O4351: A trauma-informed care approach to managing a severe case of lead poisoning: a case report illustrating an interdisciplinary team approach

Introduction: Lead poisoning remains a pervasive public health crisis, particularly for children in marginalized communities. The long-term effects of lead exposure, ranging from cognitive and behavioral impairments to developmental delays, pose significant challenges for both affected individuals and the communities at large. Lead poisoning exacerbates social, educational, and economic inequalities, particularly in families living in substandard housing where lead-based paint remains prevalent.

Case Description: R.P., a young child diagnosed with severe lead poisoning, has endured significant physical and emotional trauma due to prolonged exposure to lead in his home. His mother, unaware of the dangers of lead, moved from Florida to a rental property in Rochester, NY, where peeling paint and other hazards put her child at risk. The patient’s blood lead level reached 182 mcg/dl prompting numerous hospital visits, invasive procedures, and chelation treatments. Throughout the process, R.P.’s mother has faced numerous hardships, including job loss, isolation, and the overwhelming burden of managing ongoing medical needs. This case demonstrates the need for a coordinated, interdisciplinary care model that integrates medical treatment with social support and advocacy for safe housing.

Discussion: R.P.’s case exemplifies the critical need for a holistic, trauma-informed approach to managing lead poisoning. A pediatrician's role extends beyond administering medical care to addressing the broader social determinants that affect children's health, including housing conditions, access to healthcare, and mental health support. Coordinated care has brought together collaboration of social workers, care coordinators, housing advocates, and educators to provide a comprehensive support system for the family. The current system has failed to mitigate repeated lead exposure in the home environment due to limited “lead-safe” housing options. This case also stresses the importance of educating healthcare professionals, policymakers, and the community about the intersection of environmental health and social justice. Policy reform, particularly in housing regulations and lead abatement practices, is critical to preventing future cases of lead poisoning. Moreover, early intervention through educational and developmental support can help minimize the long-term cognitive effects of lead exposure.

Conclusion: Lead poisoning is a preventable yet persistent public health issue that disproportionately impacts vulnerable communities. The case of R.P. highlights the urgent need for comprehensive, interdisciplinary care that includes medical treatment, social support, trauma-informed approaches, and systemic policy change. To combat lead poisoning effectively, we must enforce stronger housing regulations, invest in lead abatement, and prioritize the health and well-being of children over economic interests. Only through collective action by bringing together healthcare providers, educators, policymakers, and advocates can we break the cycle of lead exposure and prevent future harm to children and families.