The Prevalence of Blood Lead Levels ≥5μg/dl among 1 to 21 Year Old U.S. Population and Trends from 1988–1994 through 1999–2002

Purpose Elevated blood lead in children is defined as ≥10ug/dl. In light of data suggesting adverse health effects at blood lead levels (PbB) <10ug/dl, lowering the current definition has been recommended. To ascertain the population level impact of such a change, we calculated the prevalence and distribution of PbB ≥5μg/dl in 1 to 21 year old population in the United States. Furthermore, we characterized changes in PbB between 1988–1994 and 1999–2002. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) III (n=10,755) and NHANES 1999–2002 (n=8,013). Results Between 1988–1994 and 1999–2002, the geometric mean PbB declined from 2.88μg/dl to 1.94μg/dl in children 1 to 5 years, 1.80 μg/dl to 1.36μg/dl in children 6 to 11 years, and 1.24μg/dl to 1.02μg/dl in children and adolescents 12 to 21 years of age. Also, the prevalence of PbB ≥5μg/dl declined from 25.7% to 8.8%, 12.8% to 3.0%, and 7.5% to 1.2% in these age groups, respectively. In 1999–2002, a disproportionately higher prevalence of PbB ≥5μg/dl was present among children 1 to 5 and 6 to 11 years old who were non-Hispanic blacks, had lower household income, were not home owners, and lived in older housing. Among 12 to 21 year olds, having lower income levels, male sex, and no health insurance were each associated with a higher prevalence of PbB ≥5μg/dl. Conclusions Despite an overall decline in PbB, a substantial proportion of children (approximately 2.4 million) may be at risk for adverse health effects from lead exposure.