摘要：Objectives . We assessed the prevalence of elevated blood lead levels (≥ 10 micrograms of lead per deciliter of blood), risk factors, and previous blood lead testing among children in 2 high-risk Chicago, Ill, communities. Methods . Through high-intensity targeted screening, blood lead levels were tested and risks were assessed among a representative sample of children aged 1 to 5 years who were at risk for lead exposure. Results . Of the 539 children who were tested, 27% had elevated blood lead levels, and 61% had never been tested previously. Elevated blood lead levels were associated with chipped exterior house paint. Conclusions . Most of the children who lived in these communities—where the prevalence for elevated blood lead levels among children was 12 times higher than the national prevalence—were not tested for lead poisoning. Our findings highlight the need for targeted community outreach that includes testing blood lead levels in accordance with the American Academy of Pediatrics’ recommendations. Lead is an environmental toxicant that affects nearly every system in the body. 1 Among children, lead is associated with decreased intelligence, growth and hearing impairment, anemia, and attention and behavioral problems. 2 High levels of exposure can cause severe brain damage and death. Young children, especially those who are aged younger than 2 years, are particularly susceptible to lead because their central nervous systems are still developing and because they absorb more lead from their environments than do adults. 2 Among children who are aged younger than 6 years, the Centers for Disease Control and Prevention (CDC) defines an elevated blood lead level as greater than or equal to 10 micrograms of lead per deciliter of blood (μg/dL), but there are subtle effects on health at lower levels. 3 Deteriorating lead-based paint is the most common high-dose source of lead exposure among young children in the United States. 1 In 1973, the Consumer Product Safety Commission established a maximum lead content in paint of 0.5% by weight, and in 1978 that amount was lowered to 0.06%. 4 Eighty-nine percent of homes in Chicago were built before 1978. 5 A federal strategy to eliminate childhood lead poisoning by 2010 was developed by the CDC, the Department of Housing and Urban Development, the Environmental Protection Agency, and other agencies. 6 Two key elements of the strategy are to identify and care for lead-poisoned children and to refine lead poisoning prevention strategies. High-intensity targeted screening is a tool that allows the CDC and its local partners to assess testing levels among children in high-risk communities and to examine the blood lead burden among children in specific locales. Chicago, Ill, is the third largest city in the United States and has an estimated 308000 children who are aged younger than 6 years. 5 It is divided into 77 communities, some of which have many risk factors for childhood lead poisoning, including a high percentage of residents who are poor, who live in old housing, who receive Medicaid assistance, and who are of minority race/ethnicity. 7, 8 Of the 114126 Chicago children who were tested for lead poisoning in 2001, 11.2% had blood lead levels greater than or equal to 10 μg/dL, and 1.9% had blood lead levels greater than or equal to 20 μg/dL. 9 The results of a collaborative blood lead study in 2 Chicago communities by the CDC and the Chicago Department of Public Health (CDPH), which was conducted in partnership with community-based organizations, are presented in this article. The objectives of our study, which was conducted during October and November 2001, were to (1) assess the prevalence of children with elevated blood lead levels who had not been previously tested, (2) obtain an unbiased prevalence estimate of elevated blood lead levels among children aged 1 to 5 years who lived in these 2 Chicago communities, and (3) identify demographic, behavioral, and environmental risk factors for elevated blood lead levels among these children.
