Joseph A. Cotruvo, President of Joseph Cotruvo & Associates LLC, who has educated me on Flint, lead and children, sent me these two papers that further expands my knowledge. The same group of researchers wrote both papers. Joe mentioned that Dr.
1) (2019) Analysis of Blood Lead Levels of Young Children in Flint, Michigan Before and During the 18-Month Switch to Flint River Water, Clinical Toxicology, DOI: 10.1080/15563650.2018.1552003
Abstract
Background:The toxicity of lead, like any xenobiotic, is directly linked to the duration of exposure and toxin concentration in the body. The elevation in blood lead levels (BLLs) in young Flint, Michigan children noted in time-periods before, and during the 18-month exposure to Flint River water (FRW) from 25 April 2014 to 15 October 2015 is well-known internationally. The length of time BLLs were elevated is unknown, yet key in understanding the potential health impact of the event. The objective of this study was to evaluate whether BLLs in Flint children were increased during the entire 18-month FRW exposure compared to similar earlier time periods.
Methods:We conducted a retrospective study analyzing BLLs from Flint children aged 5 years and under. The geometric mean (GM) BLLs and percentages of BLLs ≥5.0 μg/dL in Period I: 25 April 2006 to 15 October 2007 (earliest timeframe available for study) and Period II: 25 April 2012 to 15 October 2013 (timeframe immediately before the water switch), were compared to Period III, 25 April 2014 to 15 October 2015 (FRW exposure).
Results: There were 5663 BLLs available for study. GM ± SE BLLs decreased from 2.19 ± 0.03 μg/dL in Period I to 1.47 ± 0.02 μg/dL in Period II [95% CI, 0.64, 0.79]; p<.001 and decreased further to 1.32 ± 0.02 µg/dL during the FRW Period III [95% CI, 0.79, 0.95]; p<.001. The percentage of BLLs ≥5.0 μg/dL decreased from Period I (10.6%) to Period II (3.3%) [95% CI, 5.7, 8.8]; p<.001 and from Period I to Period III (3.9%) [95% CI, 5.0, 8.2]; p=.002. The 0.6% increase from Period II to Period III was not statistically significant [95% CI, −1.9, 0.57]; p=.30.
Conclusion:Analyses of GM and percentages ≥5.0 μg/dL of BLLs do not support the occurrence of a global increase in BLLs in young children of Flint during the entire 18-month period of FRW exposure.
Download J Peds June 2018 Flint Lead Paper
The published paper alludes to an editorial in The JoP:
Download J Peds June 2018 Editorial
Objective: We evaluated the increases in blood lead levels (BLLs) observed in young children in Flint, Michigan, during their exposure to corrosive Flint River water during the years 2014 and 2015 and compared their BLLs to those of Flint children measured during the years 2006-2013 and 2016.
Study design: This was a retrospective study design using BLLs extracted from databases from 2006 to 2016. We analyzed a population sample of 15 817 BLLs from children aged ≤5 years with potential exposure to contaminated
Flint River water. Percentages of BLLs ≥5.0 g/dL and geometric mean (GM) BLLs were analyzed over time.Results: A significant decline in the percentages of BLLs ≥5.0 g/dL from 11.8% in 2006 to 3.2% in 2016 was observed (P < .001). GM Å} SE BLLs decreased from 2.33 Å} 0.04 g/dL in 2006 to 1.15 Å} 0.02 g/dL in 2016 (P < .001). GM BLLs increased twice: from 1.75 Å} 0.03 g/dL to 1.87 Å} 0.03 g/dL (2010-2011) and from 1.19 Å} 0.02 g/dL to 1.30 Å} 0.02 g/dL (2014-2015). Overall, from 2006 to 2016, there was a 72.9% decrease in the percentage of children
with BLLs ≥5.0 g/dL and a 50.6% decrease in GM BLLs.Conclusion: These findings suggest that the 11 year trend of annual decreases in BLLs in children in Flint, Michigan, reversed to a degree consistent with random variation from 2010 to 2011, and again during the exposure to Flint River water in 2014-2015. Historically, public health efforts to reduce BLLs of young children in Flint have been effective over the 11-year period studied. (J Pediatr 2018;197:158-64).
Excellent insights. Enjoy!
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