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Epidemiologic Characteristics of Children with Blood Lead Levels ≥45 μg/dL

Published:October 19, 2016DOI:https://doi.org/10.1016/j.jpeds.2016.09.017

      Objectives

      To identify risk factors and describe outcomes for children newly identified with blood lead levels (BLLs) ≥45 µg/dL in New York City (NYC) during 2004-2010 to promote timely identification as well as inform clinical practice and public health policy.

      Study design

      Inclusion criteria were residence in NYC and an elevated confirmatory venous test within 2 weeks of the initial BLL ≥45 µg/dL. Data collected during case coordination of these children were linked with blood testing data and home inspection reports. Children with BLLs ≥45 µg/dL also were compared with the general population of children younger than 18 years of age in NYC.

      Results

      A total of 145 children <18 years of age were newly identified with BLLs ≥45 µg/dL. The mean age was 3.83 years, and the median time for BLL to decline below 10 µg/dL was 3.26 years. Major reported risk factors were eating paint (36%), spending time outside the US (34%), having a developmental delay (27%), using imported products (26%), being foreign born (14%), being of Pakistani descent (12%), eating soil (5%), and having sickle cell disease (4%). Compared with the age-standardized NYC population, cases were more likely to be Asian or black and live in housing built before 1940.

      Conclusions

      Although the incidence of lead poisoning has declined in the US, severe cases still occur. Physicians should be especially vigilant in certain at-risk populations including children who eat paint chips or soil, spend time outside the US (particularly in Pakistan), use imported products, or have developmental delays or sickle cell disease.

      Keywords

      Abbreviations:

      BLL (Blood lead level), DOHMH (Department of Health and Mental Hygiene), NYC (New York City), PDD (Pervasive development disorder), RA (Risk assessment), SCD (Sickle cell disease), XRF (X-ray fluorescence)
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