Document peGLbdk1jdy2wgpmNp9kmygVa

From: James L. Pirkle, M.D., Pb.D. Subject: Sampling of the Urban Population and the Downward Trend in NHANES II Bipod Lead Levels Questions have arisen as to whether the downward trend in the NHANES II blood lead levels could be attributed to a trend in the percentage of urban dwellers (i.e., living in areas with greater than one million population) sampled during the survey* DuPont replotted NHANES II lead data overlayed with the percent urban dwellers in the sample (attached Figure 1). Figure 2 shows the same overlay with the percent urban dwellers which were actually used in the weighted analysis at the National Center for Health Statistics* Figure 1 and Figure 2 are qualitatively similar although quantitative values for percent urban dwellers is markedly different* The somewhat similar downward trend in percent urban dwellers sampled and mean lead levels is due to the plotting intervals of January-June and July-December. When the data are plotted with April-September and October-March intervals, the similarity disappears (Figure 3). A plot of mean lead level vs. percent urban dwellers sampled for Jarjuary-June and July-December intervals is shown in Figure 4* The Pearson correlation coefficient is 0.76. A similar plot for April-September and October-March intervals is shown in Figure 5. The Pearson correlation coefficient is only 0.36* By contrast, the strong linear relationship between mean lead levels and lead used in gasoline is independent of the plotting intervals. Figures 6 and 7 show the mean blood lead level overlayed with the amount of lead used in gasoline for both sets of intervals (January-June and July-December; April-September and October-March). Figures 8 and 9 show the corresponding correlation plots. Note that the Pearson correlation coefficient is 0.95 independent of the type of interval chosen. Additional evidence that urban sampling cannot account for the downward trend in lead levels can be seen in plotting subsets of the lead data according to degree of urbanization. Figures 10-15 show three subsets of the lead data plotted vs. time: 1) urban greater than one million population, 2) urban less than one million, and 3) rural. Each subset is plotted using both types of the 6-month intervals (January-June and July-December; April-September and October-March). Distinct downward trends are present in the urban less than one million population and the rural subsets, neither of which includes any of the urban dwellers of subset one. This clearly demonstrates that trends in the percent of urban dwellers (greater than one million population) cannot account for the downward trend in the NHANES II lead data* TEH 0533237 rigraie Original Houk Figure LEAD USED IN GASOLINE PRODUCTION AND AVERAGE NHANES It BLOOD LEAD LEVELS (FEB* 1976 - FE8* 1980) Fifure I Another Plot of NHANES Data. PERCENT URBAN DWELLERS IN SAMPLE AND AVERAGE NHANES II BLOOD LEAD LEVELS Sc TEH 0533238 DUP050034505 X U J C E Z -IIU C C O _ im > U 4_4 NHANES II LEAD MEANS AND PCT URBAN POPULATION SAMPLED JANUARY - JUNE AND JULY - DECEMBER INTERVALS TEH 0533239 DUP050034506 Dbz. NHANES II LEAD MEANS AND PCT URBAN POPULATION SAMPLED APRIL - SEPT AND OCT - MARCH INTERVALS TEH 0533240 DUP050034507 ISS ` ~.... ..... Fit- V rp i< m r o s n r s s n z NHANES II MEAN LEAD VS PCT URBAN POPULATION SAMPLED JANUARY - JUNE AND JULY - DECEMBER INTERVALS 16- 15- 11312- i*; 11- 10- a CoaRBLAnotJ Co<=-(=i-i<iietur ~ oj}(g T1 I' ftT I' t l*t "{' 1 5 10 rnrTf 15 20 /\r CO per c en t u r ban po pu l at io n WT'j'Trt T*7* m TEH 0533241 DUP050034508 ILL Fi6-. S' NHANES II LEAD MEANS VS. PCT URBAN POPULATION SAMPLED APRIL - SEPT AND OCT - MRRCH INTERVALS 1?H 16- r-rn<nr- o s n r z x t iz 15m- 13- 12 ih o Q C*Retmw>\J Co<=^Fii <=-tuT ~ CL3& 9{mnT,TTrnrTTinrj-rri`.-i'j rt'i'Ti , r.ny t ' i|' 0 3 6 9 12 15 18 21 29 2? |-ri. p.. rtfrm . 11 . . p . ) .1. |r. i. T 30 33 36 39 92 45 46 51 $9 PERCENT URBAN POPULATION TEH 0533242 DUP050034509 u ua pi & 6 NHANES II LEAD MEANS AND LEAD USED IN GASOLINE JANUARY - JUNE AND JULT - DECEMBER INTERVALS TEH 0533243 DUP050034510 r - T O < P if- o n n z a jn t a s" f\&. 7 LEAD USED IN GASOLINE PRODUCTION AND AVERAGE NHANES II BLOOD LEAD APRIL - SEPT RND OCT - MARCH INTERVALS TEH 0533244 DUP050034511 Ft G- ? X U iC C Z -JIU C E O _ltU > lU _J NHANES II MEAN LEAD VS LEAD USED IN GASOLINE JifjNUfiRT - JUNE RND JULT - DECEMBER INTERVALS 17- 16 O 15 D 13- 1211- D 10. p CO(lREkfrno(0 CbtFFiCleWT ~ 0,9S' ...II i I ">'1 i i I I I - I i-i- f-i-yr I Ti-j II I II I-TT-I"! 1 I I ! 115 51 57 63 69 75 81 87 93 LEAD USED IN GASOLINE I1D00 TONS) '1 1 1 ' ...I 1 ! 99 105 TEH 0533245 DUP050034512 "S9 L h (& ? f-n)<m r- oaw nf zrom z NHANES II LEAD MEANS VS. LEAD USED IN GASOLINE APRIL - SEPT AND OCT - MARCH INTERVALS 174 IB- 15- D D DO 13- V2- U- 10- CORftEt- frTioM Co f r c tmJT O * 9f I l ` 1 1 ` ' T-i t . .-T-i | . r-T-, | . . - . | . , , . | .................. 45 51 57 63 69 75 81 87 93 99 105 LEAD USED IN GASOLINE 11000 TONS) TEH 0533246 DUP050034513 69S FIS. 10 NBANES II MEAN LEAD VS YEAR JANUARY - JUNE AND JULY - DECEMBER INTERVALS GROUP=URBRN GREATER THAN L MILLION POP, DUP050034514 6SL FI 6. II NHANES II LEAD MEANS VS. YEAR APRIL - SEPT AND OCT - MARCH INTERVALS GROUP=URBAN GREATER THAN 1 MILLION POP. TEH 0533248 DUP050034515 NHANES II MEAN LEAD VS YEAR JANUARY - JUNE AND JULY - DECEMBER INTERVALS GROUP=URBAN LESS THAN 1 MILLION POP, TEH 0533249 DUP050034516 i/S F/. !3 NHANES II LEAD MEANS VS. YEAR APRIL - SEPT AND OCT - MARCH INTERVALS GROUP-URBAN LESS THAN 1 MILLION POP. TEH 0533250 DUP050034517 pit?- t<f NHANES II MEAN LEAD VS YEAH JANUARY - JUNE AND JULY - DECEMBER INTERVALS GRQUP=RURAL TEH 0533251 DUP050034518 3C-ii fl&. LEAD 17 - NHANES II LEAD MEANS VS. YEAR RPRIL - SEPT AND OCT - MARCH INTERVALS GR0UP=3 I ''' r"' ' 1 1 ' ' ' I ' ` 0 1976 '1 1*I' 1977 " I....................... ' L L 1 ,............................................. , 1978 1979 1980 TEAR TEH 0533252 DUP050034519