Abstract
In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children’s blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children’s Pb exposure. Here we review mapping environmental Pb and children’s blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children’s blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place.
Highlights
In 2012 the U.S Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 μg/dL
―Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century.‖
Blood lead results were collected by the Louisiana Childhood Lead Poisoning Prevent Program
Summary
―Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century.‖. The common clinical approach to lead (Pb) exposure is reactive because it relies on results of children’s blood Pb level (BPb) as a trigger for intervention actions. With each analytical improvement the clinical research on lead became more refined to the degree that it became evident there was no known safe level of Pb exposure [2]. The review evaluated 14 education and dust control studies, and based on meta-analysis noted that education and household interventions are not effective at reducing BPb levels in young children [6]. This overview of New Orleans research examines the sources of lead accumulation in the environment, the urban pattern of soil Pb and Pb loading together with childhood Pb exposure, and puts forward a proactive medical approach for diagnosing conditions of a preventable, chronic childhood disease that afflicts society. The New Orleans research was an extension of empirical studies that began in the 1970s in Baltimore, Maryland, continued in the 1980s in Minneapolis and Saint Paul including various smaller cities of Minnesota, and progressed in Louisiana in the 1990s [7,8,9,10]
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