Focus limited resources on children at high risk of blood lead poisoning: What we learned from Nebraska surveillance data

Childhood blood lead poisoning remains a critical environmental health concern in Nebraska. This study utilized Nebraska lead poisoning surveillance data from Systematic Tracking of Elevated lead Levels and Remediation (STELLAR) to describe blood lead screening rate and incidence and prevalence of elevated blood lead levels (EBLL) among Nebraska children under six years old from 2001 to 2007. It also intended to identify the impact of funding availability on surveillance practice, especially among minority children.

Screening rates (based on population size), and incidence and prevalence (based on number of children screened) of EBLL in each year were calculated by county, age, gender, race, and ethnicity. Multiple test results for one child within the same calendar year were identified, and the highest test result was retained for analysis.

Screening rate increased steadily during the first five years when funding was available. However, it went down in nearly all age, gender, racial and ethnic groups in 2006 and 2007. Incidence and prevalence of EBLL followed the opposite direction of screening rate. The data suggested minority children had higher incidence and prevalence of EBLL than their counterparts; meanwhile, some subgroups, such as Native American/Alaskan Native and Asian/Pacific Islander, were not adequately screened.

Nebraska is making progress towards eliminating childhood lead poisoning, an objective for Healthy People 2010. Future work should focus on continuing to conduct screenings and secondary prevention, especially among underserved minority children, as well as to collaborate with other agencies to implement primary prevention strategies that work at the community level.