■儿童时期接触铅对儿童健康有害。铅暴露与小学学业成绩之间的关联在地理上的差异尚不清楚。
■使用允许BLL和考试成绩之间的关联在社区之间的空间变化的模型,估计血铅水平(BLL)与北卡罗来纳州的阅读和数学中的四年级标准化考试成绩之间的关联。
■我们链接地理编码,个人层面,北卡罗莱纳州公立学校学生四年级(2013-2016年)的标准化考试成绩数据,以及从北卡罗莱纳州儿童血铅状态登记处检索的详细出生记录和血铅检测数据,样本通常在1-6岁时收集.BLL分类为:1μg/dL(参考),2μg/dL,3-4μg/dL和≥5μg/dL。然后,我们拟合包含信息共享(平滑度)的空间变化系数模型,通过高斯马尔可夫随机场跨相邻社区,以提供BLL和测试分数之间关联的全局估计,以及人口普查道特定的估计(即,空间系数)。针对母体和儿童水平的协变量调整的模型,分别适用于阅读和数学。
■分析数据集中91,706个个体的平均BLL为2.84μg/dL。个人分布在北卡罗来纳州的2,002(在2,195)个人口普查区域中。在适应儿童性别的模型中,胎龄的出生体重百分位数,和医疗补助参与以及孕产妇种族/种族,教育程度,婚姻状况,和烟草的使用,2μg/dL的BLLs,3-4μg/dL和≥5μg/dL与-0.28的总体较低阅读测试得分相关[95%置信区间(CI):-0.43,-0.12],-0.53(-0.69,-0.38),和-0.79(-0.99,-0.604),分别。对于1μg/dL的BLL,2μg/dL,3-4μg/dL和≥5μg/dL,空间系数-也就是说,阅读测试分数相对于“全局”系数的特定调整范围分别为-9.70至2.52,-3.19至3.90,-11.14至7.85和-4.73至4.33。数学的结果与阅读的结果相似。
■铅暴露与阅读和数学考试成绩之间的关联在北卡罗来纳州社区中表现出相当大的异质性。这些结果强调了对各地铅暴露的预防和缓解努力的必要性,特别注意认知影响升高的地方。https://doi.org/10.1289/EHP13898.
UNASSIGNED: Exposure to lead during childhood is detrimental to children\'s health. The extent to which the association between lead exposure and elementary school academic outcomes varies across geography is not known.
UNASSIGNED: Estimate associations between blood lead levels (BLLs) and fourth grade standardized test scores in reading and
mathematics in North Carolina using models that allow associations between BLL and test scores to vary spatially across communities.
UNASSIGNED: We link geocoded, individual-level, standardized test score data for North Carolina public school students in fourth grade (2013-2016) with detailed birth records and blood lead testing data retrieved from the North Carolina childhood blood lead state registry on samples typically collected at 1-6 y of age. BLLs were categorized as: 1μg/dL (reference), 2μg/dL, 3-4μg/dL and ≥5μg/dL. We then fit spatially varying coefficient models that incorporate information sharing (smoothness), across neighboring communities via a Gaussian Markov random field to provide a global estimate of the association between BLL and test scores, as well as census tract-specific estimates (i.e., spatial coefficients). Models adjusted for maternal- and child-level covariates and were fit separately for reading and math.
UNASSIGNED: The average BLL across the 91,706 individuals in the analysis dataset was 2.84μg/dL. Individuals were distributed across 2,002 (out of 2,195) census tracts in North Carolina. In models adjusting for child sex, birth weight percentile for gestational age, and Medicaid participation as well as maternal race/ethnicity, educational attainment, marital status, and tobacco use, BLLs of 2μg/dL, 3-4μg/dL and ≥5μg/dL were associated with overall lower reading test scores of -0.28 [95% confidence interval (CI): -0.43, -0.12], -0.53 (-0.69, -0.38), and -0.79 (-0.99, -0.604), respectively. For BLLs of 1μg/dL, 2μg/dL, 3-4μg/dL and ≥5μg/dL, spatial coefficients-that is, tract-specific adjustments in reading test score relative to the \"global\" coefficient-ranged from -9.70 to 2.52, -3.19 to 3.90, -11.14 to 7.85, and -4.73 to 4.33, respectively. Results for
mathematics were similar to those for reading.
UNASSIGNED: The association between lead exposure and reading and
mathematics test scores exhibits considerable heterogeneity across North Carolina communities. These results emphasize the need for prevention and mitigation efforts with respect to lead exposures everywhere, with special attention to locations where the cognitive impact is elevated. https://doi.org/10.1289/EHP13898.