Comparing Lead Poisoning Risk Assessment Methods: Census Block Group Characteristics vs. Zip Codes as Predictors

Kaplowitz, Stan A.; Perlstadt, Harry; Post, Lori A.

doi:10.1177/003335491012500212

Cited by 29 publications

(48 citation statements)

References 32 publications

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“…20,[24][25][26][27] It is also associated with poverty. 22,[26][27][28][29][30] Neighborhoods with higher median household incomes and/or newer housing significantly protect children from elevated BLLs. 24,25,[27][28][29][30][31] Most recently, Moody et al 22 found that even in neighborhoods of the highest household incomes, black children were still significantly more at risk for lead poisoning than white children were in the Detroit Metropolitan Area (DMA).…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Neighborhood Socioeconomic Differences and Racial Residential Segregation to Childhood Blood Lead Levels in Metropolitan Detroit

2016

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This study uses a new approach to assess the impact of different neighborhood characteristics on blood lead levels (BLLs) of black versus white children in metropolitan Detroit. Data were obtained from the Michigan Department of Community Health and the US Bureau of the Census American Community Survey. The Modified Darden-Kamel Composite Socioeconomic Index, bivariate regression, and the index of dissimilarity were used to compute neighborhood BLL unevenness by neighborhood characteristics. Neighborhoods with lower socioeconomic characteristics and high racial residential segregation predicted higher average childhood BLLs. This reveals a social spatial structure that will aid researchers/policymakers in better understanding disparities in childhood BLLs.

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Section: Introductionmentioning

confidence: 99%

The Relationship of Neighborhood Socioeconomic Differences and Racial Residential Segregation to Childhood Blood Lead Levels in Metropolitan Detroit

2016

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“…Identification of environmental risk factors and understanding of the distribution of the lead in the environment is important for health departments in better targeting at risk populations [6][7][8][9]. Ecological studies modeling risk factors are also valuable because they give insight to public health intervention strategies [10][11][12][13][14][15][16][17][18]. For ecological studies of childhood lead poisoning, one needs to identify sources of lead toxicity and determine environmental risk factors based on the distribution of the toxicants and how children come into contact with them in their daily lives [19][20][21][22][23][24][25][26][27][28].…”

Section: Ecological Studies and Gis Use In Childhood Lead Poisoningmentioning

confidence: 99%

“…Public health departments recognized the advantages of GIS in screening, exposure prediction, and mapping cases. Using BLL data for lead poisoning, an increasing number of GIS-based ecological studies have identified risk factors as socioeconomic status (SES) [9][10][11][12][13][14][15][16][17][18]21], year built of housing [7][8][9][10][11]13,[15][16][17][18]20,21,23,28], race [11,13,14,16,17,21,23,27,28] and ethnicity [15,16,18].…”

Section: Ecological Studies and Gis Use In Childhood Lead Poisoningmentioning

confidence: 99%

“…At the data preparation stage, address geocoding is the most used tool to transfer tabular data sets, such as screened children addresses, into GIS [7][8][9][10][11][12][13][14][15][16][17][18][19]23]. Various GIS functions were used for multivariate mapping of BLLs and risk factors in a limited custom such as linking SES data with screened data records [49,50], map overlays [51,52], distance calculations [53], and hyperlinks to demolishing sites' photos and city maps for mapping dust-fall lead loadings [54].…”

Section: Ecological Studies and Gis Use In Childhood Lead Poisoningmentioning

confidence: 99%

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Exploring Childhood Lead Exposure through GIS: A Review of the Recent Literature

Akkus¹,

Ozdenerol²

2015

Everyday Environmental Toxins

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Childhood exposure to lead remains a critical health control problem in the US. Integration of Geographic Information Systems (GIS) into childhood lead exposure studies significantly enhanced identifying lead hazards in the environment and determining at risk children. Research indicates that the toxic threshold for lead exposure was updated three times in the last four decades: 60 to 30 micrograms per deciliter (µg/dL) in 1975, 25 µg/dL in 1985, and 10 µb/dL in 1991. These changes revealed the extent of lead poisoning. By 2012 it was evident that no safe blood lead threshold for the adverse effects of lead on children had been identified and the Center for Disease Control (CDC) currently uses a reference value of 5 µg/dL. Review of the recent literature on GIS-based studies suggests that numerous environmental risk factors might be critical for lead exposure. New GIS-based studies are used in surveillance data management, risk analysis, lead exposure visualization, and community intervention strategies where geographically-targeted, specific intervention measures are taken.

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“…Previous research in Michigan 9 and elsewhere 10,11 has led to a refined geographic approach to predicting the BLL of children. Unlike previous studies that use ZIP codes and census tracts, this research relied heavily on the characteristics of the census-block group (the smallest geographic unit for which detailed data were available).…”

mentioning

confidence: 99%

The Predictive Value of Self-Report Questions in a Clinical Decision Rule for Pediatric Lead Poisoning Screening

et al. 2012

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Objective. We derived a clinical decision rule for determining which young children need testing for lead poisoning. We developed an equation that combines lead exposure self-report questions with the child's census-block housing and socioeconomic characteristics, personal demographic characteristics, and Medicaid status. This equation better predicts elevated blood lead level (EBLL) than one using ZIP code and Medicaid status.Methods. A survey regarding potential lead exposure was administered from October 2001 to January 2003 to Michigan parents at pediatric clinics (n53,396). These self-report survey data were linked to a statewide clinical registry of blood lead level (BLL) tests. Sensitivity and specificity were calculated and then used to estimate the cost-effectiveness of the equation.Results. The census-block group prediction equation explained 18.1% of the variance in BLLs. Replacing block group characteristics with the self-report questions and dichotomized ZIP code risk explained only 12.6% of the variance. Adding three self-report questions to the census-block group model increased the variance explained to 19.9% and increased specificity with no loss in sensitivity in detecting EBLLs of $10 micrograms per deciliter. Conclusions.Relying solely on self-reports of lead exposure predicted BLL less effectively than the block group model. However, adding three of 13 self-report questions to our clinical decision rule significantly improved prediction of which children require a BLL test. Using the equation as the clinical decision rule would annually eliminate more than 7,200 unnecessary tests in Michigan and save more than $220,000.

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Comparing Lead Poisoning Risk Assessment Methods: Census Block Group Characteristics vs. Zip Codes as Predictors

Cited by 29 publications

References 32 publications

The Relationship of Neighborhood Socioeconomic Differences and Racial Residential Segregation to Childhood Blood Lead Levels in Metropolitan Detroit

The Relationship of Neighborhood Socioeconomic Differences and Racial Residential Segregation to Childhood Blood Lead Levels in Metropolitan Detroit

Exploring Childhood Lead Exposure through GIS: A Review of the Recent Literature

The Predictive Value of Self-Report Questions in a Clinical Decision Rule for Pediatric Lead Poisoning Screening

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