Blood Lead Levels Among Children Aged <6 Years — Flint, Michigan, 2013–2016

Abstract

, approximately 99,000 residents of Flint, Michigan, were affected by changes in drinking water quality after their water source was switched from the Detroit Water Authority (DWA), sourced from Lake Huron, to the Flint Water System (FWS), sourced from the Flint River.* Because corrosion control was not used at the FWS water treatment plant, the levels of lead in Flint tap water increased over time. Adverse health effects are associated with lead exposure (1). On January 2, 2015, a water advisory was issued because of detection of high levels of trihalomethanes, byproducts of disinfectants. †, § Studies conducted by local and national investigators detected an increase in the prevalence of blood lead levels (BLLs) ≥5 µg/dL (the CDC reference level) among children aged <5 years living in Flint (2) and an increase in water lead levels after the water source switch (3). On October 16, 2015, the Flint water source was switched back to DWA, and residents were instructed to use filtered tap water for cooking and drinking. During that time, pregnant and breastfeeding women and children aged <6 years were advised to consume bottled water. ¶ To assess the impact on BLLs of consuming contaminated drinking water, CDC examined the distribution of BLLs ≥5 µg/dL among children aged <6 years before, during, and after the switch in water source. This analysis enabled determination of whether the odds of having BLLs ≥5 µg/dL before the switch differed from the odds during the switch to FWS (before and after the January 2, 2015, water advisory was issued), and after the switch back to DWA. Overall, among 9,422 blood lead tests in children aged <6 years, 284 (3.0%) BLLs were ≥5 µg/dL during April 25, 2013-March 16, 2016. The adjusted probability of having BLLs ≥5 µg/dL was 46% higher during the period after the switch from DWA to FWS (and before the January 2, 2015, water advisory) than during the period before the water switch to FWS. Although unrelated to lead in the water, the water advisory likely reduced tap water consumption and increased consumption of bottled water. Characterizing exposure to lead contaminated drinking water among children aged <6 years living in Flint can help guide appropriate interventions.Blood lead testing in Michigan is targeted to children living at or below the poverty level as well as to children enrolled in Medicaid. The Centers for Medicare & Medicaid Services requires all children on Medicaid to receive blood lead screening at ages 12 and 24 months, or at ages 36 and 72 months if previous screening has not been conducted. Confirmed BLLs ≥5 µg/dL are defined as having one venous blood lead test result ≥5 µg/dL or two capillary blood lead test results ≥5 µg/dL drawn within 12 weeks of each other.Analyses of BLLs obtained during four periods were conducted. These included the period 1) before the switch from DWA to FWS (April 25, 2013-April 24, 2014; 2) after the switch from DWA to FWS, but before the water advisory was issued (April 25, 2014-January 2, 2015); 3) after the switch to FWS, and after...

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