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.