This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Bernard MY Cheung
Department of Medicine, The University of Hong Kong, Hong Kong, China
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9106-7363
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Lead is toxic without a safe limit. The current upper reference blood lead level (BLL), 5 μg/dL, came from the 97.5th percentile in children aged 1-5 years in NHANES 2007-2010.
Objectives: We studied the latest trend in BLL in US NHANES and estimated the proportion of children with BLL ≥5 μg/dL, which would inform the setting of an upper reference level.
Methods: We analyzed 68877 participants (aged 1 to 85 years) with BLL measurements in NHANES 1999-2016 using SPSS complex sample module v25.0.
Results: In NHANES 2011-2012, 2013-2014, and 2015-2016, the mean and 95% confidence intervals (CIs) of BLLs (μg/dL) were 0.97 (0.96, 0.99), 0.86 (0.85, 0.87), and 0.82 (0.81, 0.83), respectively (P <0.0001). The estimated proportion (95% CI) of children aged 1-5 years with elevated BLL (EBLL) in 2011-2012, 2013-2014, and 2015-2016 were 2.0% (1.3, 3.0), 0.5% (0.4, 0.7), and 1.3% (0.8, 2.3), respectively (P=0.267). In 2015-2016, the proportion of children with EBLL was similar in high- and low-income groups (P = 0.9979). The estimated 97.5th percentile of BLL in children was 3.71 μg/dL in NHANES 2015-2016.
Conclusions: BLL continued to decline in the overall US population. The disparity in BLL in children from higher and lower income families has decreased. Our findings support a reduction in the reference BLL, continual monitoring of population BLL and continual efforts to reduce environmental exposure to lead.
Keywords
blood lead level, United States, NHANES
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Bernard MY Cheung
Department of Medicine, The University of Hong Kong, Hong Kong, China
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9106-7363
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Mar, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Environmental Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Lead is toxic without a safe limit. The current upper reference blood lead level (BLL), 5 μg/dL, came from the 97.5th percentile in children aged 1-5 years in NHANES 2007-2010.
Objectives: We studied the latest trend in BLL in US NHANES and estimated the proportion of children with BLL ≥5 μg/dL, which would inform the setting of an upper reference level.
Methods: We analyzed 68877 participants (aged 1 to 85 years) with BLL measurements in NHANES 1999-2016 using SPSS complex sample module v25.0.
Results: In NHANES 2011-2012, 2013-2014, and 2015-2016, the mean and 95% confidence intervals (CIs) of BLLs (μg/dL) were 0.97 (0.96, 0.99), 0.86 (0.85, 0.87), and 0.82 (0.81, 0.83), respectively (P <0.0001). The estimated proportion (95% CI) of children aged 1-5 years with elevated BLL (EBLL) in 2011-2012, 2013-2014, and 2015-2016 were 2.0% (1.3, 3.0), 0.5% (0.4, 0.7), and 1.3% (0.8, 2.3), respectively (P=0.267). In 2015-2016, the proportion of children with EBLL was similar in high- and low-income groups (P = 0.9979). The estimated 97.5th percentile of BLL in children was 3.71 μg/dL in NHANES 2015-2016.
Conclusions: BLL continued to decline in the overall US population. The disparity in BLL in children from higher and lower income families has decreased. Our findings support a reduction in the reference BLL, continual monitoring of population BLL and continual efforts to reduce environmental exposure to lead.
Figure 1
Figure 3
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