Impact of the COVID-19 Pandemic on Childhood Lead Testing and Blood Lead Levels

被引:0
作者
Brewster, Ryan C. L. [1 ,2 ,4 ]
Azad, Amee D. [3 ]
Acosta, Keith [1 ,4 ]
Starmer, Amy [1 ,4 ]
Sprecher, Eli [1 ,4 ]
Rea, Corinna [1 ,4 ]
Gray, Kathryn P. [1 ,5 ]
Regan, Shannon [1 ]
Wilson, Joseph [6 ]
Bayuh, Frehiwot [1 ]
Buncher, Noah [2 ,7 ]
Hauptman, Marissa [1 ,4 ]
机构
[1] Boston Childrens Hosp, Dept Pediat, Boston, MA USA
[2] Boston Med Ctr, Dept Pediat, Boston, MA USA
[3] Massachusetts Eye & Ear, Ophthalmol Dept, Boston, MA USA
[4] Harvard Med Sch, Dept Pediat, Boston, MA USA
[5] Boston Childrens Hosp, Inst Ctr Clin & Translat Res, Boston, MA USA
[6] Harvard TH Chan Sch Publ Hlth, Boston, MA USA
[7] Reg 1 New England Pediat Environm Hlth Specialty U, Boston, MA USA
基金
美国国家卫生研究院;
关键词
environmental health; health equity; lead poisoning; YOUNG-CHILDREN; CHALLENGES;
D O I
10.1016/j.acap.2023.11.014
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on childhood lead testing and blood lead levels. METHODS: A retrospective analysis of lead tests and results was performed across 3 urban medical centers during the preCOVID-19 (March 10, 2019-March 9, 2020) and COVID-19 (March 10, 2020-March 10, 2022) periods. Interrupted time series analysis with quasi-Poisson regression was used to evaluate changes in lead testing between study periods. The relationship between sociodemographic features with detectable (>= 2 mu g/dL) and elevated (>= 3.5 mu g/dL) blood lead levels (BLLs) was assessed with multivariable logistic regression. RESULTS: Among a total of 16,364 lead tests across 10,362 patients, weekly testing rates significantly decreased during COVID-19 (relative risk (RR) 0.64, 95% (confidence interval) CI 0.53-0.78). Census tracts with the greatest proportion of pre-1950s housing had a stronger association with detectable BLLs during the COVID-19 period (pre-COVID-19 adjusted odds ratio (aOR) 1.73, 95% CI 1.35-2.20; aOR 2.58, 95% CI 2.13-3.12; interaction P value .014). When limited to 1 year following COVID-19 (March 10, 2020-March 10, 2021), the association between both elevated BLLs (pre-COVID-19: aOR 1.49, 95% CI 0.87-2.53; COVID-19: aOR 3.51, 95% CI 1.98-6.25; interaction P value .032) and detectable BLLs with pre-1950s housing were greater during the COVID-19 period (pre-COVID-19: aOR 1.73, 95% CI 1.35-2.20; COVID-19: aOR 2.56, 95% CI 1.95-3.34; interaction P value .034). CONCLUSIONS: The COVID-19 pandemic led to a significant reduction in lead surveillance and magnified the effect of known risk factors for lead exposure. Concerted clinical, public health, and community advocacy are needed to address care gaps and excess cases of lead poisoning.
引用
收藏
页码:810 / 814
页数:5
相关论文
共 17 条
  • [1] Disparities in Pediatric Medical and Childcare Disruption Due to COVID-19
    Batioja, Kelsi
    Elenwo, Covenant
    Hartwell, Micah
    [J]. JAMA PEDIATRICS, 2023, 177 (04) : 432 - 434
  • [2] COVID-19 and Routine Childhood Vaccinations-Identifying Gaps and Informing Solutions
    Brian, Jenssen P.
    Fiks, Alexander G.
    [J]. JAMA PEDIATRICS, 2022, 176 (01) : 21 - 23
  • [3] Intellectual impairment in children with blood lead concentrations below 10 μg per deciliter
    Canfield, RL
    Henderson, CR
    Cory-Slechta, DA
    Cox, C
    Jusko, TA
    Lanphear, BP
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (16) : 1517 - 1526
  • [4] Centers for Disease Control and Prevention, 2021, CDC Updates Blood Lead Reference Value for Children
  • [5] Decreases in Young Children Who Received Blood Lead Level Testing During COVID-19-34 Jurisdictions, January-May 2020
    Courtney, Joseph G.
    Chuke, Stella O.
    Dyke, Kelly
    Credle, Kimball
    Lecours, Carolina
    Egan, Kathryn B.
    Leonard, Monica
    [J]. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2021, 70 (05): : 155 - 161
  • [6] The American Community Survey and Health Insurance Coverage Estimates: Possibilities and Challenges for Health Policy Researchers
    Davern, Michael
    Quinn, Brian C.
    Kenney, Genevieve M.
    Blewett, Lynn A.
    [J]. HEALTH SERVICES RESEARCH, 2009, 44 (02) : 593 - 605
  • [7] Association of the COVID-19 Pandemic With Routine Childhood Vaccination Rates and Proportion Up to Date With Vaccinations Across 8 US Health Systems in the Vaccine Safety Datalink
    DeSilva, Malini B.
    Haapala, Jacob
    Vazquez-Benitez, Gabriela
    Daley, Matthew F.
    Nordin, James D.
    Klein, Nicola P.
    Henninger, Michelle L.
    Williams, Joshua T. B.
    Hambidge, Simon J.
    Jackson, Michael L.
    Donahue, James G.
    Qian, Lei
    Lindley, Megan C.
    Gee, Julianne
    Weintraub, Eric S.
    Kharbanda, Elyse O.
    [J]. JAMA PEDIATRICS, 2022, 176 (01) : 68 - 77
  • [8] Dignam T, 2019, J PUBLIC HEALTH MAN, V25, pS13, DOI [10.1097/PHH.0000000000000889, 10.1097/phh.0000000000000889]
  • [9] Covid-19 and community mitigation strategies in a pandemic
    Ebrahim, Shahul H.
    Ahmed, Qanta A.
    Gozzer, Ernesto
    Schlagenhauf, Patricia
    Memish, Ziad A.
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2020, 368
  • [10] Individual- and Community-Level Factors Associated With Detectable and Elevated Blood Lead Levels in US Children Results From a National Clinical Laboratory
    Hauptman, Marissa
    Niles, Justin K.
    Gudin, Jeffrey
    Kaufman, Harvey W.
    [J]. JAMA PEDIATRICS, 2021, 175 (12) : 1252 - 1260