Interview with Erin Loucks
In this interview on December 4, 2023, Dr. Erin Loucks discusses lead screening in her practice and the ways in which she assesses risk and counsels parents through treatment for children with high blood lead levels.
Dr. Erin Loucks has been practicing as a pediatric physician in Omaha for the last seventeen years, working in the Dundee area. She frequently tests for lead during annual checkups on young children, starting at age one and continuing until around age five.
Loucks noted that awareness of the dangers of lead for young children has increased over time. Dundee is an older region of Omaha, and relatively affluent, and she noted that many families are aware of the risks of living in older houses and are open to testing based on this. She tests children based on two factors: age and zip code. Geography is often critical. Understanding one's proximity to current lead manufacturing businesses and the former ASARCO plant site is beneficial when assessing risk for lead poisoning.
As kids reach age one, they become more mobile. They also begin exploring the world through touch and taste. This puts them at a higher risk of exposure. During wellness checkups, parents fill out a lead exposure risk form that includes these indicatories. A child’s tendencies to play with objects such as jewelry and keys are important potential risk factors when it comes to lead. Wellness checks also ask about certain foods consumed in the home and where the child spends a majority of their time (i.e. the home, grandparent’s house). Risky behaviors and locations may appear innocous, so parents are often surprised to learn that their child has tested positive for high blood lead levels. This speaks to the importance of testing and continued education on the topic.
Dr. Loucks also noted the the importance of follow-ups. Many parents do not realize that blood must be tested every year until the child reaches age five. The consequences of elevated blood lead is also not well understood. This can cause confusion and even resistance. “I just tell them the importance of follow-up and tell them how worrisome it is cause I think some people still to this day don't think even a small elevation is worrisome.” At the same time, not all families are equally able to follow-up. One significant limtation is access to transportation. Not everyone can easily return to the lab. When conditions are serious enough to warrant removal from a home, this can often present and insurmountable barrier to health. "Every family should have access to a house that doesn't have high levels of lead," Loucks noted, which amounts to a significant injustice.
Money from the Omaha Lead Superfund program provides necessary support for the city to perform health home checks. However, Dr. Loucks knows that many families are unable to move from homes with extreme lead exposure despite a desperate need. This frustrates families and the physicians that treat them. She said this is “definitely an injustice to lower income to families that can't afford housing that they may or may not have less lead level.” Homes are not the only place for concern, either. The stakes are high. In her practice, Dr. Loucks sees a positive test every few days.
She is grateful for the amount of education that has been done to make families aware of the problem here in Omaha. It is clear that advocacy and education in the community is present and strongly influencing parents she meets in her practice. This awareness and advocacy continues to shape the face of remediation in Omaha. Dr. Loucks says, “I think overall, we’re progressing to improvement.”