PDF(Pubmed)
Abstract：
To identify U.S. lead exposure risk hotspots, we expanded upon geospatial statistical methods from a published Michigan case study. The evaluation of identified hotspots using five lead indices, based on housing age and sociodemographic data, showed moderate-to-substantial agreement with state-identified higher-risk locations from nine public health department reports (45-78%) and with hotspots of children\'s blood lead data from Michigan and Ohio (e.g., Cohen\'s kappa scores of 0.49-0.63). Applying geospatial cluster analysis and 80th-100th percentile methods to the lead indices, the number of U.S. census tracts ranged from ∼8% (intersection of indices) to ∼41% (combination of indices). Analyses of the number of children <6 years old living in those census tracts revealed the states (e.g., Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, Massachusetts, California, Texas) and counties with highest potential lead exposure risk. Results support use of available lead indices as surrogates to identify locations in the absence of consistent, complete blood lead level (BLL) data across the United States. Ground-truthing with local knowledge, additional BLL data, and environmental data is needed to improve identification and analysis of lead exposure and BLL hotspots for interventions. While the science evolves, these screening results can inform \"deeper dive\" analyses for targeting lead actions.
摘要：
为了识别美国铅暴露风险热点，我们从已发表的密歇根州案例研究中扩展了地理空间统计方法。使用五个铅指数对确定的热点进行评估，根据住房年龄和社会人口统计数据，与9份公共卫生部门报告中确定的高风险地点（45-78％）以及来自密歇根州和俄亥俄州的儿童血铅数据热点（例如，科恩的卡帕得分为0.49-0.63）。将地理空间聚类分析和第80-100百分位数方法应用于铅指数，美国人口普查区域的数量范围从8%(指数的交叉)到41%(指数的组合)。对居住在这些人口普查区中的6岁以下儿童数量的分析显示，各州(例如，伊利诺伊州,密歇根州,新泽西,纽约,俄亥俄州,宾夕法尼亚,马萨诸塞州,加州,德克萨斯州)和潜在铅暴露风险最高的县。结果支持使用可用的铅指数作为替代，以在没有一致的情况下确定位置，全美国的全血铅水平(BLL)数据。用当地知识进行实地调查，额外的BLL数据，和环境数据是必要的，以改善识别和分析铅暴露和BLL热点的干预措施。随着科学的发展，这些筛查结果可以为针对铅行动的“更深入的潜水”分析提供信息。
