2022
DOI: 10.1289/ehp10335
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Patterns of Children’s Blood Lead Screening and Blood Lead Levels in North Carolina, 2011–2018—Who Is Tested, Who Is Missed?

Abstract: Background: No safe level of lead in blood has been identified. Blood lead testing is required for children on Medicaid, but it is at the discretion of providers and parents for others. Elevated blood lead levels (EBLLs) cannot be identified in children who are not tested. Objectives: The aims of this research were to identify determinants of lead testing and EBLLs among North Carolina children and estimate the number of additional children with EBLLs among those not te… Show more

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Cited by 14 publications
(9 citation statements)
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“…Recently, the CDC lowered children’s reference blood lead concentrations from 5.0 µg/dL to 3.5 µg/dL [ 29 ]. However, there is no safe value of blood lead [ 18 ]. In the current cohort composed of a young Taiwanese population, we found higher geometric means of urine lead levels (1.50 µg/g creatinine) than the levels in other countries [ 30 , 31 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Recently, the CDC lowered children’s reference blood lead concentrations from 5.0 µg/dL to 3.5 µg/dL [ 29 ]. However, there is no safe value of blood lead [ 18 ]. In the current cohort composed of a young Taiwanese population, we found higher geometric means of urine lead levels (1.50 µg/g creatinine) than the levels in other countries [ 30 , 31 ].…”
Section: Discussionmentioning
confidence: 99%
“…However, the results of high-dose exposure in the laboratories cannot be used to infer the results of low-dose exposure in everyday life. For lead, the Centers for Disease Control and Prevention (CDC) considers a blood lead level of 5 micrograms per deciliter (µg/dL) or higher to be elevated [ 18 ]. For cadmium, the WHO has established a reference level of 2.5 µg/L in blood as an indicator of long-term exposure to cadmium [ 19 ].…”
Section: Introductionmentioning
confidence: 99%
“… 13 , 15 Another recent study that analyzed geocoded birth certificate data and BLL results from 2011 to 2018 in North Carolina showed that 30% of highest‐risk children were never tested. 40 National estimates are similar, with 35% of a Medicaid cohort never receiving a first test, and 50% of children never receiving critical follow‐up monitoring. 41 It is critical to note that inclusive, equitable, and accurate child BLL testing simultaneously provides valid and reliable surveillance data for a given point in time, which is essential for demonstrating funding needs for primary prevention goals.…”
Section: Introductionmentioning
confidence: 92%
“…In a study that modeled the numbers of lead‐exposed children likely “missed” for testing each year (based on NHANES child BLL data from 1999 to 2010), it was estimated that, each year, at least 500,000, and possibly more than 2 million, highest‐risk children are never even tested 13,15 . Another recent study that analyzed geocoded birth certificate data and BLL results from 2011 to 2018 in North Carolina showed that 30% of highest‐risk children were never tested 40 . National estimates are similar, with 35% of a Medicaid cohort never receiving a first test, and 50% of children never receiving critical follow‐up monitoring 41 .…”
Section: Introductionmentioning
confidence: 99%
“…Modeling studies have suggested that at least 500,000 children per year, and as many as 2 million, are never tested [16] , [17] . Moreover, children living in lower-income neighborhoods are significantly less likely to be tested and monitored [18] , [19] .…”
Section: Introductionmentioning
confidence: 99%