Determination of numbers of lead-exposed U.S. children by areas of the United States: an integrated summary of a report to the U.S. Congress on childhood lead poisoning (original) (raw)
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Maternal and Child Health Journal, 2011
Toxins and other health threats can cause health problems, whether they are present in the child's own home, other neighborhood homes where the child spends time, or common areas such as playgrounds. We assess the impact of where a child lives on the burden of lead poisoning. Statewide lead screening data was obtained from the Rhode Island Department of Health. Block group level indicators of old housing and poverty were obtained from the US Census. Of the 204,746 study children, 35,416 (17.3%) had a blood lead level C10 lg/ dL. The proportion of study children who were lead poisoned in each block group ranged from 0.0 to 48.6%. The proportion of study children with an elevated blood lead level increased from 8% among children living in block groups in the lowest quintile of poverty to 31% for those in the highest quintile for poverty. Old housing also had an important impact on the risk of lead poisoning. The proportion of children with an elevated blood lead level increased from 7% among children living in block groups in the lowest quintile for pre-1950 housing to 27% for those in the highest quintile for pre-1950 housing. The adjusted odds ratio was 1.64 for the highest quintile of poverty and 1.77 for the highest quintile of pre-1950 housing. The findings of this large, statewide study demonstrate the powerful impact of where children live on the risk of lead poisoning. The findings have important implications for understanding the problem of lead poisoning and for planning primary prevention programs.
Identifying housing that poisons: a critical step in eliminating childhood lead poisoning
Journal of public health management and practice : JPHMP
The purpose of our study was to develop a method to identify and prioritize "high-risk" buildings in Chicago that could be targeted for childhood lead poisoning prevention activities. We defined "high-risk" buildings as those where multiple children younger than 6 years with elevated blood lead levels (BLLs) had lived and where lead hazards were previously identified on environmental inspection. By linking 1997-2003 Chicago elevated blood lead surveillance, environmental inspection, and building footprint data, we found that 49,362 children younger than 6 years with elevated BLLs lived at 30,742 buildings. Of those, 67 were "high-risk" buildings and these were associated with 994 children with elevated BLLs. On average, 15 children with elevated BLLs had lived in each building (range: 10-53, median: 13). Almost two thirds (n = 43) of the high-risk buildings had two or more referrals for inspection to the same apartment or housing unit; of those, 40 perc...
Census Tract Analysis of Lead Exposure in Rhode Island Children
Environmental Research, 1997
There has been increasing interest in a targeted approach to the screening and prevention of lead exposure in children. Targeted screening requires an understanding of variation in lead exposure in individual children or by region. In order to better understand variation by region, we studied Rhode Island lead poisoning screening data, examining average lead exposure to children living in 136 Providence County census tracts (CTs). The study population included 17,956 children aged 59 months and under, who were screened between May 1, 1992, and April 30, 1993. We evaluated the relationship between the percentage of children with blood lead ≥10 μg/dL (pe10) and sociodemographic and housing characteristics, derived from United States 1990 Census data, of these CTs. CT descriptors included population density, percentage of households receiving public assistance income, median per capita income, percentage of households female headed, percentage of houses owner occupied, percentage of houses built before 1950, percentage of houses vacant, percentage of population Black, percentage of recent immigrants, and intraurban mobility. On average, 109 children were screened in each census tract; mean screening rate was 44%. There was wide variation in average lead exposure among census tracts, with pe10 ranging from 3 to 60% of screened children (mean 27%). Individual census variables explained between 24 and 67% of the variance in pe10 among CTs. A multiple regression model including percentage screened, percentage of households receiving public assistance, percentage of houses built before 1950, ln (percentage of houses vacant), and percentage of recent immigrants explained 83% of variance in pe10. The percentage of houses built before 1950, a variable which models the presence of lead paint in old houses, displayed the largest adjusted effect on pe10 over the range observed for that variable in RI CTs. The percentage of houses vacant was also a highly significant and robust predictor; we suggest that vacancy is an ecological marker for the deterioration of lead-based paint, with higher vacancy neighborhoods containing houses in poorer condition. In Rhode Island, census tracts with high vacancy rates also have high rates of recent immigration, making immigrant groups vulnerable to lead exposure. Small-areas analysis may be useful in directing resources to high risk areas, explaining the sociocultural forces which produce such exposure and analyzing the effects of housing policy over time in states with high screening penetration.
Sociology of race & ethnicity, 2015
Historical and Contemporary Patterns of Race and Class Childhood lead poisoning is a critical environmental inequality issue with racial and spatial overtones. Lead poisoning in children is due primarily to environmental conditions of the children's residences. The most significant sources are chips, dust, and soil incorporated with lead-based paint used in and on housing structures. Children subsequently ingest and/or inhale these sources (Meyer et al. 2003; U.S. Agency for Toxic Substances and Disease Registry 2007; U.S. Department of Housing and Urban Development 1990). Regulations eliminating leaded paint, gasoline, and other lead-based products in the United States have reduced the 608873S REXXX10.
Predicting Blood-Lead Levels Among U.S. Children at the Census Tract Level
Efforts to prevent childhood lead exposure are hindered by difficulty in predicting where exposure is concentrated in the absence of childhood blood-lead data. To help fill that gap, we created and validated a regression model to estimate childhood lead exposure in every census tract in the United States. Publicly available factors that were the most predictive of childhood blood-lead concentration were identified by a literature review and an evaluation of childhood blood-lead level (BLL) records from a public health surveillance program in Michigan (543,295 records for the years 1999–2009). The predictive power of the regression model was validated through a comparison to blood-lead surveillance program data from Mas-sachusetts (833,951 records for the years 2000–2009), Texas (838,368 records for the years 1999–2009), and National Health and Nutrition Examination Survey (NHANES) datasets. The regression model identified percentage of pre-1960 housing, percentage of population below poverty line, and percentage of population that is non-Hispanic black as the most predictive factors, with year, season, type of blood sample, and age of child as important covariates. The model based on Michigan data predicted geometric mean (GM) blood-lead concentrations within Michigan census tracts with an R 2 of 0.69, in Massachusetts with an R 2 of 0.28, and in Texas with an R 2 of 0.20 and represents a substantial improvement over the application of the NHANES national estimate to predict local childhood BLLs. Applying the model for 1-and 2-year olds combined across the United States found that the nationally aggregated predictions matched the NHANES blood-lead distributions within 10% of the GM and within 10% of the 95th percentile of the national distributions. Such estimates may help focus on childhood lead poisoning prevention efforts.
Environmental Health Perspectives, 2009
wipe samples and housing-related questionnaire data relevant to lead exposure from the homes of children 1-5 years of age. Blood samples from these children were collected at NHANES mobile examination centers and were analyzed for lead and other parameters. We examined the relationship between PbB in children and PbD on floors and windowsills and estimated PbB across the range of floor PbD in this nationally representative cross-sectional sample of children 1-5 years of age. This marks the first time that nationally representative data on environmental and biologic measurements for lead have been obtained in a single integrated survey. A companion article in this issue presents the predictors of residential PbD (Gaitens et al 2009). Methods Study population. We analyzed data from three waves of NHANES (1999-2000, 2001-2002, 2003-2004). NHANES is a nationally representative cross-sectional household survey that uses a complex, stratified, multistage probability sampling design to track the health of the noninstitutionalized civilian U.S. population. It has been a primary source of information about the national distribution of children's PbB. Details of the NHANES protocol and all testing procedures are available elsewhere (NCHS 2006a, 2006b, 2006c). Our data set included 2,155 children 12 to 60 months of age with measured PbB. Only children living in housing built before 1978, when the United States banned the use of lead in residential paint, were included
Public health reports (Washington, D.C. : 1974)
We determined which children should be tested for elevated blood lead levels (BLLs) in the face of financial and practical barriers to universal screening efforts and within 2009 Centers for Disease Control and Prevention recommendations allowing health departments to develop BLL screening strategies. We used the Michigan database of BLL tests from 1998 through 2005, which contains address, Medicaid eligibility, and race data. Linking addresses to U.S. Census 2000 data by block group provided neighborhood sociodemographic and housing characteristics. To derive an equation predicting BLL, we treated BLL as a continuous variable and used Hierarchical Linear Modeling to estimate the prediction equation. Census block groups explained more variance in BLL than tracts and much more than dichotomized zip code risk (which is current pediatric practice). Housing built before 1940, socioeconomic status and racial/ethnic characteristics of the block group, child characteristics, and empirical ...
Lead testing of children and homes: results of a national telephone survey
PubMed, 1996
Objectives: This study was designed to estimate the percentage of young children in the United States who have been tested for lead and the percentage of dwellings in the United States in which the paint has been tested for lead. Methods: A national random digit dial telephone survey of 5238 households was conducted in 1994. Weighted national estimates and 95% confidence intervals for outcomes of interest were calculated. Results: About 24% of U.S. children ages 0 to 6 years were estimated to have been tested for lead. Higher rates of testing were reported for children living in homes constructed prior to 1960, those living in homes with low household income, those living in rental units, and those living in the Northeast. Lead paint testing was performed for only an estimated 9% of U.S. housing units. Older homes were not more likely to have been tested than newer ones. Conclusion: A high proportion of pre-school children have apparently not been screened for lead exposure, even among subgroups at increased risk. Most dwellings of pre-school children have not been tested for lead paint. These data suggest that most at-risk children are not being reached by current approaches to lead poisoning prevention.