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APHA Scientific Session and Event Listing

Recorded presentation

Elizabeth Larkin, MS¹, John Sobolewski, RS², and Chris Kippes, MS¹. (1) Epidemiology and Surveillance Services, Cuyahoga County Board of Health, 5550 Venture Drive, Parma, OH 44130, 216-201-2001 x1612, elarkin@CCBH.net, (2) Community Health, Cuyahoga County Board of Health, 5550 Venture Drive, Parma, OH 44130

Background: Lead poisoning affects children at critical developmental stages, and has the potential to cause serious and irreversible damage. While reported current blood lead levels (BLLs) have decreased, surveillance efforts based upon the CDC recommended threshold only identify children under six with BLLs at or above 10 ug/dL. Current research has begun to indicate that lead exposure at levels below 10 ug/dL can cause detriments to developing infants and children. Methods: Childhood BLL screening data from the Ohio Department of Health was analyzed to determine the prevalence of Cuyahoga County children under the age of six who were diagnosed with BLLs at or above 10 ug/dL. These rates of detection were then re-calculated using a more stringent threshold of 5 ug/dL as an indicator of elevated BLL, to determine how many additional cases would be detected if the new criteria were implemented. Results: Analysis revealed that if the lower threshold were used, the number of elevated BLLs detected in Cuyahoga County in 2004 would increase from 1,964 to 7,989 -a 400% increase. Within the city of Cleveland, the number of children determined to have elevated BLLs would increase 385% -from 1,693 previously diagnosed cases to 6,517 potentially suffering ill effects from lead exposure. Pertinent individual neighborhood data and maps are also presented. Discussion: The prevalence and distribution of low level lead poisoning is not insignificant. Geographic areas thought to be low priority, now may need to be re-evaluated. Progress made towards eliminated childhood lead poisoning should to be reassessed.

Learning Objectives:

• Understand the issues surrounding the use of blood lead level thresholds used in lead screening.
• Recognize the potential impact of lowering "elevated" blood lead level thresholds.

Keywords: Lead, Surveillance

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation