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Updated: May 5, 2026

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Identifying High-Risk ZIP Codes for Childhood Lead Exposure: A Statewide ZCTA-Level Priority List for North Carolina

Rashida Callender1,2, Carolina Avendano3, Mercedes A Bravo1,4

  • 1Children's Environmental Health Initiative, University of Illinois at Chicago.

North Carolina Medical Journal
|October 16, 2024
PubMed

Insights

Identifying high-risk ZIP codes for childhood lead exposure is crucial for early intervention. This study used census data to pinpoint areas in North Carolina needing targeted lead poisoning prevention efforts.

Area of Science:

  • Environmental Health
  • Pediatric Public Health
  • Biostatistics

Background:

  • Childhood lead exposure poses significant risks to neurological development, with no safe blood lead level (BLL) established.
  • Despite prevention efforts, lead exposure remains a critical public health concern for children.
  • Identifying high-risk areas is essential for effective public health interventions and resource allocation.

Purpose of the Study:

  • To develop a predictive risk model for childhood lead exposure at the ZIP Code Tabulation Area (ZCTA) level in North Carolina.
  • To identify high-risk ZIP codes to guide families and healthcare providers in targeted screening and prevention efforts.

Main Methods:

  • Utilized blood lead level (BLL) testing data from North Carolina (2010-2015) and ZCTA-level census data on known lead exposure risk factors.
  • Developed a multivariable regression model predicting ZCTA-level mean of log-normalized BLLs.
  • Categorized ZCTAs into 20 priority risk quantiles for lead exposure.

Main Results:

  • The study successfully categorized ZCTAs into 20 distinct risk categories.
  • The first six quantiles were identified as particularly high-risk areas for childhood lead exposure in North Carolina.

Conclusions:

  • ZCTA-level census data effectively identifies high-risk ZIP codes for childhood lead exposure.
  • This data-driven approach facilitates timely testing for high-risk children and can be replicated nationally.
  • The findings support targeted public health strategies to mitigate lead poisoning risks in vulnerable populations.
Abstract

Keywords:
Duke HealthDuke UniversityNorth CarolinaRashida Callenderblood lead levelscensus datahealth policylead poisoningoriginal research

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