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Racial/Ethnic Differences in Childhood Blood Lead Levels Among Children <72 Months of Age in the United States: a Systematic Review of the Literature

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Abstract

Childhood lead poisoning is a serious public health problem with long-term adverse effects. Healthy People 2020’s environmental health objective aims to reduce childhood blood lead levels; however, efforts may be hindered by potential racial/ethnic differences. Recent recommendations have lowered the blood lead reference level. This review examined racial/ethnic differences in blood lead levels among children under 6 years of age. We completed a search of PubMed, CINAHL, and PsycINFO databases for published works from 2002 to 2012. We identified studies that reported blood lead levels and the race/ethnicity of at least two groups. Ten studies met inclusion criteria for the review. Blood lead levels were most frequently reported for black, white, and Hispanic children. Six studies examined levels between blacks, whites, and Hispanics and two between blacks and whites. Studies reporting mean lead levels among black, whites, and Hispanics found that blacks had the highest mean blood lead level. Additionally, studies reporting blood lead ranges found that black children were more likely to have elevated levels. Studies suggest that black children have higher blood lead levels compared to other racial/ethnic groups. Future studies are warranted to obtain ample sample sizes for several racial/ethnic groups to further examine differences in lead levels.

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References

  1. Trasande L, Liu L. Reducing the staggering costs of environmental disease in children, estimated at $76.6 billion in 2008. Health Aff (Millwood). 2011;30(5):863–70.

    Article  Google Scholar 

  2. Porter RS, Kaplan JL, editors. Merck manual of diagnosis and therapy. 19th ed. Whitehouse Station: Merck Sharp & Dohme; 2011.

    Google Scholar 

  3. Yuan W, Holland SK, Cecil KM, Dietrich KN, Wessel SD, Altaye M, et al. The impact of early childhood lead exposure on brain organization: a functional magnetic resonance imaging study of language function. Pediatrics. 2006;118(3):971–7.

    Article  PubMed  Google Scholar 

  4. Landrigan PJ, Carlson JE, Bearer CF, Cranmer JS, Bullard RD, Etzel RA, et al. Children’s health and the environment: a new agenda for prevention research. Environ Health Perspect. 1998;106 Suppl 3:787–94.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Karr C. Addressing environmental contaminants in pediatric practice. Pediatr Rev. 2011;32(5):190–200.

    Article  PubMed  Google Scholar 

  6. Barbosa F, Tanus-Santos JE, Gerlach RF, Parsons PJ. A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environ Health Perspect. 2005;113(12):1669–74.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Lanphear BP, Dietrich K, Auinger P, Cox C. Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents. Public Health Rep. 2000;115(6):521–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Koller K, Brown T, Spurgeon A, Levy L. Recent developments in low-level lead exposure and intellectual impairment in children. Environ Health Perspect. 2004;112(9):987–94.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Levin R, Brown MJ, Kashtock ME, Jacobs DE, Whelan EA, Rodman J, et al. Lead exposures in US children, 2008: implications for prevention. Environ Health Perspect. 2008;116(10):1285–93.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Dilworth-Bart JE, Moore CF. Mercy mercy me: social injustice and the prevention of environmental pollutant exposures among ethnic minority and poor children. Child Dev. 2006;77(2):247–65.

    Article  PubMed  Google Scholar 

  11. Tong S, von Schirnding YE, Prapamontol T. Environmental lead exposure: a public health problem of global dimensions. Bull World Health Organ. 2000;78(9):1068–77.

    PubMed Central  CAS  PubMed  Google Scholar 

  12. Sargent JD, Dalton M, Demidenko E, Simon P, Klein RZ. The association between state housing policy and lead poisoning in children. Am J Public Health. 1999;89(11):1690–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Burns MS, Gerstenberger SL. Implications of the new centers for disease and control and prevention blood lead reference value. Am J Public Health. 2014;104(6):e27–33.

    Article  PubMed  Google Scholar 

  14. Brown RW, Longoria T. Multiple risk factors for lead poisoning in Hispanic sub-populations: a review. J Immigr Minor Health. 2010;12(5):715–25.

    Article  PubMed  Google Scholar 

  15. Wright RJ. Moving towards making social toxins mainstream in children’s environmental health. Curr Opin Pediatr. 2009;21(2):222–9.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Healthy People 2020: Environmental Health [internet]. U.S. Department of Health and Human Services [updated 2013 Aug 28; cited 2013 Sept 10]. Available from: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=12.

  17. Murad MH, Montori VM. Synthesizing evidence: shifting the focus from individual studies to the body of evidence. JAMA. 2013;309(21):2217–8.

    Article  PubMed  Google Scholar 

  18. Blumenshine P, Egerter S, Barclay CJ, Cubbin C, Braveman PA. Socioeconomic disparities in adverse birth outcomes: a systematic review. Am J Prev Med. 2010;39(3):263–72.

    Article  PubMed  Google Scholar 

  19. Effective Public Health Practice Project. Quality assessment tool for quantitative studies. Ontario, Canada: McMaster University; 2010. Available from: www.ephpp.ca/PDF/QATool.pdf.

  20. Bernard SM, McGeehin MA. Prevalence of blood lead levels > or = 5 micro g/dL among US children 1 to 5 years of age and socioeconomic and demographic factors associated with blood of lead levels 5 to 10 micro g/dL, third national health and nutrition examination survey, 1988–1994. Pediatrics. 2003;112(6):1308–13.

    Article  PubMed  Google Scholar 

  21. Centers for Disease Control and Prevention (CDC). Blood lead levels—United States, 1999–2002. MMWR Morb Mortal Wkly Rep. 2005;54(20):513–6.

  22. Dignam TA, Lojo J, Meyer PA, Norman E, Sayre A, Flanders WD. Reduction of elevated blood lead levels in children in North Carolina and Vermont, 1996–1999. Environ Health Perspect. 2008;116(7):981–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Jones RL, Homa DM, Meyer PA, Brody DJ, Caldwell KL, Pirkle JL, et al. Trends in blood lead levels and blood lead testing among US children aged 1 to 5 years, 1988–2004. Pediatrics. 2009;123(3):e376–85.

    Article  PubMed  Google Scholar 

  24. Meyer PA, Pivetz T, Dignam TA, Homa DM, Schoonover J, Brody D. Centers for disease control and prevention. surveillance for elevated blood lead levels among children–United States, 1997–2001. MMWR Surveill Summ. 2003;52(10):1–21.

    PubMed  Google Scholar 

  25. Scott LL, Nguyen LM. Geographic region of residence and blood lead levels in US children: results of the National Health and Nutrition Examination Survey. Int Arch Occup Environ Health. 2011;84(5):513–22.

    Article  CAS  PubMed  Google Scholar 

  26. Stroop DM, Dietrich KN, Hunt AN, Suddendorf LR, Giangiacomo M. Lead-based paint health risk assessment in dependent children living in military housing. Public Health Rep. 2002;117(5):446–52.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Joseph CL, Havstad S, Ownby DR, Peterson EL, Maliarik M, McCabe Jr MJ, et al. Blood lead level and risk of asthma. Environ Health Perspect. 2005;113(7):900–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Leighton J, Klitzman S, Sedlar S, Matte T, Cohen NL. The effect of lead-based paint hazard remediation on blood lead levels of lead poisoned children in New York City. Environ Res. 2003;92(3):182–90.

    Article  CAS  PubMed  Google Scholar 

  29. Raymond JS, Anderson R, Feingold M, Homa D, Brown MJ. Risk for elevated blood lead levels in 3-and 4-year-old children. Matern Child Health J. 2009;13(1):40–7.

    Article  PubMed  Google Scholar 

  30. CDC. Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Atlanta, GA: Advisory Committee on Childhood Lead Poisoning Prevention, U.S. Centers for Disease Control and Prevention (4 Jan 2012). Available: www.cdc.gov/nceh/lead/acclpp/final_document_030712.pdf [accessed 15 May 2013].

  31. CDC. CDC Response to Advisory Committee on Childhood Lead Poisoning Prevention Recommendations in “Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention.” Atlanta, GA:U.S. Centers for Disease Control and Prevention. Available: http://www.cdc.gov/nceh/lead/acclpp/cdc_response_lead_exposure_recs.pdf [accessed 15 May 2013].

  32. Gilbert SG, Weiss B. A rationale for lowering the blood lead action level from 10 to 2 μg/dL. Neurotoxicology. 2006;27(5):693–701.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. American Academy of Pediatrics (APA). AAP Commends CDC for Recognizing That for Children, There is No Safe Level of Lead Exposure. 2012, May 5. Available from: http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Statement-CDC-Revised-Lead-Exposure-Guidelines.aspx.

  34. Raymond J, Wheeler W, Brown MJ; Centers for Disease Control and Prevention (CDC). Inadequate and unhealthy housing, 2007 and 2009. MMWR Surveill Summ. 2011;60 Suppl:21–7.

  35. Burns MS, Shah LH, Marque ER, Denton SL, Neyland BA, Vereschzagin D, Gremse DA.

  36. Mehta S, Binns HJ. What do parents know about lead poisoning? the Chicago lead knowledge test. JAMA Ped. 1998;152(12):1213–8.

    CAS  Google Scholar 

  37. Oyana TJ, Margai FM. Geographic analysis of health risks of pediatric lead exposure: a golden opportunity to promote healthy neighborhoods. Arch Environ Occup Health. 2007;62(2):93–104.

    Article  PubMed  Google Scholar 

  38. Schlenker TL, Baxmann R, McAvoy P, Bartkowski J, Murphy A. Primary prevention of childhood lead poisoning through community outreach. WMJ. 2001;100(8):48–54.

    CAS  PubMed  Google Scholar 

  39. Building Blocks for Primary Prevention: Protecting Children from Lead-Based Paint Hazards. Atlanta: CDC, 2005

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Acknowledgments

The first author would like to thank Eric S. Hall, MA, MCE, and Herbert White, Jr., MD, MPH, MS, for providing feedback on the manuscript.

Ethics Approval and Consent to participate

No animal or human studies were carried out by the authors for this article.

Conflict of interest

Brandi M. White, Heather S. Bonilha, and Charles Ellis declare that they have no conflict of interest.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Health Sciences & Research, College of Health Professions, Medical University of South Carolina (MUSC), 45 Courtenay Drive, SW 974, Charleston, SC, 29425, USA

    Brandi M. White

  2. Department of Health Sciences & Research, College of Health Professions, MUSC, 77 President Street, MSC 700, Charleston, SC, 29425, USA

    Heather Shaw Bonilha

  3. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, MUSC, 77 President Street, MSC 700, Charleston, SC, 29425, USA

    Heather Shaw Bonilha

  4. Communication Equity and Outcomes Laboratory, Department of Communication Sciences and Disorders, College of Allied Health Sciences, East Carolina University, 3310H Health Sciences Building, MS 668, Greenville, NC, USA

    Charles Ellis Jr.

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  1. Brandi M. White
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Correspondence to Brandi M. White.

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White, B.M., Bonilha, H.S. & Ellis, C. Racial/Ethnic Differences in Childhood Blood Lead Levels Among Children <72 Months of Age in the United States: a Systematic Review of the Literature. J. Racial and Ethnic Health Disparities 3, 145–153 (2016). https://doi.org/10.1007/s40615-015-0124-9

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  • DOI: https://doi.org/10.1007/s40615-015-0124-9

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