Targeting lead screening: The Ohio Lead Risk Score.

Area of Science:

• Environmental health
• Pediatric public health
• Epidemiology

Background:

• Annual blood lead (BPb) screening is recommended for children aged 2 years and younger in high-risk areas.
• Current methods for identifying high-risk areas lack specificity.
• Efficient methods are needed to identify risk factors for undue lead exposure in children using community variables.

Purpose of the Study:

• To develop an efficient method for identifying community-level risk factors for elevated blood lead levels (BPb) in children.
• To validate a predictive model for high-risk lead exposure areas.

Main Methods:

• Logistic regression was used for model development on one-half of the sample and validated on the remaining half.
• Census tract characteristics from 19 Ohio counties were analyzed for association with children's BPb test results.
• High-risk status was defined as census tracts with ≥12% of BPb test results ≥10 µg/dL.

Main Results:

• Data from 897 census tracts were analyzed.
• Increased risk for lead toxicity was associated with: ≥55% of houses built before 1950 (AOR: 10.9), ≥35% Black residents (AOR: 3.5), ≥35% with less than a high school education (AOR: 6.1), and ≥50% renter-occupied housing (AOR: 3.6).
• Model validation using ROC curves showed no significant differences in the second dataset.

Conclusions:

• Community characteristics, including housing age, race, education, and occupancy, effectively predict children's risk for lead toxicity.
• This approach can help focus lead screening efforts, particularly in areas with limited public health resources.
• The methodology may also assist in identifying community factors associated with other environmental public health hazards for children.