Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond

ABSTRACT Background and Objectives Among the multitude of health effects on children associated with the COVID‐19 pandemic, there have been significant interruptions in the provision of routine pediatric primary care, including blood lead level (BLL) screening. We aimed to investigate trends in BLL...

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Main Authors: Meghan L. McCarthy, Jonah Bradenday, Elizabeth Chen, Mark R. Zonfrillo, Indra Neil Sarkar
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Public Health Challenges
Subjects:
Online Access:https://doi.org/10.1002/puh2.70021
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author Meghan L. McCarthy
Jonah Bradenday
Elizabeth Chen
Mark R. Zonfrillo
Indra Neil Sarkar
author_facet Meghan L. McCarthy
Jonah Bradenday
Elizabeth Chen
Mark R. Zonfrillo
Indra Neil Sarkar
author_sort Meghan L. McCarthy
collection DOAJ
description ABSTRACT Background and Objectives Among the multitude of health effects on children associated with the COVID‐19 pandemic, there have been significant interruptions in the provision of routine pediatric primary care, including blood lead level (BLL) screening. We aimed to investigate trends in BLL screening before and during the pandemic era using patient‐level electronic health record data extracted from CurrentCare, Rhode Island's statewide health information exchange (HIE). Methods De‐identified data were analyzed from CurrentCare for the study period January 2018 to December 2021. We utilized ATLAS, a web‐based analytics platform from the Observational Health Data Sciences and Informatics (OHDSI) community, to extract and stratify BLL by variables of interest from the CurrentCare data, standardized to OHDSI's Observational Medical Outcomes Partnership common data model. Results A decrease in BLL screening occurred in the spring of 2020, aligning with initial periods of shelter‐in‐place in response to the novel coronavirus outbreak; there was a 48% decrease comparing quarter 2 (April to June) of 2019 and 2020. BLL screening rebounded in the summer of 2020, however, it remained 16% lower overall in 2020 than in 2019. In 2021, BLL screening fell again to 23% lower than in 2019. Although overall numbers of BLL screenings were reduced, the proportion of abnormal BLLs was higher, particularly in the range of 3.5–5.0 µg/dL. Conclusions Leveraging statewide HIE data, we found that significant deficiencies in BLL screening remain unresolved since the beginning of the COVID‐19 pandemic. The disruption of children's lives by the COVID‐19 pandemic appears to have greatly affected lead screening and exposure in Rhode Island.
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spelling doaj-art-e4fdf5ff2cee4a47a8553c1e284317e52025-08-20T02:42:52ZengWileyPublic Health Challenges2769-24502025-03-0141n/an/a10.1002/puh2.70021Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and BeyondMeghan L. McCarthy0Jonah Bradenday1Elizabeth Chen2Mark R. Zonfrillo3Indra Neil Sarkar4Warren Alpert Medical School of Brown University Providence Rhode Island USABrown Center for Biomedical Informatics Providence Rhode Island USAWarren Alpert Medical School of Brown University Providence Rhode Island USADepartment of Emergency Medicine Warren Alpert Medical School of Brown University Providence Rhode Island USAWarren Alpert Medical School of Brown University Providence Rhode Island USAABSTRACT Background and Objectives Among the multitude of health effects on children associated with the COVID‐19 pandemic, there have been significant interruptions in the provision of routine pediatric primary care, including blood lead level (BLL) screening. We aimed to investigate trends in BLL screening before and during the pandemic era using patient‐level electronic health record data extracted from CurrentCare, Rhode Island's statewide health information exchange (HIE). Methods De‐identified data were analyzed from CurrentCare for the study period January 2018 to December 2021. We utilized ATLAS, a web‐based analytics platform from the Observational Health Data Sciences and Informatics (OHDSI) community, to extract and stratify BLL by variables of interest from the CurrentCare data, standardized to OHDSI's Observational Medical Outcomes Partnership common data model. Results A decrease in BLL screening occurred in the spring of 2020, aligning with initial periods of shelter‐in‐place in response to the novel coronavirus outbreak; there was a 48% decrease comparing quarter 2 (April to June) of 2019 and 2020. BLL screening rebounded in the summer of 2020, however, it remained 16% lower overall in 2020 than in 2019. In 2021, BLL screening fell again to 23% lower than in 2019. Although overall numbers of BLL screenings were reduced, the proportion of abnormal BLLs was higher, particularly in the range of 3.5–5.0 µg/dL. Conclusions Leveraging statewide HIE data, we found that significant deficiencies in BLL screening remain unresolved since the beginning of the COVID‐19 pandemic. The disruption of children's lives by the COVID‐19 pandemic appears to have greatly affected lead screening and exposure in Rhode Island.https://doi.org/10.1002/puh2.70021health information exchangelead exposurelead screeningpediatric primary carescreeningwell child care
spellingShingle Meghan L. McCarthy
Jonah Bradenday
Elizabeth Chen
Mark R. Zonfrillo
Indra Neil Sarkar
Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
Public Health Challenges
health information exchange
lead exposure
lead screening
pediatric primary care
screening
well child care
title Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
title_full Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
title_fullStr Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
title_full_unstemmed Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
title_short Reductions in Blood Lead Level Screening During Peak COVID‐19 Restrictions and Beyond
title_sort reductions in blood lead level screening during peak covid 19 restrictions and beyond
topic health information exchange
lead exposure
lead screening
pediatric primary care
screening
well child care
url https://doi.org/10.1002/puh2.70021
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