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219 Evaluation of Potential Strategies for Targeting Childhood Lead Testing in Maryland

Monday, June 10, 2013
Exhibit Hall A (Pasadena Convention Center)
Sybil Wojcio , Maryland Department of Health and Mental Hygiene, Baltimore, MD
Ezatollah Keyvan-Larijani , Maryland Department of the Environment, Baltimore, MD
John Krupinsky , Maryland Department of the Environment, Baltimore, MD
Clifford S. Mitchell , Maryland Department of Health and Mental Hygiene, Baltimore, MD

BACKGROUND:   Exposure to lead remains the most significant and widespread environmental hazard for children in Maryland (MD).  While the prevalence of elevated blood lead levels in children has declined significantly over the years, children continue to be exposed.  With the recognition that there are no “safe levels” of lead in the body, and in light of CDC’s new recommendations, the challenge is how to best target testing of MD children.  The goal of this project is to develop and assess potential targeting strategies for MD, taking into account recent trends and observations regarding childhood lead exposures in the state.

METHODS:   This analysis involved identifying and utilizing a variety of data sources to evaluate the characteristics of recent childhood lead exposures in MD.  Childhood lead registry data, containing records of all MD children tested from 2005-2009 in addition to a number of other possible data sources including Department of Assessments and Taxation property data and U.S. Census data were analyzed.  SAS Version 9.2 and ArcGIS ArcMap10 were used for data analysis and summary.

RESULTS:   Three possible targeting strategies were identified and evaluated.  These strategies included universal testing of all children, targeting based on projecting 2005-2009 test results by zip code to identify expected future high risk areas, and testing based on census tract risk, determined using a logistic regression model of census demographic variables. 

CONCLUSIONS: The strengths, weaknesses and cost effectiveness of the strategies presented here will be assessed by stakeholders in MD and used to develop a new state plan to identify those children in MD who should automatically receive testing due to their risk of lead exposure.  This plan is part of a comprehensive state strategy that includes regulation, outreach and education, case management, and close coordination between different stakeholders in the community, all of which play a significant role in the eventual elimination of the lead hazard in MD.

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