The purpose of this internal Q&A is to document changes in program offerings in Area 1 and provide THEP team members and IH shared language to reference when speaking with families in Area 1.
Questions: #
Why are families with young children in Area 1 now receiving a full dust buster kit? Has the risk in these neighbourhoods changed?
The risk to children has not changed. Recent studies in the Trail area confirm THEP’s focus on indoor dust continues to be an important way to reduce children’s potential exposure to lead. Recent studies have also shown that while homes located further from the smelter may have lower concentrations of lead in air and soil, they may still have potential lead sources (e.g. lead in paint in poor condition) that can contribute to lead in dust and pose a risk to children.
Interior Health’s (IH) Medical Health Officer (MHO) recommends[1] THEP continues to further “decrease the gap in children’s blood Pb between Trail children and an age-matched Canadian cohort by 25% over the next five years”. To support this recommendation, THEP continues to look at all potential Pb exposure sources in the home and yard (i.e., Pb in dust), particularly where HFHH is delivered since young children are most vulnerable to lead exposure. THEP is focused on supporting families to reduce children’s lead exposure in practical ways such as wet mopping and vacuuming. Accordingly, dust buster kits are now available to all HFHH families regardless of which THEP Area they reside in. As in other THEP Areas, vacuums will be provided on a case-by-case basis depending on need.
I live in Area 1 and already had a HF and/or HH visit. Can I retroactively get a dust buster kit and/or vacuum?
Provision of dust buster kits is not meant to be retroactive for Area 1 families who previously received a Healthy Home (HH) visit. However, if a family has already had a HH visit and a parent is concerned about their child’s BLL, they are encouraged to reach out for additional support if they have not yet heard from a Public Health Nurse. Children with elevated blood lead levels[2] have always received (and continue to receive) additional support from THEP, which may include provision of supplies such as a dust buster kit and vacuum.
During a Healthy Families (HF) visit, a Public Health Nurse may identify a need for material supports such as a dust buster kit or vacuum. They will reach out to the Community Program Office on behalf of the family to assess need on a case-by-case basis.
Families concerned about other sources of lead exposure in their home can request a copy of their paint testing report or sign up for interior paint testing. Vacuuming and wet mopping are strategies for reducing dust, regardless of the source.
What previous changes have taken place in Area 1?
Blood lead testing and support for elevated blood lead levels for families in Area 1 has always been part of THEP.
When the primary prevention HFHH program launched in 2012/2013, blood lead testing was recommended across all Areas (1, 2, and 3) to understand what supports best served each area. At that time, the Exposure Investigation Level (EIL)2 was 10 ug/L and the geomean blood lead levels in Area 1 were below that and lower than in Areas 2 and 3.
Based on those results, the MHO recommended primary prevention visits and material supports (HFHH) to Areas 2 and 3 along with BLL monitoring annually. For Area 1 blood lead monitoring was recommended every five years. The HFHH was not offered to Area 1 based on the data at that time.
In 2020, BC CDC lowered the EIL for children’s blood lead to 5ug/dL. In addition, the MHO noted that blood lead levels over time were becoming more similar across all THEP areas. Based on these changes, in 2021, the MHO recommended annual Blood Lead testing for young children in Area 1. Accordingly, HFHH visits were also introduced to Area 1 in 2021 with limited supports focusing on reducing indoor dust.
While the frequency of children’s blood lead level testing (and associated supports) in Area 1 has changed over time, blood lead testing for all Areas has been part of the decades long work to monitor and reduce blood lead levels in Trail area children.
Based on present day blood lead levels (which are more similar across THEP areas than they were in the past) and programming, providing similar supports across all Areas will help with consistent messaging and hopefully a reduction in exposure to lead in indoor dust (regardless of the source of the dust).
For Community Program Office staff, the full document can be found in your files:
Q:\TRAIL RESIDENTIAL PROGRAM\30_Planning\32_Plan_Sched\HFHH
20210405_HFHH_THEP Internal QA for expanded BL Testing for Area 1
References: #
[1] Medical Health Officer Recommendation Under Contaminated Sites Regulations Section 18 and 18.1 Risk-based Standards for lead (Pb) for the Environmental Management Area Surrounding Teck Trail Operations. Karin Goodison, MHO. Interior Health. December 2024. Draft.
[2] Blood lead levels over the Exposure Investigation Level (EIL) of 5 micrograms per decilitre after the fall or winter blood lead testing clinic or following other approved testing.