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This article presents information on pregnant women with incident blood lead levels (BLLs) of 20 µg per deciliter or greater as reported to the New York City Department of Health between September 1996 and June 1999 (n = 33)

Findings suggest the merits of multipronged efforts to prevent crashes and to improve bicyclist safety in NYC and in other dense, urban environments. Motorists and bicyclists should be made aware of the risks of alcohol use and the benefits of helmet-wearing. Road users should pay attention to traffic control measures and travel at safe speeds. Interventions that control traffic at intersections and on multilane streets, that dedicate and demarcate routes for motorists and cyclists, and that improve visibility, especially for large vehicles, warrant consideration.

The NYC Health Department successfully adapted its EDRS for near real-time disaster-related mortality surveillance. Retrospective assessment of deaths, advanced methods for case identification and analysis, standardized reports, and system enhancements will further improve surveillance. Local, state, and federal partners would benefit from partnering with vital records to develop EDRSs for surveillance and to promote ongoing evaluation.