446 - Recent Blood Lead Laboratory Test Results Ordered by Medical Facilities among Children Ages 1–17 Years in the United States, April 1, 2023–March 31, 2024.

Publication Number: 446.6263

Tanya T. LeBlanc, Centers for Disease Control and Prevention, Atlanta, GA, United States; Wenping Hu, CDC/NCEH, Atlanda, GA, United States; Madison R. Smith, CDC, Rome, GA, United States; Alan D. Woolf, Boston Children's Hospital, Boston, MA, United States; Aaron Bernstein, CDC, Atlanta, GA, United States; Paul Allwood, n/a, Shoreview, MN, United States

Background: No safe blood level of lead is known; children under the age of 6 years are especially vulnerable to the toxic effects of lead. Some industries that use lead continue to operate. Sources of lead exposure have emerged in international manufacturing and food production. Risk for exposure from lead brought home from work, in food, and in goods made for children might have increased.

Objective: Commercial laboratory data reported to CDC’s National Syndromic Surveillance Program were accessed to characterize the results nationally of blood lead level testing in the population of US children aged 1-17 years.

Design/Methods: Commercial laboratory data reported to CDC’s National Syndromic Surveillance Program (NSSP) from April 1, 2023–March 31, 2024 were accessed. Test orders and results for all reportable conditions and diseases in the U.S. are transmitted to NSSP twice daily via HL7® message. Blood lead testing data were analyzed to assess results for children aged 1–17 years. Nine blood lead exposure groups were established ( < 1 µg/dL, 1 to < 2.0 µg/dL, 2.0 to < 3.5 µg/dL, 3.5 to < 5.0 µg/dL, 5.0 to < 10.0 µg/dL, 10.0 to < 25.0 µg/dL, 25.0 to < 45.0 µg/dL, 45.0 to < 70.0 µg/dL and ≥70.0 µg/dL) and compared results by age, race, sex, type of clinical care provider ordering the tests, and clinical reasons for test orders. Frequency distributions and cross tabulations were performed with SAS (version 9.4; SAS Institute, Cary, NC).

Results: Of 1,139,980 blood lead tests performed on children aged 1–17 during the period, with 22,882 tests excluded because of uninterpretable results, 5% (58,781) of lead positive tests had detectable blood lead levels at or above the CDC's blood lead reference value, 3.5 µg/dL. Thirteen percent (13.1%; 146,276 tests) had blood lead levels 2.0 µg/dL or higher; and 34 tests performed on children under 6 years of age had blood lead levels of 70.0 µg/dL or higher. Sixty percent (674,532, 60.4%) of tests were ordered by either pediatric or general practice care facilities leaving 39.6% (442,562) of tests ordered by other venues, including hospitals (241,150, 21.6%).

Conclusion(s): These results underscore the urgent need for increased lead exposure awareness, screening, testing, and prevention for families with young children. Identifying lead exposed children, especially those younger than 6 years, remains a top priority for pediatric primary care as does providing exposed children appropriate intervention services quickly after diagnosis, which can reduce harm. Improving awareness among young families of lead exposure hazards as a continuing public health concern remains a priority.