{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:48:20Z","timestamp":1785415700693,"version":"3.56.0"},"reference-count":49,"publisher":"North Carolina Institute of Medicine","issue":"2","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Research has consistently shown that there is no safe blood lead level (BLL) for children. Despite progress in lead poisoning prevention, lead exposure remains a persistent threat to the health and neurological development of children. To identify high-risk ZIP codes for use by families and health care providers for the entire state of North Carolina, we developed a risk model using ZIP Code Tabula\u00adtion Area (ZCTA)-level census data.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We obtained all available BLL testing data from the North Carolina Department of Health and Human Services for the years 2010\u20132015 via data use agreement. We fit a multivariable regression model with the\n ZCTA-level mean of log normalized BLLs<\/jats:italic>\n as the de\u00adpendent variable and\n ZCTA-level census data for known risk factors of childhood lead exposure<\/jats:italic>\n as predictors. We used this model to create a priority risk categorization.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We organized ZCTAs into 20 quantiles, or priority risk categories, that can be used in local and statewide screening programs. The first six (of 20) quantiles were identified as particularly high-risk areas for childhood lead exposure.<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n Because BLL testing is not universal, the BLL testing data used in this study are likely biased toward those most at risk for lead exposure.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study demonstrates the utility of ZCTA-level census data in identifying high-risk ZIP codes for childhood lead exposure, which can be used to ensure that the highest-risk children are tested in a timely manner. This approach can be replicated to address lead exposure nationally.<\/jats:p>\n <\/jats:sec>","DOI":"10.18043\/001c.94878","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T10:25:26Z","timestamp":1710757526000},"source":"Crossref","is-referenced-by-count":1,"title":["Identifying High-Risk ZIP Codes for Childhood Lead Exposure: A Statewide ZCTA-Level Priority List for North Carolina"],"prefix":"10.18043","volume":"85","author":[{"given":"Rashida","family":"Callender","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Illinois at Chicago","department":["Children's Environmental Health Initiative"]},{"id":[{"id":"https:\/\/ror.org\/008zs3103","id-type":"ROR","asserted-by":"publisher"}],"name":"Rice University","department":["Statistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Avendano","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00mkhxb43","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Notre Dame","department":["Children's Environmental Health Initiative"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes A.","family":"Bravo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Illinois at Chicago","department":["Children's Environmental Health Initiative"]},{"id":[{"id":"https:\/\/ror.org\/00py81415","id-type":"ROR","asserted-by":"publisher"}],"name":"Duke University","department":["Global Health Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Tootoo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Illinois at Chicago","department":["Children's Environmental Health Initiative"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Norman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0293qmt12","id-type":"ROR","asserted-by":"publisher"}],"name":"NC Department of Health and Human Services","department":["Children's Environmental Health Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Lynn","family":"Miranda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Illinois at Chicago","department":["Children's Environmental Health Initiative"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7507","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"issue":"2","key":"ref1","first-page":"63","article-title":"Low level environmental lead exposure \u2013 a continuing challenge","volume":"29","author":"E. 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Canfield","year":"2005","journal-title":"Riv Ital Pediatr"},{"issue":"9","key":"ref4","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1289\/ehp.6941","article-title":"Recent developments in low-level lead exposure and intellectual impairment in children","volume":"112","author":"Karin Koller","year":"2004","journal-title":"Environmental Health Perspectives","ISSN":"https:\/\/id.crossref.org\/issn\/0091-6765","issn-type":"print"},{"issue":"16","key":"ref5","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1056\/nejmoa022848","article-title":"Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter","volume":"348","author":"Richard L. Canfield","year":"2003","journal-title":"New England Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"issue":"2","key":"ref6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1289\/ehp.10424","article-title":"lood lead concentrations < 10 microg\/dL and child intelligence at 6 years of age","volume":"116","author":"Todd A. Jusko","year":"2008","journal-title":"Environmental Health Perspectives","ISSN":"https:\/\/id.crossref.org\/issn\/0091-6765","issn-type":"print"},{"issue":"6","key":"ref7","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/phr\/115.6.521","article-title":"ognitive deficits associated with blood lead concentrations <10 microg\/dL in US children and adolescents","volume":"115","author":"B. P. 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Lanphear","year":"2005","journal-title":"Environmental Health Perspectives","ISSN":"https:\/\/id.crossref.org\/issn\/0091-6765","issn-type":"print"},{"issue":"3","key":"ref13","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1257\/app.20160056","article-title":"Life after lead: Effects of early interventions for children exposed to lead","volume":"10","author":"Stephen B. 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Morbidity and Mortality Weekly Report","ISSN":"https:\/\/id.crossref.org\/issn\/0149-2195","issn-type":"print"},{"key":"ref49","article-title":"More childhood lead poisoning is a side effect of Covid lockdowns","author":"E. Anthes","year":"2021","journal-title":"New York Times"}],"container-title":["North Carolina Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ncmedicaljournal.com\/article\/94878-identifying-high-risk-zip-codes-for-childhood-lead-exposure-a-statewide-zcta-level-priority-list-for-north-carolina","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:10:14Z","timestamp":1780603814000},"score":1,"resource":{"primary":{"URL":"https:\/\/ncmedicaljournal.com\/article\/94878-identifying-high-risk-zip-codes-for-childhood-lead-exposure-a-statewide-zcta-level-priority-list-for-north-carolina"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,18]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.18043\/001c.94878","relation":{},"ISSN":["2379-4313","0029-2559"],"issn-type":[{"value":"2379-4313","type":"electronic"},{"value":"0029-2559","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,18]]}}}