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Assessment of Child Lead Exposure in a Philadelphia Community, 2014
Abstract
Introduction
Several urban neighborhoods in Philadelphia, Pennsylvania have a history of soil, household lead paint and potential lead-emitting industry contamination.
Objectives
1) Describe blood lead levels (BLLs) in target neighborhoods; 2) identify risk factors and sources of lead exposure; 3) describe household environmental lead levels; and 4) compare results with existing data.
Methods
A simple, random, cross-sectional sampling strategy was used to enroll children ≤ 8 years living in selected Philadelphia neighborhoods with a history of lead-emitting industry during July 2014. Geometric mean of child BLLs and prevalence of BLLs ≥ 5 μg/dL were calculated. Linear and logistic regression analyses were used to ascertain risk factors for elevated BLLs.
Results
Among 104 children tested for blood lead, 13 (12.4%, 95% CI, 7.5–20.2%) had BLLs ≥ 5 μg/dL. The geometric mean BLL was 2.0 μg/dL [95% CI, 1.7–2.3μg/dL]). Higher geometric mean BLLs were significantly associated with front door entryway dust lead content, residence built prior to 1900, and a child currently or ever receiving Medicaid. Seventy-one percent of households exceeded the screening level for soil, 25% had an elevated front door floor-dust lead level, 28% had an elevated child play area floor-dust lead level and 14% had an elevated interior window-dust lead level. Children in households with 2–3 elevated environmental lead samples were more likely to have BLLs ≥5 μg/dL. A spatial relationship between household proximity to historic lead-emitting facilities and child lead sampling results was not identified.
Conclusion
Entryway floor dust lead levels were strongly associated with blood lead levels in participants. Reduction of child lead exposure is crucial and continued blood lead surveillance, testing and inspection of homes of children with BLLs ≥5 μg/dL to identify and control lead sources is recommended. Pediatric health care providers should be especially vigilant in screening Medicaid-eligible/enrolled children and children living in very old housing or near legacy lead sites.