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. 2023 Mar;101(1):48-73.
doi: 10.1111/1468-0009.12596. Epub 2023 Jan 30.

Improving Equitability and Inclusion for Testing and Detection of Lead Poisoning in US Children

Christina Sobin  1 , Marisela GUTIéRREZ-Vega  2 , Gisel Flores-Montoya  3 , Michelle Del Rio  4 , Juan M Alvarez  5 , Alexander Obeng  6 , Jaleen Avila  1 , Ganga Hettiarachchi  7
Affiliations

Improving Equitability and Inclusion for Testing and Detection of Lead Poisoning in US Children

Christina Sobin et al. Milbank Q. 2023 Mar.

Abstract

Policy Points Child lead poisoning is associated with socioeconomic inequity and perpetuates health inequality. Methods for testing and detection of child lead poisoning are ill suited to the current demographics and characteristics of the problem. A three-pronged revision of current testing approaches is suggested. Employing the suggested revisions can immediately increase our national capacity for equitable, inclusive testing and detection. ABSTRACT: Child lead poisoning, the longest-standing child public health epidemic in US history, is associated with socioeconomic inequity and perpetuates health inequality. Removing lead from children's environments ("primary prevention") is and must remain the definitive solution for ending child lead poisoning. Until that goal can be realized, protecting children's health necessarily depends on the adequacy of our methods for testing and detection. Current methods for testing and detection, however, are no longer suited to the demographics and magnitude of the problem. We discuss the potential deployment and feasibility of a three-pronged revision of current practices including: 1) acceptance of capillary samples for final determination of lead poisoning, with electronic documentation of "clean" collection methods submitted by workers who complete simple Centers for Disease Control and Prevention-endorsed online training and certification for capillary sample collection; 2) new guidance specifying the analysis of capillary samples by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry with documented limit of detection ≤0.2 μg/dL; and 3) adaptive "census tract-specific" universal testing and monitoring guidance for children from birth to 10 years of age. These testing modifications can bring child blood lead level (BLL) testing into homes and communities, immediately increasing our national capacity for inclusive and equitable detection and monitoring of dangerous lower-range BLLs in US children.

Keywords: child health disparity; child lead poisoning; social justice; social-structural inequity.

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References

    1. Breysse PN. Lead elimination for the 21st century. J Public Health Manag Pract. 2019;25(Suppl 1):S3‐S4. - PMC - PubMed
    1. Egan KB, Cornwell CR, Courtney JG, Ettinger AS. Blood lead levels in U.S. children ages 1–11 years, 1976–2016. Environ Health Perspect. 2021;129(3):37003. - PMC - PubMed
    1. Brown RW, Longoria T. Multiple risk factors for lead poisoning in Hispanic sub‐populations: a review. J Immigr Minor Health. 2010;12(5):715‐725. - PubMed
    1. Lanphear BP, Hornung R, Ho M, Howard CR, Eberly S, Knauf K. Environmental lead exposure during early childhood. J Pediatr. 2002;140(1):40‐47. - PubMed
    1. Yeter D, Banks EC, Aschner M. Disparity in risk factor severity for early childhood blood lead among predominantly African‐American Black children: the 1999 to 2010 US NHANES. Int J Environ Res Public Health. 2020;17(5):1552. - PMC - PubMed