Dataset Information

Neighborhood disparities and the burden of lead poisoning.

ABSTRACT:

Background

To assess the persistence of neighborhood-level lead poisoning disparities in Rhode Island.

Methods

Rhode Island Department of Health blood lead levels (BLL) collected from 2006-2019 were linked to census block group rates of poverty and housing built pre-1950. We computed multivariate logistic regression models of elevated BLLs (≥5 µg/dL and ≥10 µg/dL).

Results

Of the 197,384 study children, 12.9% had BLLs ≥5 µg/dL and 2.3% had BLLs ≥10 µg/dL. The proportion of children with BLL ≥ 5 µg/dL increased across quintiles of poverty and old housing. The odds ratio for highest quintiles was 1.44 (95% CI: 1.29, 1.60) and 1.92 (95% CI: 1.70, 2.17) for poverty and pre-1950 housing, respectively. A significant temporal decline was observed for BLL ≥ 5 µg/dL (2006: 20.5%, 2019: 3.6%). Disparities narrowed over the study period across quintiles of poverty and old housing with a similar trend appearing in the proportion of children with BLL ≥ 10 µg/dL.

Conclusion

Despite tremendous progress in reducing lead exposure, substantial neighborhood disparities in lead poisoning persist. These findings provide valuable considerations for primary childhood lead exposure prevention.

Impact

Through linkage of Rhode Island Department of Health childhood lead poisoning and census data, this study captures neighborhood-level disparities in lead poisoning from 2006-2019. This study demonstrates that the odds of lead poisoning increased in a stepwise fashion for neighborhood quintiles of poverty and housing built pre-1950. While the magnitude of lead poisoning disparities narrowed across quintiles of poverty and old housing, disparities persist. Children's exposure to sources of lead contamination continues to be an important public health concern. The burden of lead poisoning is not equally distributed among all children or communities.

SUBMITTER: Hauptman M

PROVIDER: S-EPMC10000346 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Neighborhood disparities and the burden of lead poisoning.

Hauptman Marissa M Rogers Michelle L ML Scarpaci Matthew M Morin Barbara B Vivier Patrick M PM

Pediatric research 20230310 2

<h4>Background</h4>To assess the persistence of neighborhood-level lead poisoning disparities in Rhode Island.<h4>Methods</h4>Rhode Island Department of Health blood lead levels (BLL) collected from 2006-2019 were linked to census block group rates of poverty and housing built pre-1950. We computed multivariate logistic regression models of elevated BLLs (≥5 µg/dL and ≥10 µg/dL).<h4>Results</h4>Of the 197,384 study children, 12.9% had BLLs ≥5 µg/dL and 2.3% had BLLs ≥10 µg/dL. The proportion of ...[more]

PMID: 36899126

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Project description:Lead is the most common heavy metal found in the Earth's crust. Lead has been widely dispersed and incorporated in the natural world since prehistoric times. In the majority of wealthy countries, the amount of lead entering the atmosphere has been significantly reduced. Acute lead exposure becomes relatively low, but chronic lead exposure remains a substantial public health hazard. Disadvantaged people, are developing and industrializing countries in the Middle East and North Africa (MENA). Between 1981 and 2018, a comprehensive literature search was undertaken in the PubMed and Scopus databases. All studies were evaluated equally based on predetermined inclusion and exclusion criteria. The Delphi method was used to identify numerous resources of lead pollutants. The Mixed Method Appraisal Tool (MMAT) was used to evaluate the quality of identified papers for inclusion in the systematic review synthesis. The studies and sources of lead toxicology were further evaluated using a scale of evidence to establish the degree of evidence based on SIGN & GRADE standards. There were 14 genres and 82 subgenres identified. Through a comprehensive analysis, our cohort developed an exposure survey tool that takes into account the local sociocultural aspects of MENA countries, which will serve as a resource forresearchers, medical toxicologists, and public health professionals in the MENA region to enhance early detection of potential subjects, conduct further studies and implement exposure prevention strategies.•There is no single tool available to detect the invisible lead poison. Lead poisoning is a serious public health problem that can have devastating consequences.•The tool, called the Lead Exposure Survey Tool (LEST), uses a combination of but not limited to data sources, including blood lead levels, environmental lead levels, and demographic information, to identify subjects who are at risk of lead poisoning. LEST is a powerful tool that can help to improve early detection and prevention of lead poisoning.•The development of LEST is a major breakthrough in the fight against lead poisoning. This tool has the potential to save lives and improve the health of high risk subjects around the world.

Project description:ContextChildhood lead poisoning prevention in the United States was marked by a largely failed medical approach from 1971 to 1990; an emergent (but small) healthy housing primary prevention strategy from 1991 to 2015; and implementation of large-scale proven interventions since then.ProgramChildhood Lead Poisoning Prevention & Healthy Housing.MethodsHistoric and recent health and housing data from the National Health and Nutrition Examination Survey (NHANES) and the American Healthy Homes Survey (AHHS) were retrieved to analyze trends and associated policy gaps.EvaluationApproximately 590 000 US children aged 1 through 5 years had elevated blood lead levels of 3.5 μg/dL and greater in 2016, and 4.3 million children resided in homes with lead paint in 2019. Despite large improvements, racial and other disparities remain stubbornly and statistically significant. The NHANES and the AHHS require larger sample sizes. The Centers for Disease Control and Prevention has not published children's blood lead surveillance and NHANES data in several years; the Department of Housing and Urban Development (HUD) has no analogous housing surveillance system; and the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) have not updated training, Superfund, and occupational standards in decades.DiscussionThe nation has been without a plan and an associated budget for more than 2 decades. Congress has not reformed the nation's main lead poisoning prevention laws in more than 30 years. Such reforms include stopping US companies from producing new residential lead paint in other countries; enabling the disclosure law to identify all residential lead hazards; closing loopholes in federally assisted housing regulations and mortgage insurance standards; harnessing tax policy to help homeowners mitigate lead hazards; streamlining training requirements; increasing the size of health and housing surveys and surveillance systems; and updating housing codes, medical guidance, dust lead standards, training, Superfund, and worker exposure limits. Congress and the president should reauthorize a cabinet-level task force (dormant since 2010) to develop a new strategic plan with an interagency budget to implement it. These reforms will scale and optimize markets, subsidies, enforcement, and other proven interventions to end ineffective, costly, harmful, and irrational cost shifting that threatens children, workers, and affordable housing.

Dataset Information

Neighborhood disparities and the burden of lead poisoning.

Background

Methods

Results

Conclusion

Impact

Publications

Neighborhood disparities and the burden of lead poisoning.

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