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Estimation of High Blood Lead Levels Among Children in Georgia: An Application of Bayesian Analysis
1National Center for Environmental Health, Centers for Disease Control and Prevention.
Insights
Children in Georgia may be undercounted for elevated blood lead levels (BLLs). This study used Bayesian methods to estimate BLLs in children under 6, revealing potential underreporting and the need for better protection strategies.
Area of Science:
- Environmental Health
- Pediatric Health
- Biostatistics
Background:
- Children in Georgia face elevated risks of lead exposure, particularly in specific counties.
- Screening for blood lead levels (BLLs) is conducted for high-risk groups, including those with Medicaid or Peach Care for Kids.
- Current screening may not identify all children with BLLs above the reference level of ≥5 microg/dL.
Purpose of the Study:
- To estimate the number of children under 6 years with BLLs between 5-9 microg/dL in targeted Georgia counties.
- To identify potential underreporting of elevated BLLs in children.
- To inform strategies for better protecting at-risk children from lead poisoning.
Main Methods:
- Utilized Bayesian statistical methods to estimate predictive density.
- Calculated the estimated mean number of children with BLLs of 5-9 microg/dL.
- Included 95% credible intervals for the estimated means in each targeted county.
Main Results:
- The Bayesian model indicated likely underreporting of children under 6 with BLLs of 5-9 microg/dL in Georgia counties.
- Estimated mean BLLs and credible intervals were calculated for targeted counties.
- The findings highlight a potential gap in identifying children with moderate lead exposure.
Conclusions:
- There is evidence suggesting underreporting of elevated BLLs in young children in Georgia.
- Further investigation is recommended to address underreporting.
- Improved identification and intervention are crucial for protecting children from lead poisoning risks.
Abstract:
In Georgia, children in high-risk counties are at increased risk for lead exposure. Those children and others in high-risk groups, such as families receiving Medicaid and Peach Care for Kids (i.e., health coverage for children in low-income families), are screened for blood lead levels (BLLs). Such screening, however, might not include all children at high risk for having BLLs above the reference levels (≥5 microg/dL) in the state. In our study, Bayesian methods were used to estimate the predictive density of the number of children <6 years with BLLs of 5-9 microg/dL in a targeted county from each of five selected regions of Georgia. Furthermore, the estimated mean number of children with BLLs of 5-9 microg/dL in each targeted county, along with its 95% credible interval, were calculated. The model revealed likely underreporting of some children <6 years with BLLs of 5-9 microg/dL in counties of Georgia. Further investigation might help reduce underreporting and better protect children who are at risk for lead poisoning.
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