Screening for lead poisoning: a geospatial approach to determine testing of children in at-risk neighborhoods.
OBJECTIVE
To develop a spatial strategy to assess neighborhood risk for lead exposure and neighborhood-level blood lead testing of young children living in the city of Atlanta, Georgia.


METHODS
This ecologic study used existing blood lead results of children aged <or=36 months tested and living in one of Atlanta's 236 neighborhoods in 2005. Geographic information systems used Census, land parcel, and neighborhood spatial data to create a neighborhood priority testing index on the basis of proxies for poverty (Special Supplemental Nutrition Program for Women, Infants and Children [WIC] enrollment) and lead in house paint (year housing built).


RESULTS
In 2005, only 11.9% of Atlanta's 18,627 children aged <or=36 months living in the city had blood lead tests, despite a high prevalence of risk factors: 75,286 (89.6%) residential properties were built before 1978, and 44% of children were enrolled in WIC. Linear regression analysis indicated testing was significantly associated with WIC status (P < .001) but not with old housing.


CONCLUSIONS
This neighborhood spatial approach provided smaller geographic areas to assign risk and assess testing in a city that has a high prevalence of risk factors for lead exposure. Testing may be improved by collaboration between pediatricians and public health practitioners.
Vaidyanathan
Ambarish
A
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Staley
Forrest
F
Shire
Jeffrey
J
Muthukumar
Subrahmanyam
S
Kennedy
Chinaro
C
Meyer
Pamela A
PA
Brown
Mary Jean
MJ
D002675:Child, Preschool; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005843:Geography; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000453:epidemiology*; D008403:Mass Screening; D012111:Residence Characteristics; D012306:Risk; D014504:Urban Health / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
D007854:Lead