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

Mielke, Howard W.; Gonzales, Christopher; Powell, Eric; Mielke, Paul W.

doi:10.3390/ijerph110707482

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

^1,*

^2,†,

² and

^3,†

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

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

Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

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

Received: 16 December 2013 / Revised: 12 March 2014 / Accepted: 13 March 2014 / Published: 21 July 2014

(This article belongs to the Special Issue Proceedings from the Tenth International Symposium on Recent Advances in Environmental Health Research)

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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

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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. https://doi.org/10.3390/ijerph110707482

AMA Style

Mielke HW, Gonzales C, Powell E, Mielke PW. Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans. International Journal of Environmental Research and Public Health. 2014; 11(7):7482-7491. https://doi.org/10.3390/ijerph110707482

Chicago/Turabian Style

Mielke, Howard W., Christopher Gonzales, Eric Powell, and Paul W. Mielke. 2014. "Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans" International Journal of Environmental Research and Public Health 11, no. 7: 7482-7491. https://doi.org/10.3390/ijerph110707482

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

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