163819 Public health policy implications of socioeconomic and demographic correlates of prenatal lead exposure

Wednesday, November 7, 2007

Ellen Wells, MEM, MPH , Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lynn Goldman, MPH, MD , Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Robert L. Jones, PhD , Inorganic Toxicology and Radionuclide Labs, Centers for Disease Control and Prevention, Atlanta, GA
Kathleen L. Caldwell, PhD , Inorganic Toxicology Laboratory, Centers for Disease Control and Prevention, Atlanta, GA
Benjamin J. Apelberg, PhD , Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Julie B. Herbstman, ScM, PhD , Columbia Center for Children's Environmental Health, Columbia University Mailman School of Public Health, New York, NY
Rolf U. Halden, PhD , Center for Environmental Biotechnology, Arizona State University, Tempe, AZ
Frank R. Witter, MD , Dept. of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
Lead is a known neurotoxicant which is especially hazardous to infants and children. Recent research has highlighted that blood lead exposures below 5 ìg/dL – levels at which a large portion of the US population is currently exposed – may still carry substantial health risks. Thus, reducing population exposure to lead remains an important public health goal. This research aims to identify correlates of prenatal lead exposure and identify targets on which to focus lead poisoning prevention efforts.

We collected 294 cord blood samples from births between 11/2004 and 3/2005 at the Johns Hopkins Hospital in Baltimore, MD. Lead levels in cord blood were determined and compared with socioeconomic data from hospital records and U.S. Census demographic data.

The geometric mean of lead concentrations in cord blood was 0.66 ìg/dL (95% CI: 0.61-0.71). Higher lead levels were significantly associated with Asian or African American ethnicity (maternal and paternal), lower educational attainment (maternal and paternal), larger parity, maternal smoking, and unmarried mothers. At the block group scale, higher lead levels were also significantly associated with higher percentage of African Americans, older housing stock, lower percentage of owner-occupied housing and lower per capita income. In multivariate analyses, higher lead levels in cord blood were associated with mothers who are active smokers, of Asian ethnicity, and mothers with three or more living children.

These results suggest that although traditional risk factors for lead exposure are still important, public health workers should also consider specific population segments when designing and conducting lead poisoning prevention programs.

Learning Objectives:
1. Describe the distribution of prenatal lead exposure in Baltimore, MD 2. Identify target groups for lead poisoning prevention efforts

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.