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Prevalence of lead poisoning among two-year-old children in Vermont
L J Paulozzi1, J Shapp, R E Drawbaugh
1Vermont Department of Health, Burlington, USA.
Insights
Elevated lead levels in 2-year-olds are a concern in rural areas. Medicaid-enrolled children show higher prevalence, indicating a need for targeted interventions for childhood lead poisoning.
Area of Science:
- Environmental Health
- Pediatric Health
- Public Health Policy
Background:
- The Centers for Disease Control and Prevention (CDC) redefined childhood lead poisoning, increasing the number of affected children.
- Assessing lead exposure in young children is crucial for early intervention and long-term health outcomes.
- Rural areas with older housing may present unique challenges for lead exposure prevention.
Purpose of the Study:
- To determine the prevalence of elevated blood lead levels (BLLs) of 10 micrograms/dL or more in 2-year-old children in a rural state.
- To identify potential high-risk groups within the pediatric population for lead exposure.
- To inform public health strategies for lead poisoning prevention in underserved areas.
Main Methods:
- Random sampling of 2-year-old children from birth certificate and Medicaid rosters.
- Capillary blood specimens were collected and confirmed with venous tests for elevated lead levels.
- Participation rates were 63.9% (birth certificate group) and 66.4% (Medicaid group).
Main Results:
- In the birth certificate sample, 9.0% of children had BLLs ≥10 µg/dL.
- In the Medicaid sample, 14.9% of children had BLLs ≥10 µg/dL.
- Children in the most urban county had significantly lower lead levels compared to the rest of the state.
Conclusions:
- Elevated lead levels in 2-year-olds can be significant in rural states, particularly those with older housing.
- Medicaid-enrolled children represent a readily identifiable and high-risk group for elevated lead levels.
- Findings underscore the importance of continued surveillance and targeted interventions for childhood lead poisoning.
Objectives:
The recent redefinition of childhood lead poisoning by the Centers for Disease Control and Prevention means that many more children are considered lead poisoned than previously. The primary purpose of this study was to determine how many 2-year-old children had lead levels of 10 micrograms/dL or more in a rural state.
Methods:
Random samples of 334 children drawn from the birth certificate file and 350 children from Vermont Medicaid rosters submitted capillary blood specimens that were confirmed by venous tests if lead levels were 10 micrograms/dL or more.
Results:
Participation rates were 63.9% in the birth certificate group and 66.4% in the Medicaid group. In the birth certificate sample, the percentages of children with confirmed lead levels 10 micrograms/dL or more, 15 micrograms/dL or more, and 20 micrograms/dL or more were 9.0 (95% confidence interval [CI], 6.2-12.6), 2.7 (95% CI, 1.2-5.0), and 1.5 (95% CI, 0.5-3.4), respectively. In the Medicaid sample, the corresponding percentages were 14.9 (95% CI, 11.4-19.2), 5.1 (95% CI, 3.1-8.0), and 2.0 (95% CI, 0.8-4.1), respectively. The percentage of children in the state's most urban county with lead levels of 10 micrograms/dL or more was significantly less than that in the rest of the state in both samples.
Conclusions:
The prevalence of elevated lead levels in 2-year-old children may be significant in rural states with old housing stock. Medicaid-enrolled children represent a readily identifiable high-risk group.