Association of blood lead levels in children 0-72 months with living in Mid-Appalachia: a semi-ecologic study.

INTRODUCTION Lead exposure in children remains a significant public health issue, although many advances have been made. The Mid-Appalachia area (Kentucky, New York, Ohio, Pennsylvania, and West Virginia) is 89-91% rural with a population density of 16-21 people/km2 (41-54 people/mi2). Mid-Appalachia has significant health disparities including concerns for the consequences of greater lead exposure to children due to mining and industrial footprints, and existing older housing. The purpose of this study is to compare the reported blood lead levels of screened children, aged 0-72 months in Mid-Appalachia, to the children in the USA in general. METHODS Data from the Centers for Disease Control and Prevention and from the US Census Bureau were analyzed in a semi-ecological study. The blood lead level of 5 μg/dL was compared between children in Mid-Appalachia and the US housing units built before 1950; US housing units built before 1940 were also compared. RESULTS The number of children with blood lead levels of 5 μg/dL was significantly greater in Mid-Appalachia than nationally (7.75% vs 5.79%, respectively; p<0.0001). The number of homes built before 1950 (p<0.0001) and built before 1940 (p<0.0001) was significantly greater in Mid-Appalachia than nationally. CONCLUSIONS Blood lead levels in children are higher in Mid-Appalachia than nationally and there is an ecological relationship with the number of homes built before 1950 and before 1940.