Flint, Mich., and lead poisoning have been synonymous for nearly two years.
The public health emergency erupted when it became known that the city’s water supply was contaminated with lead. With 41.6 percent of residents living below the poverty line, many didn’t have adequate access to health care to test for lethal levels of lead.
At one point, an independent test done by Virginia Tech researchers found lead levels at 13,200 ppb – water is considered hazardous waste at 5,000 ppb.
As lead levels rose, children began to develop rashes and suffer from mysterious illnesses, behavior and learning problems, lower IQ and hyperactivity, slowed growth, hearing problems and anemia. Lead also can cross the placental barrier exposing the fetus to lead. This can result in serious effects to the mother and her developing fetus, with outcomes of reduced growth and premature birth.
The UNMC College of Pharmacy, however, is helping to make it easier for Flint residents to get themselves tested for levels of lead for free.
In the wake of the emergency, the Michigan Pharmacists Association (MPA) reached out to one of its trusted resources – the UNMC College of Pharmacy and its collaborator, Ferris State University, Big Rapids, Mich.
This is not the first time UNMC has worked with Ferris State to help Michigan pharmacists with point-of-care testing. In 2014, rapid tests for flu and strep were initiated at community pharmacies, making them more convenient for patients and giving pharmacists a greater role in promoting public health.
Kellie Vile, Pharm.D., a pharmacist at Kroger in Flint, Mich., obtains a blood sample from a Flint resident to test for lead poisoning.
UNMC is leading a growing national movement in point-of-care testing at community pharmacies. A story in the winter 2014 issue of UNMC Connect explained how the College of Pharmacy was helping to take the program to the public – including at Omaha Hy-Vee stores.
Could pharmacists similarly test for lead and serve a role in helping Flint’s residents?
Turns out, yes. Donald Klepser, Ph.D., associate professor of pharmacy practice, and principal investigator of the “point-of-care” project, found a Clinical Laboratory Improvement Amendment (CLIA)-waived lead test.
UNMC’s team and the MPA had to navigate legalities, bureaucracy, and, unfortunately, politics. But they ultimately got the go-ahead.
Now, they just had to pay for it. “There’s no money to be made on this,” Dr. Klepser said. “It’s just good public health.”
“There’s no money to be made on this, it’s just good public health.”
Donald Klepser, Ph.D.
Magellan Diagnostics loaned LeadCare II analyzers to Flint pharmacies and decreased the required test kit quantity purchases to assist with implementation costs. And at UNMC, Dr. Klepser pored over his budget and found $5,000 to pay for “a fair number” of tests.
Dr. Klepser and his team plan to write it up as a study, the next step in the “point-of-care” project. “We hope to show that the pharmacy is an access point that can successfully screen patients,” he said. That, in similar outbreaks, pharmacists can step forward to fill a public health need.
“We are simply creating a new access point (for testing) with better hours that can take some of the pressure off the doctor’s offices and the health departments,” said Greg Pratt, the MPA’s emergency preparedness coordinator. “We are providing care and education in a way people understand and trust.”
Testing in Flint began in June, with results reported for tracking and study. If negative, patients get peace of mind. If positive, they are counseled and referred to their physician or the county health department.
For UNMC, it is both research and outreach. “It’s a remarkable opportunity for pharmacists to play a role in providing access in this type of public health emergency,” Dr. Klepser said.
Meanwhile, the UNMC Center for Drug Discovery and Lozier Center for Pharmacy Sciences and Education, with its experiential learning spaces, like a mock pharmacy, simulation suites and a compounding lab, will help prepare pharmacy students for new roles such as this.
“The new spaces for patient counseling and simulation will allow us to train our students to provide these types of services in a more realistic setting. It allows them to learn and practice with the technology,” Dr. Klepser said.
Web extras
Read more about the rapid strep and flu tests.
31 Michigan pharmacies now offering rapid-diagnostic strep/flu testing
Pharmacy point-of-care testing expands
Read the story in Connect Winter 2014 issue
View photos of the new pharmacy building opening ceremony.
Patient blood samples are tested for lead levels with LeadCare II analyzers loaned for the project by Magellan Diagnostics.