Risk factors associated with childhood Lead poisoning in Tennessee.

摘要

Lead exposure can cause serious health problems in children. In 2012, the Centers for Disease Control and Prevention lowered the reference level for childhood lead poisoning from 10 microg/dL to 5 microg/dL. The purpose of this study was to identify risk factors and high-risk geographic areas in Tennessee associated with child blood lead levels (BLLs) of the new reference level. The theoretical framework for this study was political ecology, which offers a broad assessment of human disease. A retrospective cross-sectional design was used with archival data of 127,627 children under the age of 6 with a detectable BLL reported to the Tennessee Department of Health between 2009 and 2013. Chi square, binomial logistic regression, and spatial analyses were performed. Being a boy [chi2 (2) = 30.36, p = <.0005], being 2 and 3 years old [chi2 (6) = 501.92, p = <.0005], and being Black [chi2 (5) = 375.87, p = <.0005] were found as risk factors for the new reference level. Regression results also revealed that Blacks have significantly higher odds for lower BLLs (odds ratio [OR] = 2.07, 95% CI [1.60, 2.68]). Ages 4 and 5 (OR = 0.64, 95% CI [0.45, 0.90]; OR = 0.62, 95% CI [0.42, 0.91]), compared to ages <1 through 3 years, and the highest quintile of pre-1950 housing (OR = 0.72 (95% CI [0.56, 0.93]) have significantly lower odds for lower BLLs. Memphis and Northeast Tennessee were found to be high-risk areas for all BLLs, and the highest BLLs are characterized by unique high-risk areas in Southeast Tennessee and Northwest Tennessee. These results can help public health agencies move towards Healthy People 2020 goals for childhood lead poisoning. The implications for positive social change include the use of these results by public health authorities to make evidence-based decisions regarding the prevention and mitigation of childhood lead poisoning in Tennessee.