The purpose of this meta-analysis was to examine and help quantify this relationship. Cohen's d was used as the standardized mean effect size …