MAPPING COMMUNITY LEAD (PB) LEGACIES AND URBAN GEOCHEMICAL DISPARITIES IN NEW ORLEANS: EVOLVING FROM REACTIVE TO PROACTIVE MEDICINE

The Institute of Medicine reports that American health care is falling short on quality, outcomes, costs and equity; the shortcomings are exemplified by the treatment of childhood Pb poisoning. The common medical approach for determining Pb contamination of the environment is through analysis of children’s blood Pb and then reacting to the results. I sought to gain insight into the Pb toxicity characteristics of New Orleans communities, evaluate medical and societal outcomes of exposures, and propose proactive intervention methods based on the results. Based on an extensive soil Pb mapping project, New Orleans was divided into two areas, high (≥100 mg/kg) and low (<100 mg/kg) soil Pb domains. The pre-Katrina children’s blood Pb prevalence ≥ 5 µg/dL for the high and low Pb domains were 58.5% and 24.8%, respectively, vs. post-Katrina prevalence of 29.6% and 7.5%, respectively; this indicates substantial improvements since 2005. At the community scale, soil Pb is an excellent predictor of children’s blood Pb. Elevated soil Pb permeates the high Pb domain and children playing outdoors generally lack Pb-safe environments. According to the toxicological and medical literature the high Pb communities of New Orleans experience the expected health disparities, including learning and late live violence disorders. New Orleans is undergoing major environmental change within selected communities. Low Pb soils from the outskirts of New Orleans are available for intervention of Pb contaminated soil at public and private properties. I expect that all large cities exhibit similar characteristics to those observed in New Orleans. Mapping soil Pb at the scale of an entire city provides an overview of community scale Pb exposure problems, and the maps assist with comprehending urban community needs for evolving from reactive to proactive Pb exposure prevention.