Assessing Child Lead Poisoning Case Ascertainment in the US, 1999–2010

Roberts, Eric M.; Madrigal, Daniel; Valle, Jhaqueline; King, Galatea; Kite, Linda

doi:10.1542/peds.2016-4266

Cited by 35 publications

(25 citation statements)

References 21 publications

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“…Safe housing efforts that include the abatement, remediation, and prevention of environmental Pb hazards in older housing may therefore not be reaching young Black children in as equitable of a manner as their peers. Higher rates of substandard housing conditions afforded to Black families has previously been suggested to significantly contribute to early childhood blood Pb disparities [38,74]. Black children are more likely to reside in homes with leaded paint hazards and are exposed to more household Pb dust [67][68][69].…”

Section: Safe Housing and Environmental Justicementioning

confidence: 99%

“…Targeted screening of predominantly Black areas at high risk in Chicago, Illinois, during 2001 revealed that nearly two out of three children with an EBLL ≥10 µg/dL were not previously tested and therefore went unidentified until the study had examined them [98]. At the national level, efforts in targeted screening miss one in three children with an EBLL ≥10 µg/dL, while up to two out of three EBLL-positive children in the South are not identified [74]. These conditions disproportionately impact Black children, as they are exposed to greater amounts of environmental Pb and continue to have much higher BLLs than their White or Hispanic peers.…”

Section: Targeted Screening and Public Health Implicationsmentioning

confidence: 99%

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Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Yeter¹,

Banks

Aschner

2020

IJERPH

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There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1-5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.

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Section: Safe Housing and Environmental Justicementioning

confidence: 99%

Section: Targeted Screening and Public Health Implicationsmentioning

confidence: 99%

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Yeter¹,

Banks

Aschner

2020

IJERPH

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“…Local, state, and national childhood blood lead surveillance data are imperfect owing to the reliance on health care providers to identify appropriate children for testing (without sufficient tools to determine a child’s individual risk) and incomplete reporting of test results by clinicians and clinical laboratories to public health departments. 30 …”

mentioning

confidence: 99%

Invited Perspective: Identifying Childhood Lead Exposure Hotspots for Action

Ettinger

2022

Environ Health Perspect

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“…28,29 As a result of undertesting of children, it is estimated that the state identifies only 37% of children with BLLs ‡10 mg/dL. 30 There is little evidence that the State's childhood lead database has been used for the planning or evaluation of prevention of lead exposure. Rather, it is narrowly focused on limited investigation of individual cases and addressing sources of exposure only after poisoning has occurred.…”

Section: Childrenmentioning

confidence: 99%

Industrial Lead Poisoning in Los Angeles: Anatomy of a Public Health Failure

Johnston¹,

Hricko²

2017

Environmental Justice

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The recent environmental tragedy in Flint, Michigan, where lead-contaminated drinking water raised fears of potential health effects for exposed children, revealed the failure of a regulatory system to protect residents from lead exposure. Flint is clearly not alone as a community of color where residents are disproportionately exposed to lead from paint, dust, soil, or water. In southeast Los Angeles County, California, a facility that recycled lead-acid batteries has polluted the air and soil of communities nearby for decades. Termed as ''environmental disaster'' by the governor, this large-scale pollution of the air and soil in largely Latino communities is emblematic of the continued risk associated with facilities that make or recycle lead-acid batteries. We discuss the influence of industrial lead emissions on public health, the roles of agencies charged with prevention of lead exposure in California, and the fractured system that allowed this large-scale contamination to persist for decades. Finally, we offer recommendations on how public agencies can improve public health surveillance of lead exposures and step out of their individual ''silos'' to share information and collaborate to better protect vulnerable children, workers, and communities.

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Assessing Child Lead Poisoning Case Ascertainment in the US, 1999–2010

Abstract: Based on the best available estimates, undertesting of blood lead levels by pediatric care providers appears to be endemic in many states.

Cited by 35 publications

References 21 publications

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Invited Perspective: Identifying Childhood Lead Exposure Hotspots for Action

Industrial Lead Poisoning in Los Angeles: Anatomy of a Public Health Failure

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