Résumé :
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[BDSP. Notice produite par INIST-CNRS R0xAqkp5. Diffusion soumise à autorisation]. Objective. Screening children to identify those with blood lead levels>=10 pg/dl fails to protect children from lead-associated cognitive deficits and behavioral problems. To broaden our efforts at primary prevention, screening criteria are needed to identify lead-contaminated housing before children are unduly exposed. The purpose of this study was to identify and validate housing characteristics associated with children having elevated blood lead levels (>=10 pg/dl). Methods. Two existing studies were used to examine housing characteristics linked with undue lead exposure : a cross-sectional study of 205 children aged 12 to 31 months, and a random sample from a longitudinal study of 276 children followed from 6 to 24 months of age. Logistic regression analysis was conducted to examine the association of children's blood lead levels>=10 pg/dl. Results. The mean age of the 481 children was 17.8 months ; 99 (20.6%) had a blood lead concentration of 10 pg/dl or higher. The following characteristics were associated with blood lead concentration>=10 pg/dl : floor lead loading>15 mug/ft2 (odds ratio [OR]=2.2 ; 95% confidence interval [Cl] 1.3,3.8) ; rental housing (OR=3.2 ; 95% Cl 1.3,7.6) ; poor housing condition (OR=2.1 ; Cl 1.2,3.6) ; African American race (OR=3.3 ; Cl 1.9,6.1) ; paint chip ingestion (OR=5.8 ; Cl 1.3,26.5) ; and soil ingestion (OR=2.2 ; Cl 1.1,4.2). Housing characteristics including rental status, lead-contaminated floor dust, and housing condition had a range of sensitivity from 47% to 92% ; specificity from 28% to 76% ; a positive predictive value from 25% to 34% ; and a negative predictive value of 85% to 93%. Conclusions. Housing characteristics and floor dust lead levels can be used to screen housing to identify lead hazards prior to occupancy, before purchasing a home, or after renovation to prevent children's exposure to lead hazards.
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