High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates

Abstract

Lead in maternal blood can cross the placenta and result in elevated blood lead levels in newborns, potentially producing negative effects on neurocognitive function, particularly if combined with childhood lead exposure. Little research exists, however, into the burden of elevated blood lead levels in newborns, or the places and populations in which elevated lead levels are observed in newborns, particularly in rural settings. Using ~2300 dried bloods spots collected within 1–3 days of birth among Iowa newborns, linked with the area of mother’s residence at the time of birth, we examine the spatial patterns of elevated (>5 μg/dL) blood lead levels and the ecological-level predictors of elevated blood lead levels. We find that one in five newborns exceed the 5 μg/dL action level set by the US Centers for Disease Control & Prevention (CDC). Bayesian spatial zero inflated regression indicates that elevated blood lead in newborns is associated with areas of increased pre-1940s housing and childbearing-age women with low educational status in both rural and urban settings. No differences in blood lead levels or the proportion of children exceeding 5 μg/dL are observed between urban and rural maternal residence, though a spatial cluster of elevated blood lead is observed in rural counties. These characteristics can guide the recommendation for testing of infants at well-baby appointments in places where risk factors are present, potentially leading to earlier initiation of case management. The findings also suggest that rural populations are at as great of risk of elevated blood lead levels as are urban populations. Analysis of newborn dried blood spots is an important tool for lead poisoning surveillance in newborns and can direct public health efforts towards specific places and populations where lead testing and case management will have the greatest impact.

How Does Low Socioeconomic Status Increase Blood Lead Levels in Korean Children?

“…These findings are in disagreement with those published by Meza-Montenegro (2013) [ 45 ].The reason for this difference may be due to differences in the SES of each country’s agricultural area. However, recent study has shown that lead exposure in rural areas is high as in our study [ 46 ].…”

Relation between low birth weight and Maternal blood lead levels in Sidi Bel Abbes, Algeria: a case-control study

“…In this item,contamination generally is greater in urban than rural areas where there is no specific or identified point sources, though, our finding showed that no differences in blood lead levels are observed between urban and rural maternal residence. A detailed research [21] confirm our result and suggest that rural populationsare at as great of risk of elevated blood lead levels as are urban populations.…”

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

“…Therefore, we only examined individual-level characteristics and not ecological-level variables such as the percent Black population. Other geographical covariates in the NHANES such as differing US regions or urban vs. rural setting were also not examined, although authors have reported such significant variations in childhood blood Pb nationally and between different states [82,[105][106][107][108][109].…”