AN UPDATE ON BLOOD LEAD LEVELS IN PEDIATRIC-PATIENTS OF A NEIGHBORHOOD HEALTH-CENTER AND AN ANALYSIS OF SOURCES OF EXPOSURE

This article continues the report of a study at the St Louis Comprehen sive Neighborhood Health Center in which definitive blood lead levels were routinely determined in pediatric patients younger than 5 years o f age. Data on changes during the 1980s in population, housing, and so il lead levels also are provided for possible correlation with changes in blood lead levels. From 1976 through 1993, there has been a progre ssive decline in annual mean blood lead leaves and in the percentage o f patients at several ranges indicative of different degrees of risk f or brain damage. Comparisons of blood lead levels in residents of othe r neighborhoods in the city of St Louis show that most predominantly b lack neighborhoods and a single predominantly poor white neighborhood are particularly high-risk areas. In the study catchment area, the tot al population has decreased but the number of children younger than 5 years of age has increased. The latter has resulted in about a doublin g of admissions to our health center in 1993. There also has been a de cline in occupied housing units, an increase in unoccupied units (prob ably unfit for habitation), and the demolition of more than 6700 units . There also has been a remarkable citywide reduction in soil lead lev els, somewhat more marked in the study catchment area than in some oth er areas of the city. The reduction in the lead burden in children in the study catchment area appears to be associated with the decline in housing units and the decline in soil lead levels.