Lead exposure sources and public health investigations for children with elevated blood lead in England, 2014 to 2022-Reference-Cited by-同舟云学术

Lead exposure sources and public health investigations for children with elevated blood lead in England, 2014 to 2022

Published:2024-07-18 Issue:7 Volume:19 Page:e0304866
ISSN:1932-6203
Container-title:PLOS ONE
language:en
Short-container-title:PLoS ONE

Author:

Dave Mona^ORCID,Busby Araceli,Shammari Lena Al,Iqbal Neelam,Coole Louise,Bagnall Helen,Crabbe Helen

Abstract

Background Lead exposure at any concentration can adversely impact health, with children being more vulnerable to its effects. In England, children with an elevated blood lead concentration (BLC) are reported to Health Protection Teams (HPTs) for public health investigation. A detailed review of these cases has not yet been conducted. Objectives The objectives of this study were to describe the demographics, likely setting and sources of lead exposure, risk behaviours, public health investigations and outcomes for children aged <16 years with a BLC requiring public health action reported to HPTs between 2014–2022 in England. Methods Data were collected via a lookback questionnaire and a live enhanced surveillance questionnaire. Data were deduplicated, cleaned and results summarised as numbers and percentages using R studio. A thematic analysis was conducted on qualitative responses to a question relating to problems experienced during case investigation. Results There were 340 cases in our study: the majority were aged 1–4 years old (53%) and male (69%). Ethnicity data was poorly recorded. A higher than expected proportion (31%) lived in the most deprived areas. Pica (76%) and learning difficulties (60%) were often present. Cases were primarily exposed to lead in the domestic setting (92%) with paint (43%) and soil (29%) the most common exposures. Most cases lived in rented accommodation (63%), with a higher proportion in social rentals (48%) than privately rented (37%). Case investigations were resource intensive and poor stakeholder engagement/response was most frequently identified as challenging by HPTs. Conclusions Lead exposure is harmful to children and requires public health and clinical management, which can be complex and challenging. Prevention of lead exposure in children should be the focus of intervention efforts. Outreach, engagement and preventative work should focus on both renters and homeowners. Collecting ethnicity data consistently may enable identification of more specific groups at increased risk of lead exposure in England.

Funder

UK Health Security Agency (UKHSA) Grant in Aid

National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health

Publisher

Public Library of Science (PLoS)

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