If a child had multiple BLL tests during a single period, the single highest result was used, with venous blood tests preferred over capillary tests. Flint residents have been recently advised by the U. No significant change was seen outside the city. Regular household tap water can be used for bathing and showering; however, young children should be prevented from drinking bath water. However, children and adults also can be exposed to lead through drinking water 4. Analyses were limited to tests on children living in residences in the FWS service area; children living in areas serviced by an alternative water system were not included.
Flint residents have been recently advised by the U. First, spurious associations might have resulted from failure to control for all confounders because substantial information for certain covariates e. We analyzed differences in pediatric elevated blood lead level incidence before and after Flint, Michigan, introduced a more corrosive water source into an aging water system without adequate corrosion control. Regular household tap water can be used for bathing and showering; however, young children should be prevented from drinking bath water. The findings in this report are subject to at least five limitations. Incidence of elevated blood lead levels increased from 2. The pre time period before the water source change was January 1, , to September 15, , and the post time period after the water source change was January 1, , to September 15, We assessed the percentage of elevated blood lead levels in both time periods, and identified geographical locations through spatial analysis. Based on the date of the blood test, results were assigned to one of the four periods. We identified Flint wards with high WLLs with water lead sampling maps. We derived overall neighborhood-level socioeconomic disadvantage from census block group variables intended to measure material and social deprivation. Among these children, 7, received 9, blood lead tests before, during, and after the water source switch period. Lead most commonly enters drinking water as a result of corrosion of leaded plumbing materials and is rarely found at the distribution point or wellhead 5. Water is a growing source of childhood lead exposure because of aging infrastructure. Children were excluded once they reached age 6 years. Additionally, BLLs in children tend to rise in warm weather months, a phenomenon that might be related to differential seasonal distribution of lead dust in houses as well as higher exposure to street dust associated with increased outdoor activity 8. We conducted a series of spatial joins to assign participant records to Greater Flint municipalities and Flint wards including those with high WLL , enabling the calculation of the number and percentage of children with EBLLs in each geographic region for both time periods. What are the implications for public health practice? For each child, only the highest BLL was maintained in the data set. Lead solubility and particulate release is highly variable and depends on many factors including water softness, temperature, and acidity. Analyses were limited to tests on children living in residences in the FWS service area; children living in areas serviced by an alternative water system were not included. We reviewed blood lead levels for children younger than 5 years before and after water source change in Greater Flint, Michigan. Multivariable regression analyses were conducted for the combined analysis period to adjust for possible confounding variables by age group, sex, race, and season. We calculated these scores from an unweighted z score sum of rates of lone parenthood, poverty, low educational attainment, and unemployment adapted from Pampalon et al. This research has immediate public policy, public health, environmental, and socioeconomic implications. After institutional review board approval and Health Insurance Portability and Accountability Act waiver, we drew data from the Epic electronic medical record system including BLL, medical record number, date of birth, date of blood draw, full address, sex, and race. However, children and adults also can be exposed to lead through drinking water 4.
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