Policy Changes and Child Blood Lead Levels by Age 2 Years for Children Born in Illinois, 2001–2014
Bibliographic Data
Objectives. To evaluate how lowering the blood lead level (BLL) intervention threshold affects childhood lead testing policy. Methods. We geocoded 4.19 million Illinois lead testing records (2001–2016) and linked to 2.37 million birth records (2001–2014), data on housing age, industrial emissions, and roads. We used multinomial logistic regression to determine predictors of BLLs of 10 micrograms per deciliter (μg/dL) or greater, 5 to 9 μg/dL, and 4 μg/dL. Results. We found that 2.2% of children had BLLs of 10 μg/dL or greater, 8.9% had BLLs of 5 to 9 μg/dL, and 5.7% had BLLs of 4 μg/dL. Pre-1930 housing was associated with more than 2- to 4-fold increased relative risk of BLLs above all thresholds. Housing built in 1951 to 1978 was associated with increased relative risk of BLLs of 5 to 9 μg/dL (relative risk ratio [RRR] = 1.14; 95% confidence interval [CI] = 1.06, 1.21) but not with increased relative risk of BLLs of 10 μg/dL or greater (RRR = 0.99; 95% CI = 0.84, 1.16). At a given address, previous BLLs of 5 to 9 μg/dL or BLLs of 10 μg/dL or greater were associated with increased risk of BLLs of 5 to 9 μg/dL or BLLs of 10 μg/dL or greater among current occupants by 2.37- (95% CI = 2.20, 2.54) fold and 4.08- (95% CI = 3.69, 4.52) fold, respectively. Conclusions. The relative importance of determinants of above-threshold BLLs changes with decreasing intervention thresholds. Public Health Implications. States may need to update lead screening guidelines when decreasing the intervention threshold
Confidence interval · Environmental health · Relative risk · Demography · Environmental Justice and Health Disparities · Heavy Metal Exposure and Toxicity · Internal Medicine · Medicine · Noise Effects and Management · Pediatrics
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