A large number of children with elevated blood lead levels (EBLL) might have been left undiagnosed in the U.S., according to a study published in Pediatrics, the flagship journal of the American Academy of Pediatrics (AAP). As part of the study, the researchers pooled data from the Centers for Disease Control and Prevention (CDC)’s Childhood Lead Poisoning Prevention Program and the National Health and Nutrition Examination Survey. The CDC data revealed that 38 states and Washington D.C. had childhood lead exposure of 10 micrograms per deciliter or higher.
According to statistics, approximately 1.2 million cases of elevated blood lead levels may have occurred during the study period. However, only 606,709 or about 50 percent were reported to the CDC. The other half consisted of missed cases and states failing to report in the previous years, the CDC stated. The report also found that the reporting rate for elevated blood lead levels in children was only 64 percent. In addition, the report showed that pediatric care providers in 23 of 39 reporting states were able to identify less than half of children with high lead exposure.
The estimated prevalence of elevated blood lead levels in children was 99.5 percent in the Northeast region, and 94.3 percent in the Midwest. In contrast, the CDC estimated that 25.3 percent of children in the South and more than 21 percent in the West had elevated blood lead levels. In line with this, the AAP has recommended that pediatric care providers assess children for elevated blood lead levels based on federal, state, and local guidelines.
“While we find no evidence of under-ascertainment in a number of states, the majority appear to successfully identify fewer than half of their children with EBLL…clinicians are frequently unaware of the guidelines, and — if they are aware — then lack of enforcement undermines any effect they may have on clinician behavior,” the researchers wrote in AAPPublications.org.
High blood lead levels adversely impact pediatric health
According to the United States Environmental Protection Agency (EPA), lead exposure commonly stems from various lead-based products such as gasoline, batteries, cosmetics, and the like. Lead exposure is associated with a plethora of adverse health effects, especially in children.The EPA notes that heavy exposure to lead may trigger conditions such as behavioral problems, anemia, and lower IQ in children.
A 2014 study demonstrated that lead exposure may cause behavioral issues in the said population. As part of the study, researchers examined 1,341 Chinese children aged three to five years old. The study revealed that each increase in blood lead exposure was linked to a simultaneous increase in teacher-reported behavior scores on emotional reactivity, anxiety problems, and pervasive developmental problems. This effect was more pronounced in girls, the research team found. “This association showed different patterns depending on age and sex. As such, continued monitoring of blood lead concentrations, as well as clinical assessments of mental behavior during regular pediatric visits, may be warranted,” the researchers wrote in JAMANetwork.com. The findings were published in the journal JAMA Pediatrics.
Another study revealed that lead exposure was tied to lower IQ in children. To carry out the study, researchers examined 172 children and found that participants whose blood lead levels increased from one to 10 micrograms per deciliter suffered an IQ loss of 7.4 points. The study also showed that children whose blood lead levels increased from 10 to 30 micrograms per deciliter experienced an IQ loss of about two to three points. The results were published in the New England Journal of Medicine.
In addition, a Taiwanese study showed that environmental exposure to lead may negatively impact a child’s academic performance. As part of the study, the research team examined 934 children from 32 primary schools in 11 districts of Kaohsiung City in Taiwan. The researchers found that children with high blood lead levels fared worse in language capacity and mathematical ability. The findings were published in the journal Environmental Research.
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