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      Revisiting Nonresidential Environmental Exposures and Childhood Lead Poisoning in the US: Findings from Kansas, 2000–2005

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          Abstract

          Although blood lead levels (BLLs) in US children have dramatically declined over the past 40 years, there remain pockets of children living in areas with elevated BLLs. While some increases (≥10  μg/dL) may be associated with legacy lead paint, ambient air lead may be contributing to the problem. A deidentified dataset of information on over 60,000 Kansas children under 3 years of age who were tested for BLL was provided through the Kansas Environmental Public Health Tracking Network for the period 2000–2005. Using ArcGIS, we calculated distance (in miles) from a lead-emitting industry referred to as a toxic release inventory (TRI) site. The USEPA TRI database tracks the management of certain toxic chemicals that may pose a threat to human health. US facilities in different industry sectors must report annually amount of substances like lead into the environment including their exact location. Distance from a TRI site was inversely related to BLL after controlling for area-level poverty and pre-1950 housing. The results of our evaluation indicate there is a significant relationship between proximity to lead industry and childhood BLLs. Proximity to sources of lead emissions should be evaluated as a possible factor when identifying children for targeted BLL testing.

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          Most cited references22

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          Trends in blood lead levels and blood lead testing among US children aged 1 to 5 years, 1988-2004.

          To evaluate trends in children's blood lead levels and the extent of blood lead testing of children at risk for lead poisoning from national surveys conducted during a 16-year period in the United States. Data for children aged 1 to 5 years from the National Health and Nutrition Examination Survey III Phase I, 1988-1991, and Phase II, 1991-1994 were compared to data from the survey period 1999-2004. The prevalence of elevated blood lead levels, >/=10 microg/dL, among children decreased from 8.6% in 1988-1991 to 1.4% in 1999-2004, which is an 84% decline. From 1988-1991 and 1999-2004, children's geometric mean blood lead levels declined in non-Hispanic black (5.2-2.8 microg/dL), Mexican American (3.9-1.9 microg/dL), and non-Hispanic white children (3.1 microg/dL to 1.7 microg/dL). However, levels continue to be highest among non-Hispanic black children relative to Mexican American and non-Hispanic white children. Blood lead levels were distributed as follows: 14.0% were /=10 microg/dL. Multivariable analysis indicated that residence in older housing, poverty, age, and being non-Hispanic black are still major risk factors for higher lead levels. Blood lead testing of Medicaid-enrolled children increased to 41.9% from 19.2% in 1988-1991. Only 43.0% of children with elevated blood lead levels had previously been tested. Children's blood lead levels continue to decline in the United States, even in historically high-risk groups for lead poisoning. To maintain progress made and eliminate remaining disparities, efforts must continue to test children at high risk for lead poisoning, and identify and control sources of lead. Coordinated prevention strategies at national, state, and local levels will help achieve the goal of elimination of elevated blood lead levels.
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            Geographic information systems: their use in environmental epidemiologic research.

            Advances in geographic information system (GIS) technology, developed by geographers, provide new opportunities for environmental epidemiologists to study associations between environmental exposures and the spatial distribution of disease. A GIS is a powerful computer mapping and analysis technology capable of integrating large quantities of geographic (spatial) data as well as linking geographic with nongeographic data (e.g., demographic information, environmental exposure levels). In this paper we provide an overview of some of the capabilities and limitations of GIS technology; we illustrate, through practical examples, the use of several functions of a GIS including automated address matching, distance functions, buffer analysis, spatial query, and polygon overlay; we discuss methods and limitations of address geocoding, often central to the use of a GIS in environmental epidemiologic research; and we suggest ways to facilitate its use in future studies. Collaborative efforts between epidemiologists, biostatisticians, environmental scientists, GIS specialists, and medical geographers are needed to realize the full potential of GIS technology in environmental health research and may lead to innovative solutions to complex questions. Images p598-a Figure 2. Figure 3. A Figure 3. B Figure 3. C Figure 3. D Figure 3. E
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              Lead in drinking water and human blood lead levels in the United States.

              Lead is a pervasive environmental contaminant. The adverse health effects of lead exposure in children and adults are well documented, and no safe blood lead threshold in children has been identified. Lead can be ingested from various sources, including lead paint and house dust contaminated by lead paint, as well as soil, drinking water, and food. The concentration of lead, total amount of lead consumed, and duration of lead exposure influence the severity of health effects. Because lead accumulates in the body, all sources of lead should be controlled or eliminated to prevent childhood lead poisoning. Beginning in the 1970s, lead concentrations in air, tap water, food, dust, and soil began to be substantially reduced, resulting in significantly reduced blood lead levels (BLLs) in children throughout the United States. However, children are still being exposed to lead, and many of these children live in housing built before the 1978 ban on lead-based residential paint. These homes might contain lead paint hazards, as well as drinking water service lines made from lead, lead solder, or plumbing materials that contain lead. Adequate corrosion control reduces the leaching of lead plumbing components or solder into drinking water. The majority of public water utilities are in compliance with the Safe Drinking Water Act Lead and Copper Rule (LCR) of 1991. However, some children are still exposed to lead in drinking water. EPA is reviewing LCR, and additional changes to the rule are expected that will further protect public health. Childhood lead poisoning prevention programs should be made aware of the results of local public water system lead monitoring measurement under LCR and consider drinking water as a potential cause of increased BLLs, especially when other sources of lead exposure are not identified.
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                Author and article information

                Journal
                J Environ Public Health
                J Environ Public Health
                JEPH
                Journal of Environmental and Public Health
                Hindawi Publishing Corporation
                1687-9805
                1687-9813
                2016
                2 March 2016
                : 2016
                : 8791686
                Affiliations
                1University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
                2University of Pittsburgh, Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
                3University of Pittsburgh, Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA, USA
                Author notes
                *Evelyn O. Talbott: eot1@ 123456pitt.edu

                Academic Editor: Terry Tudor

                Article
                10.1155/2016/8791686
                4793145
                27042184
                e8617e76-31b9-4f8f-aeb6-6258c4807c9d
                Copyright © 2016 Lu Ann Brink et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 October 2015
                : 18 December 2015
                : 26 January 2016
                Categories
                Research Article

                Public health
                Public health

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