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Sickle Cell Disease and Lead Poisoning in New York City, 2005-2019
Leah Seifu1,2, Slavenka Sedlar2, Ta'Sharee Grant2
1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Children with sickle cell disease (SCD) showed a higher prevalence of lead poisoning and pica. This suggests a potential link between SCD and lead exposure, possibly requiring updated prevention guidelines.
Area of Science:
- Pediatric Health
- Environmental Health
- Hematology
Background:
- Previous analyses of New York City (NYC) lead registry data revealed an increased prevalence of sickle cell disease (SCD) among children with lead poisoning.
- SCD is not currently recognized as a risk factor for lead poisoning.
Purpose of the Study:
- To assess the association between SCD and childhood lead poisoning.
- To determine if targeted lead poisoning prevention strategies are necessary for children with SCD.
Main Methods:
- Analysis of NYC's lead registry data for children with blood lead levels (BLLs) ≥15 mcg/dL from 2005 to 2019.
- Comparison of demographic characteristics, BLLs, and lead exposure risks between non-Hispanic Black children with and without SCD using t tests and χ2 tests.
- Comparison of observed SCD prevalence in Black children with elevated BLLs against the estimated SCD prevalence in the general Black NYC child population.
Main Results:
- Among 1728 Black children with BLLs ≥15 mcg/dL, 37 (2.14%) had SCD.
- Children with SCD had a higher mean age at peak BLL (62.8 vs. 42.7 months) and higher peak BLLs (42.59 vs. 23.06 mcg/dL) compared to those without SCD.
- Pica was a more prevalent risk factor for lead exposure in children with SCD. Observed SCD prevalence was significantly higher than estimated (1.71% higher; P < .001).
Conclusions:
- A potential association exists between SCD and childhood lead poisoning.
- Pica may be a significant risk factor linking SCD and lead poisoning.
- Findings may inform lead poisoning prevention guidelines for children with SCD.
Objectives:
Previous analyses of New York City (NYC) health department's lead registry indicated that, among children with lead poisoning, an increased prevalence of sickle cell disease (SCD) exists. However, SCD is not considered a risk factor for lead poisoning. We assessed the association between SCD and childhood lead poisoning to determine if specific lead poisoning prevention efforts are needed for children with SCD.
Methods:
We analyzed NYC's lead registry data for children with venous blood lead levels (BLLs) ≥15 mcg/dL during 2005 to 2019. t tests and χ2 tests were performed to compare demographic characteristics, BLLs, and lead exposure risks in non-Hispanic Black children with and without SCD. A t test was used to compare observed SCD prevalence among Black children with BLLs ≥15 mcg/dL with an estimated 0.43% SCD prevalence among Black NYC children.
Results:
Among 1728 Black children with BLLs ≥15 mcg/dL identified, 37 (2.14%) had SCD. When comparing children with and without SCD, both mean age at peak BLL (62.8 versus 42.7 months; P = .003) and peak BLL (42.59 versus 23.06 mcg/dL; P = .008) were higher for children with SCD. Among risk factors for lead exposure, children with SCD had higher prevalence of pica. Observed SCD prevalence was 1.71% higher than estimated SCD prevalence among Black NYC children (P < .001).
Conclusions:
We found a potential association between SCD and childhood lead poisoning. Pica emerged as a potentially important risk factor. Our findings might have implications for lead poisoning prevention guidelines for children with SCD.
