Blood Lead Levels in U.S. Children Ages 1–11 Years, 1976–2016

Abstract

Background: Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1–11 y by selected sociodemographic and housing characteristics over a 40-y period. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) II (1976–1980), NHANES III (Phase 1: 1988–1991 and Phase II: 1991–1994), and Continuous NHANES (1999–2016) were used to describe the distribution of BLLs (in micrograms per deciliter; ) in U.S. children ages 1–11 y from 1976 to 2016. For all children with valid BLLs ( ), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence (95% CI) were calculated overall and by selected characteristics, stratified by age group (1–5 y and 6–11 y). Results: The GM BLL in U.S. children ages 1–5 y declined from (95% CI: 14.3, 16.1) in 1976–1980 to (95% CI: 0.78, 0.88) in 2011–2016, representing a 94.5% decrease over time. For children ages 6–11 y, GM BLL declined from (95% CI: 11.9, 13.4) in 1976–1980 to (95% CI: 0.58, 0.63) in 2011–2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011–2016), estimates indicate that approximately 385,775 children ages 1–11 y had BLLs greater than or equal to the CDC blood lead reference value of . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age. Discussion: Overall, BLLs in U.S. children ages 1–11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932

Risk of lead exposure, subcortical brain structure, and cognition in a large cohort of 9- to 10-year-old children

“…Even though lead-based house paint and leaded gasoline (for on-road vehicles) were banned in the US in 1978 [ 78 ] and 1996 [ 79 ], children remain at risk for ingesting lead via (1) drinking water provided through lead service lines (i.e., lead-containing plumbing) [ 80 ], (2) lead-contaminated dust and soil given the prior use of lead-based paint in older buildings [ 27 ], and (3) lead-contaminated topsoil from past leaded-gasoline vehicle emissions [ 81 ]. Indeed, while average blood lead levels have substantially declined over the past several decades, a 2021 study estimated that nearly 400,000 1-to-11-year-olds in 2011–2016 had blood-lead levels exceeding the CDC’s reference level of 5 μg/dL [ 82 ]. Here, about one in five houses in our participants’ neighborhoods were estimated to contain lead-based paint hazards, which is consistent with national surveys showing that 25% of United States housing stock contains one or more lead hazards [ 27 ].…”

Examining the Lead Exposure and its Effects among U.S Children

“…Lead exposure commonly comes from old lead pipes, faucets, and plumbing fixtures. In addition to water contamination, nearly 23 million houses have lead-based paint hazards in the United States (Egan et al, 2021). Egan and his colleagues also found that there are more than 3.6 million households with children younger than six years old living in these lead-filled homes.…”

“…Lead exposure is one of the most common and well-known direct and indirect environmental diseases among children in the United States. The dust in older housing and leadbased paint is one of the primary sources of lead exposure among U.S children (Egan et al, 2021). Consumer products such as imported foods as well as lead exposure in the workplace are the other common sources of lead exposure (Ettinger et al, 2019).…”

“…There are several persistent risk factors that are behind the higher prevalence of blood lead levels in U.S children. Although blood lead levels dramatically decreased in children in the U.S over the past 40 years, minority children with low socioeconomic status have higher blood lead levels of more than non-minority children (Egan et al, 2021). Egan and his colleagues found that Black and Hispanic children have higher blood lead level prevalence when compared to white children and those from higher-income families.…”

“…Likewise, Seifu et al (2020) reported that low socioeconomic status is a major risk factor that drives the elevated blood lead levels in U.S children. Egan et al (2021) also suggested that sociodemographic characteristics such as income level and housing are the other factors that drive the higher prevalence of blood lead levels in U.S children.…”