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Stanek LW, Xue J, Zartarian VG, Poulakos AG, Tornero-Velez R, Snyder EG, Walts A, Triantafillou K. Identification of high lead exposure locations in Ohio at the census tract scale using a generalizable geospatial hotspot approach. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:718-726. [PMID: 38575709 PMCID: PMC11303242 DOI: 10.1038/s41370-024-00666-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Lead is a persistent, ubiquitous pollutant whose historical sources have been largely addressed through regulation and voluntary actions. The United States (U.S.) has achieved significant decreases in children's blood lead levels (BLL) over the past 40 years; however, there is no known safe level of Pb exposure. Some communities continue to be disproportionately impacted by exposure to Pb, including Black children and families living in older homes. OBJECTIVE To identify Ohio (OH) census tracts with children exposed to Pb and evaluate potential exposure determinants. METHODS We obtained individual children's blood Pb data from 2005-2018 in OH. The percent of children with elevated BLL (EBLL) was calculated for OH census tracts using three blood Pb reference values (3.5, 5, and 10 µg/dL). Getis-Ord Gi* geospatial hotspot or top 20th percentile methodologies were then applied to identify "hotspots." Findings across multiple time periods and blood Pb reference values were evaluated and compared with existing Pb exposure indices and models. RESULTS Consistency was observed across different blood Pb reference values, with the main hotspots identified at 3.5 µg/dL, also identified at 5 and 10 µg/dL. Substantial gains in public health were demonstrated, with the biggest decreases in the number of census tracts with EBLL observed between 2008-2010 and 2011-2013. Across OH, 355 census tracts (of 2850) were identified as hotspots across 17 locations, with the majority in the most populated cites. Generally, old housing and sociodemographic factors were indicators of these EBLL hotspots. A smaller number of hotspots were not associated with these exposure determinants. Variables of race, income, and education level were all strong predictors of hotspots. IMPACT STATEMENT The Getis-Ord Gi* geospatial hotspot analysis can inform local investigations into potential Pb exposures for children living in OH. The successful application of a generalizable childhood blood Pb methodology at the census tract scale provides results that are more readily actionable. The moderate agreement of the measured blood Pb results with public Pb indices provide confidence that these indices can be used in the absence of available blood Pb surveillance data. While not a replacement for universal blood Pb testing, a consistent approach can be applied to identify areas where Pb exposure may be problematic.
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Affiliation(s)
- Lindsay W Stanek
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA.
| | - Jianping Xue
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA
| | - Valerie G Zartarian
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA
| | - Antonios G Poulakos
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA
- LinTech Global, Inc., Boston, MA, USA
| | - Rogelio Tornero-Velez
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA
| | - Emily G Snyder
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, North Carolina, NC, USA
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Grokhowsky N. An inferential spatiotemporal approach for knowledge synthesis to identify trends in public health research. Heliyon 2024; 10:e28537. [PMID: 38628744 PMCID: PMC11019166 DOI: 10.1016/j.heliyon.2024.e28537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Background Decisions follow patterns that are introduced by human perception. Research and development (R&D) are influenced by these patterns. Furthermore, R&D publications can represent repetitive attempts to solve similar, or the same problems. Literature reviews serve as an important tool for identifying these trends, but they are time consuming. The time commitment of a literature review can be reduced by using a sample of research. This will allow an infinite population of research to be generalized. Additionally, spatiotemporal analysis is most appropriate for fields that follow time and geographic trends, such as public health. Also, using research locations to perform this analysis potentially captures the social return of R&D, as knowledge gained. As a result, an inferential spatiotemporal methodological framework is introduced to quickly identify research trends using public health research. This was applied to a childhood Pb exposure case study. Methods A body of more than 1000 childhood elevated blood lead (Pb) level (EBLL) research articles were used to extract publication years, research locations, and subtopics. These publications were grouped into research locations (i.e., U.S. states where research was conducted; not publication location) and averaged over years published (i.e., 29 years). Binary indicator variables were derived using the subtopics extracted and the periods identified in time trend analyses. Explanatory variables were used to conduct hypothesis testing. Significant variables were used to generalize the population of the annual average EBLL articles written per state. Results The range of the annual average of EBLL research articles by state was 0-1.7 articles, with a mean of 0.3 articles. Thirty-eight explanatory variables suggested a significant effect on research article production. These included temporal, sociodemographic, education, structure age, environmental, and economic variables. The strongest effect on research production for U.S. states came from the number of structures built before 1950. A predictive model was selected to generalize the population of articles using time-periods 1990-95, environmental subtopic, and structures built before 1950. The locations with the most research production for this topic were California and New York. The locations with the least research production for this topic were Alaska, Hawaii, Nevada, Wyoming, North Dakota, South Dakota, Mississippi, Delaware, and New Hampshire. Conclusion If the trend for R&D is to make fast decisions, more human bias will be introduced into the decision-making process. Analytical tools that enable researchers to identify trends and ask more questions about their field will mitigate these biases. This hypothesis testing and predictive modeling methodology provide researchers and other decision makers with analytical tools they can use to quickly identify research trends and narrow their field of research. Additionally, this analysis potentially captures the impact of discovered ideas, as a social return spillover, for this topic.
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Zartarian VG, Xue J, Poulakos AG, Tornero-Velez R, Stanek LW, Snyder E, Helms Garrison V, Egan K, Courtney JG. A U.S. Lead Exposure Hotspots Analysis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024. [PMID: 38334298 PMCID: PMC10882963 DOI: 10.1021/acs.est.3c07881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
To identify U.S. lead exposure risk hotspots, we expanded upon geospatial statistical methods from a published Michigan case study. The evaluation of identified hotspots using five lead indices, based on housing age and sociodemographic data, showed moderate-to-substantial agreement with state-identified higher-risk locations from nine public health department reports (45-78%) and with hotspots of children's blood lead data from Michigan and Ohio (e.g., Cohen's kappa scores of 0.49-0.63). Applying geospatial cluster analysis and 80th-100th percentile methods to the lead indices, the number of U.S. census tracts ranged from ∼8% (intersection of indices) to ∼41% (combination of indices). Analyses of the number of children <6 years old living in those census tracts revealed the states (e.g., Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, Massachusetts, California, Texas) and counties with highest potential lead exposure risk. Results support use of available lead indices as surrogates to identify locations in the absence of consistent, complete blood lead level (BLL) data across the United States. Ground-truthing with local knowledge, additional BLL data, and environmental data is needed to improve identification and analysis of lead exposure and BLL hotspots for interventions. While the science evolves, these screening results can inform "deeper dive" analyses for targeting lead actions.
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Affiliation(s)
- Valerie G Zartarian
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
| | - Jianping Xue
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
| | - Antonios G Poulakos
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
- LinTech Global, Inc., Boston, Massachusetts 02109, United States
| | - Rogelio Tornero-Velez
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
| | - Lindsay W Stanek
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
| | - Emily Snyder
- U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, North Carolina 27711, United States
| | - Veronica Helms Garrison
- U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Washington, D.C. 20410, United States
| | - Kathryn Egan
- Centers for Disease Control and Prevention, National Center for Environmental Health, Agency for Toxic Substances and Disease Registry, Office of Science, Atlanta, Georgia 30329, United States
| | - Joseph G Courtney
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta, Georgia 30329, United States
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Zartarian VG, Xue J, Gibb-Snyder E, Frank JJ, Tornero-Velez R, Stanek LW. Children's lead exposure in the U.S.: Application of a national-scale, probabilistic aggregate model with a focus on residential soil and dust lead (Pb) scenarios. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167132. [PMID: 37730047 DOI: 10.1016/j.scitotenv.2023.167132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023]
Abstract
Lead (Pb) exposures from soil and dust ingestion contribute to children's blood lead levels (BLLs) in the United States. The U.S. Environmental Protection Agency (EPA)'s Strategy to Reduce Lead Exposures and Disparities in U.S. Communities and the Federal Action Plan to Reduce Childhood Lead Exposure describe multi-pronged collaborative approaches. These include reducing multi-media lead exposures nationally using analytical tools such as EPA's Stochastic Human Exposure and Dose Simulation model for lead [SHEDS-Pb; formerly known as SHEDS-IEUBK (Integrated Exposure Uptake Biokinetic model)], which was initially developed and applied with a focus on children's drinking water exposures. In this study we applied SHEDS-Pb to determine what residential soil Pb and dust Pb concentrations (individually and their sum) can keep BLLs of potentially exposed young children in the general U.S. population below specified values, considering aggregate exposures from water, soil, dust, food, and air. We considered two age groups (1 to <2 years and 2 to <6 years), two BLL values (5 μg/dL and 3.5 μg/dL), and two population percentiles (95th and 97.5th). Sensitivity analyses were conducted using several alternative model inputs and data sets, yielding 15 scenarios summarized in the paper. Of those scenarios, we focused on ones with the most recent science and available data. Modeled soil Pb concentrations by age group, population percentile and reference BLL scenarios for the focus scenarios ranged from 70 ppm to 220 ppm; and modeled dust Pb concentrations ranged from 110 ppm to 240 ppm. These results are consistent with current soil and dust Pb concentrations in the U.S. general population and are lower than most of the current U.S. Federal standards. Estimated BLLs compared well with measured BLLs from CDC's NHANES 2009-2016 (0-27 % relative error for focus scenarios). This analysis can be used to inform EPA and other federal Pb efforts.
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Affiliation(s)
- V G Zartarian
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, United States of America
| | - J Xue
- Retired, formerly U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, United States of America
| | - E Gibb-Snyder
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, United States of America.
| | - J J Frank
- U.S. Environmental Protection Agency, Office of Research and Development, Office of Science Advisor, Policy, and Engagement, United States of America
| | - R Tornero-Velez
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Computational Toxicology and Exposure, United States of America
| | - L W Stanek
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, United States of America
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Jacobs DE, Brown MJ. Childhood Lead Poisoning 1970-2022: Charting Progress and Needed Reforms. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:230-240. [PMID: 36442070 PMCID: PMC9897265 DOI: 10.1097/phh.0000000000001664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CONTEXT Childhood lead poisoning prevention in the United States was marked by a largely failed medical approach from 1971 to 1990; an emergent (but small) healthy housing primary prevention strategy from 1991 to 2015; and implementation of large-scale proven interventions since then. PROGRAM Childhood Lead Poisoning Prevention & Healthy Housing. METHODS Historic and recent health and housing data from the National Health and Nutrition Examination Survey (NHANES) and the American Healthy Homes Survey (AHHS) were retrieved to analyze trends and associated policy gaps. EVALUATION Approximately 590 000 US children aged 1 through 5 years had elevated blood lead levels of 3.5 μg/dL and greater in 2016, and 4.3 million children resided in homes with lead paint in 2019. Despite large improvements, racial and other disparities remain stubbornly and statistically significant. The NHANES and the AHHS require larger sample sizes. The Centers for Disease Control and Prevention has not published children's blood lead surveillance and NHANES data in several years; the Department of Housing and Urban Development (HUD) has no analogous housing surveillance system; and the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) have not updated training, Superfund, and occupational standards in decades. DISCUSSION The nation has been without a plan and an associated budget for more than 2 decades. Congress has not reformed the nation's main lead poisoning prevention laws in more than 30 years. Such reforms include stopping US companies from producing new residential lead paint in other countries; enabling the disclosure law to identify all residential lead hazards; closing loopholes in federally assisted housing regulations and mortgage insurance standards; harnessing tax policy to help homeowners mitigate lead hazards; streamlining training requirements; increasing the size of health and housing surveys and surveillance systems; and updating housing codes, medical guidance, dust lead standards, training, Superfund, and worker exposure limits. Congress and the president should reauthorize a cabinet-level task force (dormant since 2010) to develop a new strategic plan with an interagency budget to implement it. These reforms will scale and optimize markets, subsidies, enforcement, and other proven interventions to end ineffective, costly, harmful, and irrational cost shifting that threatens children, workers, and affordable housing.
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Affiliation(s)
- David E. Jacobs
- National Center for Healthy Housing, Columbia, Maryland (Dr Jacobs); University of Illinois Chicago, Chicago, Illinois (Dr Jacobs); and Harvard Chan School of Public Health, Boston, Massachusetts (Dr Brown)
| | - Mary Jean Brown
- National Center for Healthy Housing, Columbia, Maryland (Dr Jacobs); University of Illinois Chicago, Chicago, Illinois (Dr Jacobs); and Harvard Chan School of Public Health, Boston, Massachusetts (Dr Brown)
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Zartarian V, Poulakos A, Garrison VH, Spalt N, Tornero-Velez R, Xue J, Egan K, Courtney J. Lead Data Mapping to Prioritize US Locations for Whole-of-Government Exposure Prevention Efforts: State of the Science, Federal Collaborations, and Remaining Challenges. Am J Public Health 2022; 112:S658-S669. [PMID: 36179290 PMCID: PMC9528653 DOI: 10.2105/ajph.2022.307051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 09/03/2023]
Abstract
For this state-of-science overview of geospatial approaches for identifying US communities with high lead-exposure risk, we compiled and summarized public data and national maps of lead indices and models, environmental lead indicators, and children's blood lead surveillance data. Currently available indices and models are primarily constructed from housing-age and sociodemographic data; differing methods, variables, data, weighting schemes, and geographic scales yield maps with different exposure risk profiles. Environmental lead indicators are available (e.g., air, drinking water, dust, soil) at different spatial scales, but key gaps remain. Blood lead level data have limitations as testing, reporting, and completeness vary across states. Mapping tools and approaches developed by federal agencies and other groups for different purposes present an opportunity for greater collaboration. Maps, data visualization tools, and analyses that synthesize available geospatial efforts can be evaluated and improved with local knowledge and blood lead data to refine identification of high-risk locations for prioritizing prevention efforts and targeting risk-reduction strategies. Remaining challenges are discussed along with a work-in-progress systematic approach for cross-agency data integration, toward advancing "whole-of-government" public health protection from lead exposures. (Am J Public Health. 2022;112(S7):S658-S669. https://doi.org/10.2105/AJPH.2022.307051).
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Affiliation(s)
- Valerie Zartarian
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Antonios Poulakos
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Veronica Helms Garrison
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Nicholas Spalt
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Rogelio Tornero-Velez
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Jianping Xue
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Kathryn Egan
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Joseph Courtney
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
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Ettinger AS. Invited Perspective: Identifying Childhood Lead Exposure Hotspots for Action. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:71301. [PMID: 35894591 PMCID: PMC9327736 DOI: 10.1289/ehp10916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Adrienne S. Ettinger
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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