Lead Exposure Risk and Testing for Pregnant People in Milwaukee

Despite established lead exposure risks in Milwaukee from leaded water service lines and lead dust exposure with aged housing stock, most pregnant people do not have lead levels tested. We aimed to assess the prevalence of elevated lead levels among pregnant people and assess for differences in maternal and neonatal outcomes by lead detection.

We conducted a prospective, longitudinal study. English-speaking pregnant people ≥18 years of age receiving prenatal care were consented to receive a point-of-care (POC) lead test from June 2019 through July 2021. POC lead testing was not offered outside of the study. Venous lead labs were ordered to confirm elevated POC results (≥5 mcg/dL).

Overall (n=233), 42.1% had an exposure risk given lead service line to their homes. Nine (3.9%) had an elevated POC lead test; half completed venous lead tests, and none were elevated. Twenty-two (9.4%) had detectable lead (≥3.3 mcg/dL).

Venous lead testing should be considered in high-risk areas with standard prenatal labs to facilitate effective lead screening given the study population's risk of lead exposure.