Rural-urban blood lead differences in North Carolina children

E. H. Norman, W. C. Bordley, Irva Hertz-Picciotto, D. A. Newton

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective. To examine the prevalence of and risk factors for having a blood lead elevation among young children in a predominantly rural state. Methods. 20 720 North Carolina children at least 6 months and <6 years of age were screened between November 1, 1992 and April 30, 1993 using either capillary or venous measurements of blood lead. Children were tested through routine screening programs that target low-income families and, hence, were not randomly selected. Eighty-one percent of the children were screened through local public health departments, and 19% were tested at private clinics. Results. The estimated prevalences of having an elevated blood lead level among those tested were: 20.2% (≥10 μg/dL), 3.2% (≥15 μg/dL), and 1.1% (≥20 μg/dL). Black children were at substantially increased risk of having a blood lead ≥15 μg/dL (odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.7 to 2.5). Children aged 2 years old had an elevated risk (OR = 1.4, 95% CI = 1.1 to 1.7) compared to 1-year-olds, and males were at slightly increased risk (OR = 1.2, 95% CI = 1.0 to 1.4). Living in a rural county was nearly as strong a risk factor as race (OR = 1.9, 95% CI = 1.6 to 2.4). The effect of rural residence was even greater among certain subgroups of children already at highest risk of having an elevated blood lead. The type of clinic (public vs private) where a child was screened was not associated with blood lead outcome. These same trends were seen for children with blood lead levels ≥20 μg/dL. Conclusions. Among children screened from rural communities, the prevalence of elevated blood lead is surprisingly high. Though few physicians have embraced universal lead screening, these data support the need for greater awareness of lead exposure in children living outside of inner-cities.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalPediatrics
Volume94
Issue number1
StatePublished - 1994
Externally publishedYes

Fingerprint

Odds Ratio
Confidence Intervals
Rural Population
Lead
Public Health
Physicians

Keywords

  • blood lead
  • children
  • lead poisoning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Norman, E. H., Bordley, W. C., Hertz-Picciotto, I., & Newton, D. A. (1994). Rural-urban blood lead differences in North Carolina children. Pediatrics, 94(1), 59-64.

Rural-urban blood lead differences in North Carolina children. / Norman, E. H.; Bordley, W. C.; Hertz-Picciotto, Irva; Newton, D. A.

In: Pediatrics, Vol. 94, No. 1, 1994, p. 59-64.

Research output: Contribution to journalArticle

Norman, EH, Bordley, WC, Hertz-Picciotto, I & Newton, DA 1994, 'Rural-urban blood lead differences in North Carolina children', Pediatrics, vol. 94, no. 1, pp. 59-64.
Norman, E. H. ; Bordley, W. C. ; Hertz-Picciotto, Irva ; Newton, D. A. / Rural-urban blood lead differences in North Carolina children. In: Pediatrics. 1994 ; Vol. 94, No. 1. pp. 59-64.
@article{35574a95784e4b0da7461f652d252fc9,
title = "Rural-urban blood lead differences in North Carolina children",
abstract = "Objective. To examine the prevalence of and risk factors for having a blood lead elevation among young children in a predominantly rural state. Methods. 20 720 North Carolina children at least 6 months and <6 years of age were screened between November 1, 1992 and April 30, 1993 using either capillary or venous measurements of blood lead. Children were tested through routine screening programs that target low-income families and, hence, were not randomly selected. Eighty-one percent of the children were screened through local public health departments, and 19{\%} were tested at private clinics. Results. The estimated prevalences of having an elevated blood lead level among those tested were: 20.2{\%} (≥10 μg/dL), 3.2{\%} (≥15 μg/dL), and 1.1{\%} (≥20 μg/dL). Black children were at substantially increased risk of having a blood lead ≥15 μg/dL (odds ratio (OR) = 2.1, 95{\%} confidence interval (CI) = 1.7 to 2.5). Children aged 2 years old had an elevated risk (OR = 1.4, 95{\%} CI = 1.1 to 1.7) compared to 1-year-olds, and males were at slightly increased risk (OR = 1.2, 95{\%} CI = 1.0 to 1.4). Living in a rural county was nearly as strong a risk factor as race (OR = 1.9, 95{\%} CI = 1.6 to 2.4). The effect of rural residence was even greater among certain subgroups of children already at highest risk of having an elevated blood lead. The type of clinic (public vs private) where a child was screened was not associated with blood lead outcome. These same trends were seen for children with blood lead levels ≥20 μg/dL. Conclusions. Among children screened from rural communities, the prevalence of elevated blood lead is surprisingly high. Though few physicians have embraced universal lead screening, these data support the need for greater awareness of lead exposure in children living outside of inner-cities.",
keywords = "blood lead, children, lead poisoning",
author = "Norman, {E. H.} and Bordley, {W. C.} and Irva Hertz-Picciotto and Newton, {D. A.}",
year = "1994",
language = "English (US)",
volume = "94",
pages = "59--64",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "1",

}

TY - JOUR

T1 - Rural-urban blood lead differences in North Carolina children

AU - Norman, E. H.

AU - Bordley, W. C.

AU - Hertz-Picciotto, Irva

AU - Newton, D. A.

PY - 1994

Y1 - 1994

N2 - Objective. To examine the prevalence of and risk factors for having a blood lead elevation among young children in a predominantly rural state. Methods. 20 720 North Carolina children at least 6 months and <6 years of age were screened between November 1, 1992 and April 30, 1993 using either capillary or venous measurements of blood lead. Children were tested through routine screening programs that target low-income families and, hence, were not randomly selected. Eighty-one percent of the children were screened through local public health departments, and 19% were tested at private clinics. Results. The estimated prevalences of having an elevated blood lead level among those tested were: 20.2% (≥10 μg/dL), 3.2% (≥15 μg/dL), and 1.1% (≥20 μg/dL). Black children were at substantially increased risk of having a blood lead ≥15 μg/dL (odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.7 to 2.5). Children aged 2 years old had an elevated risk (OR = 1.4, 95% CI = 1.1 to 1.7) compared to 1-year-olds, and males were at slightly increased risk (OR = 1.2, 95% CI = 1.0 to 1.4). Living in a rural county was nearly as strong a risk factor as race (OR = 1.9, 95% CI = 1.6 to 2.4). The effect of rural residence was even greater among certain subgroups of children already at highest risk of having an elevated blood lead. The type of clinic (public vs private) where a child was screened was not associated with blood lead outcome. These same trends were seen for children with blood lead levels ≥20 μg/dL. Conclusions. Among children screened from rural communities, the prevalence of elevated blood lead is surprisingly high. Though few physicians have embraced universal lead screening, these data support the need for greater awareness of lead exposure in children living outside of inner-cities.

AB - Objective. To examine the prevalence of and risk factors for having a blood lead elevation among young children in a predominantly rural state. Methods. 20 720 North Carolina children at least 6 months and <6 years of age were screened between November 1, 1992 and April 30, 1993 using either capillary or venous measurements of blood lead. Children were tested through routine screening programs that target low-income families and, hence, were not randomly selected. Eighty-one percent of the children were screened through local public health departments, and 19% were tested at private clinics. Results. The estimated prevalences of having an elevated blood lead level among those tested were: 20.2% (≥10 μg/dL), 3.2% (≥15 μg/dL), and 1.1% (≥20 μg/dL). Black children were at substantially increased risk of having a blood lead ≥15 μg/dL (odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.7 to 2.5). Children aged 2 years old had an elevated risk (OR = 1.4, 95% CI = 1.1 to 1.7) compared to 1-year-olds, and males were at slightly increased risk (OR = 1.2, 95% CI = 1.0 to 1.4). Living in a rural county was nearly as strong a risk factor as race (OR = 1.9, 95% CI = 1.6 to 2.4). The effect of rural residence was even greater among certain subgroups of children already at highest risk of having an elevated blood lead. The type of clinic (public vs private) where a child was screened was not associated with blood lead outcome. These same trends were seen for children with blood lead levels ≥20 μg/dL. Conclusions. Among children screened from rural communities, the prevalence of elevated blood lead is surprisingly high. Though few physicians have embraced universal lead screening, these data support the need for greater awareness of lead exposure in children living outside of inner-cities.

KW - blood lead

KW - children

KW - lead poisoning

UR - http://www.scopus.com/inward/record.url?scp=0028225405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028225405&partnerID=8YFLogxK

M3 - Article

VL - 94

SP - 59

EP - 64

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 1

ER -