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Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans

Author

Listed:
  • Howard W. Mielke

    (Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA 70112, USA)

  • Christopher Gonzales

    (Lead Lab, Inc., New Orleans, LA 70119, USA
    These authors contributed equally to this work.)

  • Eric Powell

    (Lead Lab, Inc., New Orleans, LA 70119, USA)

  • Paul W. Mielke

    (Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA
    These authors contributed equally to this work.)

Abstract

In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children’s blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children’s Pb exposure. Here we review mapping environmental Pb and children’s blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children’s blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place.

Suggested Citation

  • Howard W. Mielke & Christopher Gonzales & Eric Powell & Paul W. Mielke, 2014. "Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans," IJERPH, MDPI, vol. 11(7), pages 1-10, July.
  • Handle: RePEc:gam:jijerp:v:11:y:2014:i:7:p:7482-7491:d:38358
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    References listed on IDEAS

    as
    1. Mielke, H.W. & Anderson, J.C. & Berry, K.J. & Mielke, P.W. & Chaney, R.L. & Leech, M., 1983. "Lead concentrations in inner city soils as a factor in the child lead problem," American Journal of Public Health, American Public Health Association, vol. 73(12), pages 1366-1369.
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    Cited by:

    1. Howard W. Mielke & Christopher R. Gonzales & Eric T. Powell, 2017. "Soil Lead and Children’s Blood Lead Disparities in Pre- and Post-Hurricane Katrina New Orleans (USA)," IJERPH, MDPI, vol. 14(4), pages 1-12, April.
    2. Mark A.S. Laidlaw & Gabriel M. Filippelli & Richard C. Sadler & Christopher R. Gonzales & Andrew S. Ball & Howard W. Mielke, 2016. "Children’s Blood Lead Seasonality in Flint, Michigan (USA), and Soil-Sourced Lead Hazard Risks," IJERPH, MDPI, vol. 13(4), pages 1-13, March.
    3. Howard W. Mielke & Christopher R. Gonzales & Eric T. Powell & Sara Perl Egendorf, 2022. "Lead in Air, Soil, and Blood: Pb Poisoning in a Changing World," IJERPH, MDPI, vol. 19(15), pages 1-11, August.
    4. Howard W. Mielke, 2016. "Editorial: Lead Risk Assessment and Health Effects," IJERPH, MDPI, vol. 13(6), pages 1-3, June.

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