Lead is the leading environmental poison of young children in New York State (NYS). Lead poisoning is associated with serious and lifelong adverse health, developmental, and cognitive outcomes that are completely preventable. New York State is committed to achieving the goal of eliminating childhood lead poisoning by the year 2010. Elimination of childhood lead poisoning is essential to improving the lives of children in New York State, especially socio-economically disadvantaged children who are disproportionately affected by lead poisoning. New York has made significant progress towards reducing both the incidence and severity of childhood lead poisoning. Despite this success, childhood lead poisoning remains a serious public health problem.
The majority of children with lead poisoning are exposed to lead from deteriorating lead paint in their homes. NYS has the largest number and percent of pre-1950 housing of all states in the nation. Additional sources of lead exposure may include lead-contaminated soil, imported food, pottery and cosmetics, traditional medicines and some imported children's toys and jewelry. Children may also be exposed to lead if their parents or guardians have occupations or hobbies that expose them to lead. Because medical treatment options for lead poisoning are limited, it is critical that children be protected from lead exposure in their environments before they become lead poisoned.
Under current NYS Public Health Law and regulations, health care providers are required to screen all children using blood lead tests at or around age one year and again at or around age two years. Health care providers are also required to assess all children age six months to 72 months of age at least once annually for risk of lead exposure, with blood lead testing for all children found to be at risk, based on those assessments. Early identification of children with elevated blood lead levels through routine blood lead screening is essential to assure coordination of follow up services to minimize harmful effects and prevent further exposure to lead.
The analysis and application of data are important tools used by the Department to assess the extent of the childhood lead poisoning problem, to identify high-risk communities and populations with the highest need for interventions, and to monitor and evaluate the effectiveness of interventions. Eliminating Childhood Lead Poisoning in New York State summarizes the status of screening and lead poisoning in NYS, excluding New York City (NYC) for children less than six years of age1. This surveillance report contains several new measures to more effectively assess and monitor progress toward the elimination of childhood lead poisoning by 2010. Historical data have been included to show trends over time for these new measures.
NYS has made significant gains in the prevention, early identification, and effective management of childhood lead poisoning. The State and Local Health Departments, in collaboration with a wide range of partners, are working to continue the positive trends described in this report through the development and implementation of effective public health strategies. Additional information on these efforts may be found in New York's strategic plan, Eliminating Childhood Lead Poisoning in New York State by 2010, which is available on the Department's website at www.nyhealth.gov/environmental/lead/.
This report highlights a number of important findings for New York State:
- Screening rates for children at or around age one year are improving. A 7.5% increase in screening rates for children at or around age one year was observed among children born in 2002 compared to children born in 1998. Fifty three percent of children born in 2002 were tested for lead at or around age one year, compared to 49.4% of children born in 1998.
- Screening rates for children tested at or around age two years are improving. A 17.1% increase in screening rates for children at or around age two years was observed among children born in 2002 compared to children born in 1998. Forty five percent of children born in 2002 were tested for lead at or around age two, compared to 38.6% of children born in 1998. Although screening rates for two year old children are improving, the percentage of children screened at age two years is lower than the percentage screened at age one year.
- A high percent of children receive at least one lead screening test by age three years. Of children born in New York State in 2002, 77.1% received at least one lead screening test by age 36 months. Although the percent of children receiving at least two tests by age three years is significantly lower than the percent of children receiving at least one test by age three years, trend data indicate this measure is improving. The number of children receiving two screening tests by age three years increased 25.1% between children born in 1998 and children born in 2002, from 27,321 children born in 1998 to 34,180 children born in 2002. The percent of children who received at least two screening tests by age three years increased from 26.8% of children born in 1998 to 33.1% of children born in 2002.
- The incidence of elevated blood lead levels (EBLLs) among children under age six years is steadily declining across all blood lead level (BLL) categories. Trend data show the dramatic improvement in both the number and percent of children identified with confirmed BLLs ≥ 10 mcg/dL, the current definition of lead poisoning established by the federal Centers for Disease Control and Prevention (CDC). In 1998, 5,198 children less than six years of age were newly identified with BLLs ≥ 10mcg/dL, compared to 2,283 children in 2005. This represents a striking 56.1% decline in the number of children with EBLLs since 1998. A 59.3% decrease in the rate of incidence of lead poisoning was observed over the same time period, from 29.0 per 1,000 children tested in 1998 to 11.8 per 1,000 children tested in 2005.
- The prevalence of elevated blood lead levels among children under age six years continues to decline. Trend data show a significant improvement in both the total number and percentage of children under age six years with BLLs ≥ 10 mcg/dL in New York State. In 1998, 10,155 children less than six years of age had BLLs ≥ 10mcg/dL compared to 3,666 children in 2005, representing a 63.9% decline. A 65.1% decrease in prevalence rates was observed over the past seven years; from 53.3 per 1,000 children tested in 1998 to 18.6 per 1,000 children tested in 2005.
- The incidence of childhood lead poisoning varies greatly across the state. In 2005, the majority (61.1% of cases outside of New York City) of children newly identified with BLLs ≥ 10 mcg/dL resided in the seven highest upstate incidence counties: Albany, Erie, Monroe, Oneida, Onondaga, Orange, and Westchester.
- 1The New York City Department of Health and Mental Hygiene (NYCDOHMH) has released annual reports for New York City 2004 and 2005 blood lead surveillance data entitled "Preventing Lead Poisoning in New York City". These reports may be accessed on line at http://www.nyc.gov/lead. The full reports may be obtained by contacting the NYCDOHMH Lead Poisoning Prevention Program's Education Unit.