Horton CJ, Acharya L, Wells EM. Association between self-reported length of time in the USA and blood lead levels: National Health and Nutrition Examination Survey 2013-2016.
BMJ Open 2019;
9:e027628. [PMID:
31296509 PMCID:
PMC6624031 DOI:
10.1136/bmjopen-2018-027628]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/20/2019] [Accepted: 06/18/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES
The aim of this study is to determine the association between length of time in the USA with blood lead (BPb).
DESIGN
Population-based cross-sectional study using data from the 2013-2016 National Health and Nutrition Examination Survey.
SETTING
USA.
PARTICIPANTS
5933 men and women (≥15 years); subgroups of men only (n=2867), women only (n=3064) and women of childbearing age (15-45 years) (n=1580).
PRIMARY AND SECONDARY OUTCOMES
The primary outcome was BPb concentration. The main exposure variable was self-reported number of years spent in the USA, categorised as: born in the USA; 0-4 years; 5-9 years; 10-19 years and ≥20 years. We used linear regression models adjusted for race/ethnicity, education, blood cotinine, age, sex (as appropriate) and accounted for complex survey design.
RESULTS
Women of childbearing age who have lived 0-4 years in the USA have, on average, a 54% (95% CI 36% to 75%) higher BPb compared with women born in the USA. Corresponding results for all women, men and the entire population were 49% (95% CI 34% to 66%), 49% (95% CI 28% to 75%) and 49% (95% CI 33% to 66%), respectively. Similar, statistically significant, results were observed for other time periods (5-9 years, 10-19 years and ≥20 years); the magnitude of the association decreased with increasing time in the USA.
CONCLUSIONS
This study provides additional evidence that newcomers to the USA may be a population at higher risk of elevated BPb.
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