Improved Targeting of Childhood Lead Poisoning Prevention Efforts with Maine's Secure Tracking Portal

BACKGROUND:  The number of children in Maine with a Blood Lead Level (BLL) equal to or above 10 ug/dL is about half of what it was 10 years ago, from over 200 cases per year to less than 100. Yet there is no safe level of lead exposure, the sequellae of exposure are lifelong and costly, and the practice of clinical follow-up falls short of primary prevention. The Maine Environmental Public Health Tracking Program (EPHT) and the Maine Childhood Lead Poisoning Prevention initiated detailed surveillance mapping to identify high density areas for lead poisoning and direct resources toward primary prevention from the state’s Lead Poisoning Prevention Fund.

METHODS:  Maine EPHT street-level geocoded all childhood blood lead testing data from 2003 on. Community-level data on screening and elevated BLLs were first used to identify five high density areas of childhood lead poisoning. The Lead Poisoning Prevention Fund directs resources to community-based organizations in the high density areas for primary prevention activities, including education and lead dust testing by families and landlords. To better target activities and empower managers with data to evaluate the effectiveness of these efforts, Maine EPHT developed a secure portal facility for online interactive mapping of childhood blood lead testing data and related demographic variables. The secure mapping environment shows street address locations of elevated blood lead level children, along with individual characteristics, in a query-able environment that can render spatial summary “heat maps” and bivariate displays that incorporate Census data, such as the frequency of pre-1950 housing.

RESULTS:   Using the rest of the State as a baseline, half the excess childhood lead poisoning in the five high density areas has been eliminated. But this positive trend is not uniformly shared among targeted communities. Access to confidential, address-level data in the secure portal, with enhanced, interactive mapping tools, allows managers to quickly evaluate small-scale trends and identify specific neighborhoods that Lead Poisoning Prevention Fund grant recipients should focus on.

CONCLUSIONS:  Analysis of small-scale, confidential data in Maine EPHT’s secure portal has become integral to the ongoing targeting and evaluation of primary prevention activities for childhood lead poisoning prevention. The Tracking tools support a much more efficient, continuous feedback loop of public health action and evaluation.