Table 2 Lead and children's health policy (NOM-199-SSA1-2000) in Mexico
From: A qualitative analysis of environmental policy and children's health in Mexico
Blood lead levels (BLL) | Children < 3 years | Children 3 - 15 yrs | Pregnant and breast feeding women |
|---|---|---|---|
< 10 μg/dL | NO ACTION REQUIRED | NO ACTION REQUIRED | NO ACTION REQUIRED |
10 - 14 μg/dL | Follow up (BLL). Inform parents (BLL results) Identify sources of exposure Hygiene and nutritional advice | Follow up (BLL). Inform parents (BLL results) Identify sources of exposure Hygiene and nutritional advice | Inform BLL results Identify sources of exposure Follow up (Mother and child) Hygiene and nutritional advice |
15 - 24 μg/dL | Repeat venous blood test periodically until BLL < 10 μg/dL Prescribe nutritional supplementation (Iron, Calcium) Assess BLL among family members (<15 years, pregnant and breast feeding women). Identify sources of exposure. Notification to the Health Authority. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice | Repeat venous blood test periodically until BLL < 10 μg/dL Prescribe nutritional supplementation (Iron, Calcium) Assess BLL among family members (<15 years, pregnant and breast feeding women). Identify sources of exposure. Notification to the Health Authority. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice | Repeat venous blood test until breast feeding period is concluded and BLL< 10 μg/dL Prescribe nutritional supplementation (Iron, Calcium) Assess BLL among family members (<15 years, pregnant and breast feeding women). Identify sources of exposure. Notification to the Health Authority. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice |
25 - 44 μg/dL | Monthly monitoring (venous blood test) until BLL< 25 μg/dL Case management and nutritional supplementation (Iron, Calcium) Assess BLL among family members. Identify sources of exposure. Notification to the Health Authority. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice | Bi-monthly monitoring (venous blood test) until BLL< 25 μg/dL Case management and nutritional supplementation (Iron, Calcium) Assess BLL among family members. Identify sources of exposure. Notification to the Health Authority. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice | Monthly monitoring (venous blood test) until BLL< 25 μg/dL or breast feeding period is concluded Case management and nutritional supplementation (Iron, Calcium). Identify sources of exposure and notification to the Health Authority. Assess BLL in cord blood. Assess BLL among family members. Protection measures (e.g., glazed pottery removal). Hygiene and nutritional advice Follow up mother-child |
45 - 69 μg/dL | Recommendations similar to above category. In addition, chelating agents, under strict medical supervision, until BLL <45 μg/dL. Referral to social worker, if necessary | Recommendations similar to above category. In addition, chelating agents, under strict medical supervision, until BLL <45 μg/dL. Referral to social worker, if necessary | Recommendations similar to above category. Notification to Health Officer; referral to specialized health care within the next 48 hrs and repeat BLL test. No pharmacological treatment during pregnancy. Careful decision after delivery. |
> 70 μg/dL | Emergency case. Recommended procedures are similar to above category (<69 μg/dL) Specialized medical care | Emergency case. Recommended procedures are similar to above category (<69 μg/dL) Specialized medical care | Emergency case. Recommended procedures are similar to above category (<69 μg/dL) Specialized medical care and careful decision regarding treatment. |