Effect of the COVID-19 Global Pandemic on Illinois Children Tested for Blood Lead Level and Exposure

Objectives. To determine whether the number of children tested for lead exposure and the number of case rates increased (rate ratio [RR] > 1), decreased (RR < 1), or remained stable (RR = 1) during COVID-19 pandemic year 2020 compared with prepandemic year 2019. Methods. We analyzed more than 415 000 children’s records reported to the Illinois Department of Public Health in 2019 and 2020 by demographic characteristics. The testing rate was the number of children tested yearly per population. The case rate was the proportion of children whose yearly tests showed a blood lead level of 5 or more micrograms per deciliter. RR was the 2020 case rate divided by the 2019 case rate. Results. In 2020, 19.6% of children were tested for lead compared with 25.5% in 2019. Testing decreased in 97% of counties. The 24% decreased testing in 2020 was notably in African Americans (36.4% decrease), high-risk zip codes (29.8% decrease), and rural counties (26.9% decrease). Case rates increased in rural counties, high-risk zip codes, Whites, and Hispanics. Conclusions. During pandemic year 2020, the number of children tested for lead decreased by 24%, and case rates increased in 51% of counties. Public Health Implications. Redesignation of high-risk zip codes is recommended to increase the testing of at-risk populations. (Am J Public Health. 2023;113(1):89–95. https://doi.org/10.2105/AJPH.2022.307109 )