Identifying High-Risk ZIP Codes for Childhood Lead Exposure: A Statewide ZCTA-Level Priority List for North Carolina

Q2 Medicine
Rashida Callender, Carolina Avendano, Mercedes A. Bravo, Joshua L. Tootoo, Ed Norman, Marie Lynn Miranda
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引用次数: 0

Abstract

Research has consistently shown that there is no safe blood lead level (BLL) for children. Despite progress in lead poisoning prevention, lead exposure remains a persistent threat to the health and neurological development of children. To identify high-risk ZIP codes for use by families and health care providers for the entire state of North Carolina, we developed a risk model using ZIP Code Tabula­tion Area (ZCTA)-level census data. We obtained all available BLL testing data from the North Carolina Department of Health and Human Services for the years 2010–2015 via data use agreement. We fit a multivariable regression model with the ZCTA-level mean of log normalized BLLs as the de­pendent variable and ZCTA-level census data for known risk factors of childhood lead exposure as predictors. We used this model to create a priority risk categorization. We organized ZCTAs into 20 quantiles, or priority risk categories, that can be used in local and statewide screening programs. The first six (of 20) quantiles were identified as particularly high-risk areas for childhood lead exposure. Because BLL testing is not universal, the BLL testing data used in this study are likely biased toward those most at risk for lead exposure. This study demonstrates the utility of ZCTA-level census data in identifying high-risk ZIP codes for childhood lead exposure, which can be used to ensure that the highest-risk children are tested in a timely manner. This approach can be replicated to address lead exposure nationally.
确定儿童铅暴露的高风险邮政编码:北卡罗来纳州全州 ZCTA 级优先列表
研究一致表明,儿童的血铅含量 (BLL) 没有安全值。尽管在预防铅中毒方面取得了进展,但铅暴露仍然对儿童的健康和神经系统发育构成持续威胁。为了确定北卡罗来纳州全境的高风险邮政编码,供家庭和医疗服务提供者使用,我们利用邮政编码表区 (ZCTA) 级人口普查数据开发了一个风险模型。我们通过数据使用协议从北卡罗来纳州卫生与公众服务部获得了 2010-2015 年的所有可用 BLL 检测数据。我们以 ZCTA 级对数归一化 BLL 平均值为因变量,以 ZCTA 级人口普查数据中已知的儿童铅暴露风险因素为预测因子,拟合了一个多变量回归模型。我们使用该模型创建了优先风险分类。我们将 ZCTA 划分为 20 个量级,即优先风险类别,可用于地方和全州范围内的筛查计划。前六个量级(共 20 个量级)被确定为儿童铅暴露的高风险地区。由于 BLL 检测并不普遍,本研究中使用的 BLL 检测数据很可能偏向于铅暴露风险最高的人群。本研究证明了 ZCTA 级人口普查数据在确定儿童铅暴露高风险邮政编码方面的实用性,可用于确保及时对高风险儿童进行检测。这种方法可在全国范围内推广,以解决铅暴露问题。
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来源期刊
North Carolina Medical Journal
North Carolina Medical Journal Medicine-Medicine (all)
CiteScore
1.40
自引率
0.00%
发文量
121
期刊介绍: NCMJ, the North Carolina Medical Journal, is meant to be read by everyone with an interest in improving the health of North Carolinians. We seek to make the Journal a sounding board for new ideas, new approaches, and new policies that will deliver high quality health care, support healthy choices, and maintain a healthy environment in our state.
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