New Jersey

About the program

The State of New Jersey received $664,227 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in the third funding year. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2023, to September 29, 2024.

The strategies focus on:

• Ensuring blood lead testing and reporting
• Enhancing blood lead surveillance
• Improving linkages to recommended services

To learn more about these efforts in New Jersey, contact the program below.

New Jersey Department of Health

Childhood Lead Program, Office of Local Public Health

P.O. Box 369

Trenton, NJ 08625

Phone: 609-292-5666

Success story: funding year 3

New Jersey increases support for children testing above the blood lead reference value

Challenge

New Jersey is updating New Jersey Administrative Code (N.J.A.C.) 8:51 (State regulation) to lower its blood lead reference value (BLRV) for children from 5 to 3.5 µg/dL. A lower BLRV will increase the actionable caseload of children with blood lead, as approximately 3,100 more nurse case management will need to be conducted by local health departments.

Intervention

New Jersey allocated $17 million in funding in fiscal year 2024 (an increase of $5 million) to local health departments for nurse case management of children who have a blood lead level (BLL) at or above the BLRV.

Impact

The increase in funding will allow local health departments to enhance their childhood lead programs by allowing additional staff to provide nurse case management. The decrease in the BLRV and additional staffing will allow interventions to be provided to lead burdened children sooner and mitigate higher BLLs.

Funding for this work was made possible in part by CDC-RFA-EH21-2102CONT23 from the Centers for Disease Control and Prevention. The views expressed in this material do not necessarily reflect the official policies of CDC, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Success story: funding year 2

Increasing environmental investigations in New Jersey during state fiscal years 2018–2021

Challenge

New Jersey enacted the Hotels and Multi Dwelling Act N.J.A.C. 55:13A-1 in 1967, ensuring that hotels and multiple-family buildings of three or more dwelling units are properly maintained and do not pose a threat to health and safety. N.J.A.C 8:51 requires the environmental investigation of all housing units where a child with a blood lead level at or above the state action level resides if 1) the blood lead level result is two venous blood lead levels of 5–9 micrograms per deciliter (µg/dL) taken at an interval of one to four months apart or one venous blood lead level of 10 µg/dL and 2) that the dwelling was built prior to 1978.¹ In 2005, the Act (N.J.A.C. 55:13A-1) included lead paint hazard inspection criteria. However, many properties in New Jersey were not inspected for lead because of gaps in the law, including one- and two-family rental units. The enforcement of the Act resides with the Department of Community Affairs (DCA).

Intervention

Using the environmental investigations data from LeadTrax, the New Jersey Department of Health Childhood Lead Poisoning Prevention Program (CLPPP) staff analyzed the dwelling types for state fiscal years 2018–2021. Data indicated that the greatest number of environmental investigations were detected for multi-unit dwellings. The combined number of environmental investigations during this timeframe was 1,767 for multi-unit dwellings and 1,088 for single-family homes.

DCA enacted a new law called the Rental Act N.J.A.C. 5:28A. Effective July 22, 2022, it requires that any rental property in New Jersey built before 1978 be inspected for lead. This law requires two different types of inspection based on the percentage of children residing in a municipality who have higher blood lead levels. If the percentage of children residing in the municipality with BLLs above the state action level is ≥3% and the dwelling was built prior to 1978, the municipality must perform dust wipe sampling of the residence. If it is <3%, the municipality must perform a visual inspection for lead paint hazards.

The CLPPP provides the data on blood lead levels in children to DCA to determine the type of lead inspection for one- and two-family homes. This closes a gap in the state's existing lead testing regulations, which had allowed single-family and two-family rental units to go without inspection.

Impact

Impacts of N.J.A.C. 5:28A have not currently been documented because the law was recently enacted. It is expected that there will be a decrease in the number of children with higher blood lead levels due to lead inspection and remediation prior to children residing in those homes.

Note: New Jersey is revising NJAC 8:51 for the action level to be 3.5 µg/dL.

Funding for this work was made possible in part by NUW2EH001440 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the CDC, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. Findings are preliminary, pre-decisional, and deliberative. Subject to change. Content is descriptive only and not meant to constitute legal, clinical, or policy advice. Limitations: 41% of the environmental investigations from 2018 to 2021 have dwelling type information missing. Please interpret cautiously.

Success story: funding year 1

Testing pregnant women for higher blood lead levels in New Jersey

Challenge

Lead burden can cause adverse effects on maternal health and infants. In New Jersey, pregnant women are not routinely screened for higher blood lead levels (BLLs).

Intervention

The New Jersey Department of Health, in collaboration with Monmouth County Health Department and Central Jersey Visiting Nurses Association, conducted a pilot study to screen pregnant women for BLLs to assess lead burden in pregnant women. The pilot study was conducted on women receiving prenatal care from the Central Jersey Visiting Nurses Association during January–June 2018. At their first prenatal visit, 64 women received screening for higher BLLs. The Central Jersey Visiting Nurses Association distributed educational material for reducing lead exposure to all pregnant women. If BLL was above CDC's blood lead reference value, defined as any blood lead level greater than or equal to 5 micrograms per deciliter (µg/dL), staff members also provided appropriate case management based on CDC guidelines.

Impact

The study identified six women with higher BLLs. One woman received chelation because her BLL was 94 micrograms per deciliter. Her child received an immediate blood lead screen during delivery and was chelated post-delivery.

Following the pilot study, the New Jersey Department of Health conducted a similar study in collaboration with New Jersey State Laboratories in Newark – a city with an extremely high lead burden due to legacy lead from paint factories, lead smelting plants, old housing in poor condition, and other sources. Through this study, pregnant women receiving prenatal care at University Hospital in Newark were provided blood lead screening and lead exposure reduction education and nurse case management if they had higher blood lead levels. Hospital staff also conducted cord blood testing for all participants immediately after birth. If the child had an elevated blood lead level, the New Jersey Department of Health conducted an environmental intervention at the primary home.

Funding for this work was made possible in part by NUE2EH001394 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.