Childhood Lead Exposure & Sexually Transmitted Infections: New Evidence

The adverse health effects of lead exposure in children are well documented and include intellectual and behavioral maladies. Childhood lead exposure has also been linked to impulsive behaviors, which, in turn, are associated with a host of negative health outcomes including an increased risk for sexually transmitted infections (STI). The purpose of this study was to assess the association of lead exposure with STI rates across census tracts in St. Louis City, Missouri.

Incident cases of gonorrhea and chlamydia (GC) during 2011 were identified from the Missouri Department of Health and Senior Services and aggregated by census tract. We also geocoded the home address of 59,645 children >72 months in age who had blood lead level tests performed in St. Louis City from 1996 to 2007. Traditional regression and Bayesian spatial models were used to determine the relationship between GC and lead exposure while accounting for confounders (condom and alcohol availability, crime, and an index of concentrated disadvantage).

Incident GC rates were found to cluster across census tracts (Moran's I=0.13, p=0.006). After accounting for confounders and their spatial dependence, a linear relationship existed between lead exposure and GC incidence across census tracts, with higher GC rates occurring in the northern part of St. Louis City 

At the census-tract level, higher lead exposure is associated with higher STI rates. Visualizing these patterns through maps may help deliver targeted interventions to reduce geographic disparities in GC rates.

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By: Nelson EJ1, Shacham E2, Boutwell BB3, Rosenfeld R4, Schootman M2, Vaughn M5, Lewis R6.

• 1Department of Epidemiology, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63104-1399, USA. Electronic address: nelsonej@slu.edu.
• 2Department of Epidemiology, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63104-1399, USA.
• 3Department of Epidemiology, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63104-1399, USA; School of Social Work, College for Public Health & Social Justice, Saint Louis University, 3550 Lindell Boulevard, St. Louis, MO 63103-1021, USA. Electronic address: bboutwell@slu.edu.
• 4Department of Criminology and Criminal Justice, University of Missouri-St. Louis, One University Blvd., St. Louis, MO 6312, USA. Electronic address: richard_rosenfeld@umsl.edu.
• 5School of Social Work, College for Public Health & Social Justice, Saint Louis University, 3550 Lindell Boulevard, St. Louis, MO 63103-1021, USA.
• 6Department of Environmental and Occupational Health, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63104-1399, USA. Electronic address: lewisrd@slu.edu.  

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