title: Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico--2010.
abstract: BACKGROUND
  Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program.
  
  
  OBJECTIVE
  We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010.
  
  
  METHODS
  We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs.
  
  
  RESULTS
  The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). The weighted prevalence of children younger than 6 years with BLLs of 5 μg/dL or more was 3.18% (95% CI, 0.93-5.43) and for BLLs of 10 μg/dL or more was 0.50% (95% CI, 0-1.31). Higher mean BLLs were significantly associated with data collection during the summer months, a lead-related activity or hobby of anyone in the residence, and maternal education of less than 12 years. Few environmental lead hazards were identified.
  
  
  CONCLUSIONS
  The prevalence of elevated BLLs among Puerto Rican children younger than 6 years is comparable with the most recent (2007-2010) US national estimate (BLLs ≥5 μg/dL = 2.6% [95% CI = 1.6-4.0]). Our findings suggest that targeted screening of specific higher-risk groups of children younger than 6 years can replace island-wide or insurance-specific policies of mandatory blood lead testing in Puerto Rico.
authors.affiliation: Division of Emergency and Environmental Health Services, National Center for Environmental Health (Drs Dignam, Kennedy, and Brown and Mr Curtis), Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (Dr Creanga), Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities (Dr Azofeifa), Division of Global Health Protection, National Center for Global Health (Mr Blanton), and Division of Laboratory Sciences, National Center for Environmental Health (Dr Caldwell), Centers for Disease Control and Prevention, Atlanta, Georgia; Puerto Rico Department of Public Health, San Juan (Drs García and Rullán and Ms De León); and Environmental Protection Agency, Region 2, New York (Ms O'Neill).
authors.forename: Timothy
authors.initials: T
authors.lastname: Dignam
authors.forename: Brenda
authors.initials: B
authors.lastname: Rivera García
authors.forename: Maridali
authors.initials: M
authors.lastname: De León
authors.forename: Gerald
authors.initials: G
authors.lastname: Curtis
authors.forename: Andreea A
authors.initials: AA
authors.lastname: Creanga
authors.forename: Alejandro
authors.initials: A
authors.lastname: Azofeifa
authors.forename: Maureen
authors.initials: M
authors.lastname: OʼNeill
authors.forename: Curtis
authors.initials: C
authors.lastname: Blanton
authors.forename: Chinaro
authors.initials: C
authors.lastname: Kennedy
authors.forename: Maria
authors.initials: M
authors.lastname: Rullán
authors.forename: Kathy
authors.initials: K
authors.lastname: Caldwell
authors.forename: John
authors.initials: J
authors.lastname: Rullán
authors.forename: Mary Jean
authors.initials: MJ
authors.lastname: Brown
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D007854:Lead
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