Frances Boreland Project: Broken Hill Centre for Remote Health Research, Department of Rural Health – Broken Hill, The University of Sydney Funding: Supported by the Primary Health Care Research, Evaluation and Development Strategy

In 1991, elevated blood lead levels were identified as a significant public health issue for pre-school aged children in the western NSW mining town of Broken Hill. A major program to reduce blood lead levels was subsequently introduced. Although average blood lead levels have fallen by two-thirds, levels in one in four children remain above the current guideline.

Annual blood screening of one to four-year-old children is undertaken to identify those needing further preventive health measures and to monitor the overall success of the program. However, in recent years less than half of eligible children have been attending for screening.

An initial descriptive study found the average age at which children first attended screening was increasing. If this trend continued a significant proportion of the children would miss out on testing entirely. A subsequent community survey showed people perceived that lead had largely gone off the public health agenda, and that children’s distress and pain in response to venous blood sampling was not worth it if lead was no longer a major issue.

The study findings resulted in the lead management program being reinvigorated with the  establishment of a whole-of-community lead steering group. To minimize children’s distress, routine screening was done using a finger prick method, with venous samples only collected to confirm high blood lead levels. Feedback from parents about the new testing method was positive
and it removed a significant barrier to screening.

This project was strategic and timely, identifying an emerging problem and helping to develop workable solutions for it.