252 - Assessing Blood Lead Levels in Children 12-48 Months and Caregiver Lead Knowledge in the Dominican Republic

Publication Number: 1238.252

Anabel Fernandez, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; María Elena Sánchez, Niños Primeros en Salud Program, Consuelo, San Pedro De Macoris, Dominican Republic; Maria Dunn, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Allison Slager, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States; Danuary Josefina. Garcia, Pediatrician, Niños Primeros en Salud Program, San pedro de macoris, San Pedro De Macoris, Dominican Republic; Angie Álvarez, Niños primeros en salud program, San Pedro de Macorís, San Pedro De Macoris, Dominican Republic; Francia Acosta, Childrens Hospital of Philadelphia, Santo Domingo, Distrito Nacional, Dominican Republic; Elizabeth D. Lowenthal, Departments of Pediatrics and Biostatistics, Epidemiology and Informatics, Philadelphia, PA, United States; Harriet Okatch, Thomas Jefferson University, Philadelphia, PA, United States

Background: Lead poisoning in children can cause serious health effects, including neurological disorders, developmental delays, learning difficulties, and anemia. Many children are exposed to lead through contaminated soil, water, lead-containing paints or toys, and other environmental sources. A study conducted 25 years ago in the Dominican Republic (DR) showed elevated blood lead levels (EBLLs) among children in 2 communities. Newer data from other Dominican communities are lacking, as routine pediatric screening is not available.

Objective: To determine the prevalence of EBLLs in children 12-48 months of age in the rural community of Consuelo, DR, and to assess caregiver lead knowledge.

Design/Methods: Institutional review board (IRB) approval was obtained for this cross-sectional study from both the sponsoring institution (Children’s Hospital of Philadelphia) IRB and the national IRB in the DR. Following informed consent, caregivers first completed a questionnaire obtaining demographic information and assessing environmental and behavioral risk factors. The standardized Chicago Lead Knowledge Test was then administered. Both surveys were conducted in participants’ primary language (Spanish or Haitian Creole). Blood samples were collected from each child participant to assess serum lead level. An EBLL was defined as >5 micrograms/deciliter (µg/dL), according to World Health Organization standards.

Results: Data collection occurred from July 2024 to September 2025. Mean age of child participants was 26 months, with 58% female. Results from the Chicago Lead Knowledge Test showed a mean score of 55%, with questions about sources of lead poisoning most commonly answered incorrectly. A majority of families exhibited at least one high risk behavior, including children putting jewelry or metal keys in their mouths (81%) or parents administering an herbal remedy (57%). None of the 69 participants exhibited a lead level >5 µg/dL.

Conclusion(s): Despite low levels of lead knowledge in the study population and common high-risk behaviors, no EBLL was identified. Knowledge surveys have indicated educational opportunities in this rural community. To better understand factors mitigating or exacerbating lead exposure, environmental assessments will be conducted as a second phase of the study.