Rural and Urban Ecologies of Early Childhood Toxic Lead Exposure -- the State of Kansas, 2005 to 2012

Abstract

Introduction. No safe detectable level of lead (Pb) exists in the blood of children. Until recently, Centers for Disease Control and Prevention (CDC) guidelines designate a blood lead level (BLL) ≥5 µg/dL as an elevated BLL (EBLL). For the State of Kansas, early childhood blood lead burdens lack reporting in the literature. Methods. Secondary analysis of passively-reported EBLL rates ≥5 µg/dL among children ages 0–5 years at the zip code-level in Kansas during 2005 to 2012. Data weights using corresponding population estimates were applied to produce statewide outcomes. Results. Statewide estimates of annual testing coverage in Kansas among children ages 0–5 years were low (9.7%). Approximately 17,000 children ages 0–5 years developed an EBLL ≥5 µg/dL each year in Kansas with a 6.9% statewide EBLL rate compared to the national rate of 3.2% for the corresponding years. Significant variations in EBLL rates were found between suburban zip codes compared to urban, urban cluster, or rural at 3.1%, 7.2%, 8.8%, and 10.0% respectively. Among the worst outcomes in EBLL rates was observed for zip codes in Southeast Kansas (13.5%) and rural areas with <500 persons (15.1%). Conclusions. Young children in Kansas have twice the risk of developing an EBLL ≥5 µg/dL compared to the national rate, while higher rates are consistently seen outside of the suburbs and particularly in rural areas. At-risk children and troubled areas of toxic lead exposure in the State of Kansas require increased recognition with improved targeting and interventions.