Blood Lead Testing of Young Children in Chicago Fell During the Pandemic

Lead can seriously harm young children: early exposure can damage the brain and nervous system, slow growth and development, and cause hearing and speech problems. Screening for elevated blood lead levels is a standard part of young children's care. When the COVID-19 pandemic began, routine preventive care was badly disrupted; from January to May 2020, 34% fewer U.S. children under 6 were tested for lead than in the same months of 2019. The Chicago Department of Public Health looked at what happened in Chicago.

How testing was measured

Every child living in Chicago should be screened at 12, 24 and 36 months, and Illinois requires all results to be reported to the state, which shares them with the city. The analysis counted all blood lead tests of Chicago children aged 11 to 48 months — covering the recommended ages plus catch-up testing — from March to September each year, to account for the seasonal pattern of testing, the stay-at-home order and the worst months of disruption. Tests were compared with the number of children under 5, and the 2017–2019 average served as the prepandemic baseline.

The city's community areas were also grouped into low, medium and high risk for blood lead levels above the Blood Lead Reference Value, based on their history from 2010 to 2018.

What happened

Blood lead tests among Chicago children aged 11–48 months per 100 children under 5, March–September, 2017–2022. CDC, MMWR.

• 2020: 14.7 tests per 100 children — 29.1% below the 2017–2019 average of 20.7.
• 2021: 17.5 — still 15.4% below.
• 2022: 18.5 — still 10.6% below.

The areas at highest risk had the most testing before the pandemic, and they also saw the largest drop:

What it means

Testing rebounded in 2021 and 2022 but did not return to its prepandemic level, and the neighborhoods with the most lead risk were hit hardest — which may have deepened long-standing health inequities. Those communities should get extra attention to promote testing for the children most at risk. Other jurisdictions should also look at how the pandemic changed lead testing, including by geography or demographics, to see its effect on the most vulnerable communities.

Sources

• Spencer H, Jorgensen E, Seo J, Robinson C. "Notes from the Field: COVID-19 Pandemic-Related Changes in Blood Lead Screening — Chicago, Illinois, 2017–2022." MMWR 72(50). CDC.