Geographic region of residence and blood lead levels in US children: results of the National Health and Nutrition Examination Survey.

PURPOSE: This study investigated the association between geographic region and blood lead levels (BLLs) in US children, as well as trends in this relationship, using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS: SAS® and SUDAAN® software programs were utilized to develop linear regression models adjusted for several factors associated with BLLs.

RESULTS: The largest decline in BLLs was observed in Northeastern children, while the percentage of children with elevated blood lead levels decreased the most for the West and Northeast. Lead levels of Northeastern children were still higher than those of children living in the West. However, levels were not different among children residing in the Northeast, Midwest, and South, and the blood lead concentrations were less than 5 μg/dL for all but one subgroup of children and less than 2 μg/dL for >70% of the subgroups. More importantly, the effects of different risk factors for higher blood lead levels varied by region even after adjusting for all other covariates.

CONCLUSIONS: The results of this study not only provide relevant and current blood lead levels for US children that can be used as reference values to evaluate biomonitoring data, but can also be used to help direct prevention and surveillance strategies to reduce lead in the environment of at-risk children.