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Int. J. Environ. Res. Public Health 2014, 11(7), 7482-7491; doi:10.3390/ijerph110707482

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

1
Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA 70112, USA
2
Lead Lab, Inc., New Orleans, LA 70119, USA
3
Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 16 December 2013 / Revised: 12 March 2014 / Accepted: 13 March 2014 / Published: 21 July 2014
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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. View Full-Text
Keywords: soil lead mapping; Pb loading; clinical Pb testing; exposure intervention soil lead mapping; Pb loading; clinical Pb testing; exposure intervention
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Mielke, H.W.; Gonzales, C.; Powell, E.; Mielke, P.W. Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans. Int. J. Environ. Res. Public Health 2014, 11, 7482-7491.

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