Sharunda Buchanan

Blood lead levels and risk factors for lead poisoning among children in Jakarta, Indonesia

The phase-out of leaded gasoline began in Jakarta, Indonesia on July 1, 2001. We evaluated mean blood lead levels (BLLs) and the prevalence of elevated BLLs of Jakarta school children and assessed risk factors for lead exposure in these children before the beginning of the phase-out activities. The study involved a population-based, cross-sectional blood lead survey that included capillary blood lead sampling and a brief questionnaire on risk factors for lead poisoning. A cluster survey design was used. Forty clusters, defined as primary schools in Jakarta, and 15 2nd- and 3rd-grade children in each cluster were randomly selected for participation in the study. The average age of children in this study was 8.6 years (range 6-12) and the geometric mean BLL of the children was 8.6 microg/dl (median: 8.6 microg/dl; range: 2.6-24.1 microg/dl) (n=397). Thirty-five percent of children had BLLs > or =10 microg/dl and 2.4% had BLLs > or =20 microg/dl. Approximately one-fourth of children had BLLs 10-14.9 microg/dl. In multivariate models, level of education of the childs primary caregiver, water collection method, home varnishing and occupational recycling of metals, other than lead, by a family member were predictors of log BLLs after adjustment for age and sex. BLLs of children who lived near a highway or major intersection were significantly higher than those of children who lived near a street with little or no traffic when level of education was not included in the model. Water collection method was a significant predictor of BLLs > or =10 microg/dl after adjustment for age and sex. BLLs in children in this study were moderately high and consistent with BLLs of children in other countries where leaded gasoline is used. With the phase-out of leaded gasoline, BLLs of children in Jakarta are expected to rapidly decline as they have in other countries that have phased lead out of gasoline.

Relation between housing age, housing value, and childhood blood lead levels in children in Jefferson County, Ky.

Lead poisoning is the most common cause of environmental disease in children. Elevated blood lead levels are associated with lower IQs, impaired growth and neurological development, and behavior problems. Approximately 890 000 (4.4%) children younger than 6 years in the United States have blood lead levels of 10 μg/dL or greater.1 Children who are Black, are poor, and live in older houses are at greatest risk.2 The Centers for Disease Control and Prevention recommend screening based on housing age and zip code. Geographic information systems technology allows a more specific mapping of areas with older housing than do zip codes.3 We refined this approach by linking socioeconomic data to tax assessor data to determine whether living in older or less-expensive housing is a risk factor for having an elevated blood lead level among children.

Strengthening the Capacity of Local Health Agencies Through Community-Based .Assessment and Planning

Objectives. We evaluated the effectiveness of the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) in building competency in essential environmental health services and renewing efforts to engage the community in problem solving. Competency and community engagement have been identified by environmental health practitioners as important to meet new threats to public health. Methods. We conducted a national survey and 24 case studies of public health agencies. We invited 917 organizations to participate in the national survey because they had requested a copy of the protocol. Results. We received 656 total responses: 354 had not considered implementation, 302 had considered implementation, and 66 had implemented PACE EH. For the 24 case studies, we interviewed 206 individuals in communities implementing PACE EH. We found that PACE EH has had a positive effect on building community and professional networks, enhancing leadership, developing workforce competence, and expanding definitions of environmental health practice. Conclusions. With appropriate investments, PACE EH can be an effective tool to meet the environmental health challenges identified by local environmental health practitioners and state, tribal, and federal agencies.