Yeter Deniz, Woodall Deena, Dietrich Matthew, Polivka Barbara
Medical Telemetry, University of Kansas Health System, Kansas City, KS.
School of Nursing, University of Kansas Medical Center, Kansas City, KS.
Kans J Med. 2022 Aug 22;15(2):285-292. doi: 10.17161/kjm.vol15.17960. eCollection 2022.
No safe detectable level of lead (Pb) exists in the blood of children. Until recently, U.S. Centers for Disease Control and Prevention (CDC) guidelines designated a blood lead level (BLL) ≥ 5 μg/dL as an elevated BLL (EBLL). For the State of Kansas, early childhood blood lead burdens lack reporting in the literature.
Secondary analysis was conducted of passively reported EBLL rates ≥ 5 μg/dL among children ages 0 - 5 years at the zip code-level in Kansas during 2005 to 2012. Data weights using corresponding population estimates were applied to produce statewide outcomes.
Statewide estimates of annual testing coverage in Kansas among children ages 0 - 5 years were low (9.7%). Approximately 17,000 children ages 0 - 5 years developed an EBLL ≥ 5 μg/dL each year in Kansas with a 6.9% statewide EBLL rate compared to the national rate of 3.2% for the corresponding years. Significant variations in EBLL rates were found between suburban zip codes compared to urban, urban cluster, or rural at 3.1%, 7.2%, 8.8%, and 10.0%, respectively. Among the worst outcomes in EBLL rates was observed for zip codes in southeast Kansas (13.5%) and rural areas with < 500 persons (15.1%).
Young children in Kansas had twice the risk of developing an EBLL ≥ 5 μg/dL compared to the national rate, while higher rates consistently were seen outside of the suburbs and particularly in more rural and less populated areas. At-risk children and troubled areas of toxic lead exposure in the State of Kansas require increased recognition with improved targeting and interventions.
儿童血液中不存在安全的可检测铅（Pb）水平。直到最近，美国疾病控制与预防中心（CDC）的指南将血铅水平（BLL）≥5μg/dL定义为血铅水平升高（EBLL）。对于堪萨斯州而言，幼儿期血铅负担在文献中缺乏相关报道。
对2005年至2012年堪萨斯州邮政编码级别0至5岁儿童中被动报告的EBLL率≥5μg/dL进行二次分析。使用相应人口估计数的数据权重来得出全州范围的结果。
堪萨斯州0至5岁儿童的年度检测覆盖率在全州范围内较低（9.7%）。堪萨斯州每年约有17,000名0至5岁儿童的EBLL≥5μg/dL，全州EBLL率为6.9%，而相应年份的全国率为3.2%。与城市、城市集群或农村地区相比，郊区邮政编码区域的EBLL率存在显著差异，分别为3.1%、7.2%、8.8%和10.0%。在EBLL率最差的结果中，堪萨斯州东南部的邮政编码区域（13.5%）和人口不足500人的农村地区（15.1%）尤为突出。
堪萨斯州幼儿出现EBLL≥5μg/dL的风险是全国水平的两倍，而在郊区以外地区，尤其是在人口更为稀少的农村地区，EBLL率一直较高。堪萨斯州的高危儿童和有毒铅暴露问题突出的地区需要得到更多关注，同时要改进目标定位和干预措施。
