Linking Childhood Lead Poisoning and Developmental Disabilities

in FloridaState EPHT Team

Greg Kearney, RS, MPHEpidemiologist, Project Manager

Chris DuClos, MSGIS Manager

David R. Johnson, MD, MS, DABT, FACOEMPrincipal Investigator

University of MiamiDevelopmental Epidemiology

TeamKeith G. Scott, Ph.D.

Marygrace Yale Kaiser, Ph.D.Carrie Lazarus, M.S.Tony Gonzalez, B.A.

Trading Partner Acknowledgement

The studies are conductedunder an agreement with the

Florida Department of Education.

Aims of the DET

1. Assist in planning for the provision of services.

2. Help identify groups that would benefit from the provision of early intervention.

3. Help identify conditions that lead to the need for special education services.

The Florida Childhood Lead PoisoningPrevention Program (CLPPP)

STATEWIDE BLOOD LEAD SURVEILLANCE

CLPPP began conducting statewide blood lead surveillance in 1993.

Data is housed at the Florida Department of Health.

Blood lead level results are entered, checked for quality, and merged to the main database.

Exposure Data Set

Patient Information(Name, Date of Birth, Ethnicity, Race, Gender, Address, Medicaid #, Age at Test)

Provider Information (Name, Address)

Lab Information(Name, Address)

Test Information(Report Type, Test Type, Date of Blood Draw, Date Sample Received, Date Sample Reported, Result – Blood Lead Level)

Outcome Data Set

• Demographics (school number, district number, race/ethnicity, sex, dob, grade, native language, free lunch eligibility)

• Exceptionality (Disability Classification) (primary exceptionality: Mental Retardation, Behavior Problems, Autism)

Linked Data Set

FL Birth Records

FL S

choo

l Rec

ords

2002-20032001-20012000-20011999-20001998-19991997-19981996-19971995-19961994-19951993-19941992-1993

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FL Birth Records: 139,000-196,000 records/yr

FL Public School Data: 2.3-2.8 million records/yr

New Linkage withExposure Data

Birth/School/CLPPPBirth

Data (Geocoded)CLPPP

Data (Geocoded)

Birth/SchoolData

Birth/CLPPP/School Data (Geocoded)

Birth/CLPPPData (Geocoded)

Final AggregatedData set

Data LinkageFirst NameLast Name

Data of BirthMother’s Name

IdentifiersData

Individual Blood Lead Data

Individual Disability Data Absolute andProbabilistic

Linkage

AggregatedDisability RatesBy Blood Level

Relative Risk andConfidence Intervals

Tabulated and Graphedresults

GIS Map Data(Rate of Lead AF of

Disability)

GIS Map – ToxicRelease Inventory

Data

Produce CombinedGIS Map

Expected Products

Linked Disability/Exposure Data SetControlled for Major Confounders

e.g. Parental EducationBirthweight Education

Gestational Age

Expected ProductsControlled Study of Lead Exposure

Dose/Response RelationshipBlood lead level and disability rates

Develop map ofvalidated high-risk areas based on

disability/exposure

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Universal Screening Areas for Childhood Lead Poisoning

• Screening areas based on older housing

All Florida county maps on the internet

e.g. Miami-Dade County

http://www.doh.state.fl.us/environment/community/lead/CountyMap.html