Abstract

Background:

Despite great progress in reducing environmental lead (Pb) levels, many children in the United States are still being exposed.

Objective:

Our aim was to develop a generalizable approach for systematically identifying, verifying, and analyzing locations with high prevalence of children’s elevated blood Pb levels (EBLLs) and to assess available Pb models/indices as surrogates, using a Michigan case study.

Methods:

We obtained $\sim 1.9\text{\hspace{0.17em}million}$ BLL test results of children $<6\text{\hspace{0.17em}years}$ of age in Michigan from 2006–2016; we then evaluated them for data representativeness by comparing two percentage EBLL (%EBLL) rates (number of children tested with EBLL divided by both number of children tested and total population). We analyzed %EBLLs across census tracts over three time periods and between two EBLL reference values ($\ge 5$ vs. $\ge 10\mathrm{\mu }\mathrm{g}/\text{dL}$) to evaluate consistency. Locations with high %EBLLs were identified by a top 20 percentile method and a Getis-Ord Gi* geospatial cluster “hotspot” analysis. For the locations identified, we analyzed convergences with three available Pb exposure models/indices based on old housing and sociodemographics.

Results:

Analyses of 2014–2016 %EBLL data identified 11 Michigan locations via cluster analysis and 80 additional locations via the top 20 percentile method and their associated census tracts. Data representativeness and consistency were supported by a 0.93 correlation coefficient between the two EBLL rates over 11 y, and a Kappa score of $\sim 0.8$ of %EBLL hotspots across the time periods (2014–2016) and reference values. Many EBLL hotspot locations converge with current Pb exposure models/indices; others diverge, suggesting additional Pb sources for targeted interventions.

Discussion:

This analysis confirmed known Pb hotspot locations and revealed new ones at a finer geographic resolution than previously available, using advanced geospatial statistical methods and mapping/visualization. It also assessed the utility of surrogates in the absence of blood Pb data. This approach could be applied to other states to inform Pb mitigation and prevention efforts. https://doi.org/10.1289/EHP9705

中文翻译：

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一种可概括的评估方法，应用先进的地理空间统计方法，以识别人口普查区域规模的高铅暴露位置：密歇根案例研究

摘要

背景：

尽管在降低环境铅 (Pb) 水平方面取得了很大进展，但美国的许多儿童仍然受到暴露。

客观的：

我们的目标是开发一种可推广的方法，用于系统地识别、验证和分析儿童血铅水平升高 (EBLL) 高流行的位置，并使用密歇根案例研究评估可用的 Pb 模型/指数作为替代指标。

方法：

我们获得了$～1.9\text{\hspace{0.17em}百万}$儿童BLL测试结果$<6\text{\hspace{0.17em}年}$2006-2016 年在密歇根州的年龄；然后，我们通过比较两个百分比的 EBLL (%EBLL) 率（接受 EBLL 测试的儿童数量除以测试的儿童数量和总人口）来评估它们的数据代表性。我们在三个时间段和两个 EBLL 参考值之间分析了人口普查区的 %EBLL（$\ge 5$对比$\ge 10\mathrm{\mu }\mathrm{G}/\text{dL}$) 来评估一致性。通过前 20 个百分位方法和 Getis-Ord Gi* 地理空间集群“热点”分析确定具有高 %EBLL 的位置。对于确定的位置，我们分析了基于旧住房和社会人口统计的三个可用铅暴露模型/指数的收敛性。

结果：

对 2014-2016 年 %EBLL 数据的分析通过聚类分析确定了密歇根州的 11 个地点，并通过前 20 个百分位数方法及其相关的人口普查区确定了另外 80 个地点。数据的代表性和一致性得到了 11 年内两个 EBLL 率之间 0.93 的相关系数和 Kappa 评分的支持。$～0.8$整个时间段（2014-2016 年）的 %EBLL 热点和参考值。许多 EBLL 热点位置与当前的铅暴露模型/指数趋同；其他人分歧，建议有针对性的干预措施额外的铅来源。

讨论：

该分析使用先进的地理空间统计方法和制图/可视化，确认了已知的铅热点位置，并以比以前更精细的地理分辨率揭示了新的热点位置。它还评估了在没有血铅数据的情况下替代物的效用。这种方法可以应用于其他州，为铅减排和预防工作提供信息。https://doi.org/10.1289/EHP9705