Individual and Neighborhood Characteristics Associated With Confirmatory and Follow-up Blood Lead Testing Among Children With Elevated Blood Lead Levels.
J Public Health Manag Pract
; 29(2): 250-261, 2023.
Article
em En
| MEDLINE
| ID: mdl-36715597
ABSTRACT
OBJECTIVES:
The aim of this study was to assess the proportions and likelihood of children who receive confirmatory and follow-up blood lead testing within the recommended time frames after an initial capillary elevated blood lead level (EBLL) and confirmed EBLL, respectively, by individual and neighborhood-level sociodemographic characteristics.DESIGN:
We linked and used blood testing and sociodemographic characteristics data from a Pennsylvania birth cohort including children born between 2017 and 2018. Generalized linear mixed models were constructed to examine the associations between sociodemographic factors and having recommended confirmatory and follow-up testing.SETTING:
A population-based, retrospective cohort study.PARTICIPANTS:
In this birth cohort, children who underwent at least 1 BLL test were followed up to 24 months of age. Children with a first unconfirmed (n = 6259) and confirmed BLL (n = 4213) ≥ 5 µg/dL were included in the analysis. MAIN OUTCOMEMEASURE:
Children had confirmatory and follow-up testing within the recommended time frames.RESULTS:
Of the children with unconfirmed and confirmed EBLLs, 3555 (56.8%) and 1298 (30.8%) received confirmatory and follow-up testing, respectively. The proportions of the 2 outcome measures were lower among children experiencing certain sociodemographic disadvantages. In the univariate analyses, lower initial BLLs, older age, non-Hispanic Blacks, lower maternal educational levels, maternal Medicaid, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment, maternal smoking, and higher quartiles of neighborhood poverty and old housing were associated with lower odds of having confirmatory and follow-up testing. However, in multivariate models, children with lower initial BLLs, older age, maternal smoking, and non-Hispanic Blacks were significantly less likely to have confirmatory and follow-up testing.CONCLUSIONS:
There were deficiencies in having recommended confirmatory and follow-up blood lead testing among children, especially those with sociodemographic disadvantages. Public health agencies and stakeholders should finetune policies to improve follow-up testing in conjunction with primary and secondary preventions for early detection and reduction of lead exposure among targeted children at risk of lead poisoning.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Chumbo
/
Intoxicação por Chumbo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Child
/
Female
/
Humans
/
Infant
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Public Health Manag Pract
Assunto da revista:
SAUDE PUBLICA
/
SERVICOS DE SAUDE
Ano de publicação:
2023
Tipo de documento:
Article