Impact of the COVID-19 Pandemic on Childhood Lead Testing and Blood Lead Levels.

Autor: Brewster RCL; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster and N Buncher), Boston Medical Center, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass. Electronic address: ryan.brewster@childrens.harvard.edu., Azad AD; Department of Ophthalmology (AD Azad), Massachusetts Eye and Ear, Boston, Mass., Acosta K; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass., Starmer A; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass., Sprecher E; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass., Rea C; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass., Gray KP; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Institutional Centers of Clinical and Translational Research (KP Gray), Boston Children's Hospital, Boston, Mass., Regan S; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass., Wilson J; Harvard T.H. Chan School of Public Health (J Wilson), Boston, Mass., Bayuh F; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass., Buncher N; Department of Pediatrics (RCL Brewster and N Buncher), Boston Medical Center, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (N Buncher and M Hauptman), Boston, Mass., Hauptman M; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, KP Gray, S Reagan, F Bayuh, and M Hauptman), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (RCL Brewster, K Acosta, A Starmer, E Sprecher, C Rea, and M Hauptman), Harvard Medical School, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (N Buncher and M Hauptman), Boston, Mass.
Jazyk: angličtina
Zdroj: Academic pediatrics [Acad Pediatr] 2024 Jul; Vol. 24 (5), pp. 810-814. Date of Electronic Publication: 2023 Nov 17.
DOI: 10.1016/j.acap.2023.11.014
Abstrakt: Objective: To evaluate the effect of the COVID-19 pandemic on childhood lead testing and blood lead levels.
Methods: A retrospective analysis of lead tests and results was performed across 3 urban medical centers during the pre-COVID-19 (March 10, 2019-March 9, 2020) and COVID-19 (March 10, 2020-March 10, 2022) periods. Interrupted time series analysis with quasi-Poisson regression was used to evaluate changes in lead testing between study periods. The relationship between sociodemographic features with detectable (≧2 µg/dL) and elevated (≧3.5 µg/dL) blood lead levels (BLLs) was assessed with multivariable logistic regression.
Results: Among a total of 16,364 lead tests across 10,362 patients, weekly testing rates significantly decreased during COVID-19 (relative risk (RR) 0.64, 95% (confidence interval) CI 0.53-0.78). Census tracts with the greatest proportion of pre-1950s housing had a stronger association with detectable BLLs during the COVID-19 period (pre-COVID-19 adjusted odds ratio (aOR) 1.73, 95% CI 1.35-2.20; aOR 2.58, 95% CI 2.13-3.12; interaction P value .014). When limited to 1 year following COVID-19 (March 10, 2020-March 10, 2021), the association between both elevated BLLs (pre-COVID-19: aOR 1.49, 95% CI 0.87-2.53; COVID-19: aOR 3.51, 95% CI 1.98-6.25; interaction P value .032) and detectable BLLs with pre-1950s housing were greater during the COVID-19 period (pre-COVID-19: aOR 1.73, 95% CI 1.35-2.20; COVID-19: aOR 2.56, 95% CI 1.95-3.34; interaction P value .034).
Conclusions: The COVID-19 pandemic led to a significant reduction in lead surveillance and magnified the effect of known risk factors for lead exposure. Concerted clinical, public health, and community advocacy are needed to address care gaps and excess cases of lead poisoning.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors have received support from the following for the production of this manuscript:
(Copyright © 2023 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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