Resurgent lead poisoning and renewed public attention towards environmental social justice issues: A review of current efforts and call to revitalize primary and secondary lead poisoning prevention for pregnant women, lactating mothers, and children within the U.S.

Abstract

The recent Colorado Gold King Mine waste-water spill and Michigan's water supply re-routing program catastrophe, has directed renewed public attention towards resurgent environmental lead contamination threats. Leaded environments present social justice issues for children and mothers possessing blood lead levels (BLLs) > 5 μg/dL. Childhood lead exposure remains a continual U.S. public health problem manifesting in lifelong adverse neuropsychological consequences. The 2007 Inspector General Report demonstrated low BLL screening rates across the U.S. and this study examined the regularity of children's BLL screening rates. The Centers for Disease Control and Prevention (CDC) Lead Poisoning National Surveillance 2010-2014 children's BLL screening rates, were examined to assess BLL screening regularity in states traditionally known to have regularly occurring BLL screenings: New York, New Jersey, and Pennsylvania. The results extracted from the CDC data showed that < 50% of children were BLL screened by six-years of age across the states that were sampled. The findings highlight that without a "clear map" of lead exposed areas through accurate and consistent BLL screenings, how the potential for such disparities within - and between-states within the U.S. could arise due to environmental social justice issues in relation to BLL screening barriers. Barriers preventing children's BLL screenings were considered, and public health interventions recommended to improve screening rates included: routine BLL screening for all pregnant women, lactating mothers, and children; while, removing known lead exposure sources within communities. This study calls for action during a time of renewed public attention to resurgent lead poisoning within the U.S.

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

“…Although it is more costly than targeted screening, universal BLL testing during early childhood would close gaps in identification by detecting all cases that are EBLL-positive [99]. Universal testing of early childhood BLLs would also allow for a near-complete understanding of the remaining troubled areas of Pb contamination, continuing socio-economic or racial/ethnic disparity, and how to devise better performing targeting, preventive, intervention, and abatement or remediation efforts [100,101]. Furthermore, conservative estimates demonstrate that each $1 US dollar invested in controls just for leaded paint hazards alone generate a return of at least $17 USD, which then results in a net savings of $181 billion USD [102].…”

Effects of Individual and Neighborhood Characteristics on Childhood Blood Lead Testing and Elevated Blood Lead Levels, A Pennsylvania Birth Cohort Analysis

“…19 Another study showed that 50% or fewer children in New York, New Jersey, Pennsylvania, and Michigan were screened for BLLs before 6 years of age, and Pennsylvania children had the lowest screening rate and the highest burden of EBLLs. 20 Only a few studies have examined independent effects of selected characteristics such as age, race/ethnicity, parental educational attainment, Medicaid enrollment, and neighborhood characteristics on the likelihood of receipt of lead testing. 10 , 11 It is unclear whether community-level characteristics interact with individual risk factors on the likelihood of being tested for BLLs.…”

Chronic Developmental Lead Exposure increases μ-Opiate Receptor Levels in the Adolescent Rat Brain

“…In the United States, public health policy implemented in the late 1970s to remove Pb 2+ from paint and gasoline was effective in markedly reducing the overall levels of Pb 2+ in blood of the general population and in particular in children (Lanphear et al, 2003;Pirkle et al, 1994;Pirkle et al, 1998). However, there is still a significant number of children with blood Pb 2+ levels that are detrimental to their health (Christensen et al, 2019;Han et al, 2018;Neuwirth, 2018;Tirima et al, 2018). Recent events indicate that a significant number of municipalities suffer from Pb 2+ contamination in drinking water in homes and schools throughout the United States (Hanna-Attisha et al, 2016).…”