Screening for Lead Poisoning: A Geospatial Approach to Determine Testing of Children in At-Risk Neighborhoods

• Published in: The Journal of pediatrics Vol. 154; no. 3; pp. 409 - 414
• Main Authors: Vaidyanathan, Ambarish, MS, Staley, Forrest, MUP, Shire, Jeffrey, MS, Muthukumar, Subrahmanyam, MCRP, Kennedy, Chinaro, DrPH, MPH, Meyer, Pamela A., PhD, Brown, Mary Jean, ScD, RN
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.03.2009; Elsevier
• Subjects: Biological and medical sciences; Child, Preschool; Environmental Exposure - statistics & numerical data; General aspects; Geography; Georgia - epidemiology; Humans; Infant; Infant, Newborn; Lead - blood; Lead Poisoning - blood; Lead Poisoning - epidemiology; Mass Screening; Medical sciences; Pediatrics; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Residence Characteristics; Risk; Urban Health - statistics & numerical data; Urban Population - statistics & numerical data; Georgia; GIS; WIC; BLL; CDC; Centers for Medicare and Medicaid Services; Centers for Disease Control and Prevention; GACLPPP; Geographic information system; Georgia Childhood Lead Poisoning Prevention Program; CMS; Blood lead level; Special Supplemental Nutrition Program for Women, Infants, and Children; Human; Social influence; Pediatrics; Exposure; Residential neighborhoods; Medical screening; Saturnism; Heavy metal; Geographic distribution; Risk factor; Lead; Poisoning; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2008.09.027

Objective To develop a spatial strategy to assess neighborhood risk for lead exposure and neighborhood-level blood lead testing of young children living in the city of Atlanta, Georgia. Study design This ecologic study used existing blood lead results of children aged ≤36 months tested and living in one of Atlanta's 236 neighborhoods in 2005. Geographic information systems used Census, land parcel, and neighborhood spatial data to create a neighborhood priority testing index on the basis of proxies for poverty (Special Supplemental Nutrition Program for Women, Infants and Children [WIC] enrollment) and lead in house paint (year housing built). Results In 2005, only 11.9% of Atlanta's 18 627 children aged ≤36 months living in the city had blood lead tests, despite a high prevalence of risk factors: 75 286 (89.6%) residential properties were built before 1978, and 44% of children were enrolled in WIC. Linear regression analysis indicated testing was significantly associated with WIC status ( P < .001) but not with old housing. Conclusions This neighborhood spatial approach provided smaller geographic areas to assign risk and assess testing in a city that has a high prevalence of risk factors for lead exposure. Testing may be improved by collaboration between pediatricians and public health practitioners.