Colorado detects cluster of elevated blood lead levels

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Background Information

Lead poisoning is the number one preventable environmental health threat to children. While average childhood lead exposure has decreased significantly in recent decades, there have been places where blood lead levels have suddenly increased due to changes in environmental lead exposure. The most severe of these cases was the Flint Water Crisis in 2014, where increased lead in drinking water caused the fraction of children with elevated blood lead levels (EBLLs) to double. Being able to rapidly detect increased rates of EBLLs can help identify unknown sources of lead exposure and guide public health interventions at the local level.  

What was CO Tracking’s role?

The Colorado Tracking Program worked collaboratively with the Colorado Childhood Lead Poisoning Prevention Program (CCLPPP) to develop a statistical tool to detect changes in the rates of elevated blood lead levels in children. 

The statistical tool was tested by measuring how quickly it could detect a simulated cluster of EBLLs. The simulated clusters varied in where they were located, how big an area they affected, and how severe they were. The statistical tool developed detected these clusters in an average of 9 months. Larger, more severe clusters were usually detected in less than 6 months. 

What product or output came from CO Tracking’s role?

The tool combines a statistical model of the number of EBLLs in each census tract with a mathematical function that compares the observed and expected number of EBLLs. 

The statistical tool was developed into a computer program that staff can run as part of their routine work. The computer program runs the statistical tool and automatically generates a report if any potential cluster of EBLLs is identified.

What action or decision was taken to resolve the problem?

Provided data analysis expertise during the development of the tool.

What was the outcome of this action or decision? 

Identify clusters of elevated blood lead levels to quickly respond and identify exposure.

Quantify the impact or the resulting action

When the tool was run in April 2022, it identified a cluster of  114 EBLL reports among 38 unique patients. Colorado Tracking and CCLPPP worked quickly to connect with the Refugee Health Program at the department to ensure the appropriate steps were taken for follow-up care. We determined that the cluster was identified based on temporary patient addresses, as all newcomers are initially housed at a hotel near the airport after they arrive in Denver.