NEHA October 2022 Journal of Environmental Health

October 2022 • Journal of Environmental Health 13 highest around 2 or 3, indicating that the number of all children <6 years with BLLs of 5–9 µg/dL is closer to the observed value of 1, which is acceptable. Discussion The estimated probabilities for all children <6 years with BLLs of 5–9 µg/dL in the targeted county in the Central region was highest for 1, 2, and 3 children (Table 4). The observed number of all children <6 years with BLLs of 5–9 µg/dL in the targeted county was 1 (Table 7). These results support the observed value. As further corroboration, the estimated number of all children with BLLs of 5–9 µg/dL in the targeted county in the Central region was found to be 2.1 through simulation. Its 95% credible interval was [0.0, 5.9] (Table 7), which included 1. Similar results were found for all, White, and non-White children for the North and Central regions. For the East region, however, the observed number of all children with BLLs of 5–9 µg/dL in the targeted county was 2 (Table 2) and the highest estimated probabilities were for 9, 10, and 11 children (Table 4). Similarly, the number of all children with BLLs of 5–9 µg/dL in the targeted county in the East region was estimated to be 11.9 by simulation and its 95% credible interval was [5.1, 20.2] (Table 7), which did not include 2. This finding shows discrepancies between the observed and estimated values of children with BLLs of 5–9 µg/dL in the targeted county. Similar results were found in the East region for White and non-White children. Discrepancies between observed and estimated numbers of children <6 years with BLLs of 5–9 µg/dL were also found for the targeted county in the South and West regions (Table 7). Our model shows the possibility of checking the validity of observed numbers of children with BLLs of 5–9 µg/dL and, if necessary, replacing those numbers with estimates that better reflect the actual probable numbers in the targeted counties. The model could reveal incorrect reporting of elevated BLLs in children <6 years, which might be the case if many of the targeted counties in di˜erent regions of a state show discrepancies between the observed and estimated numbers of children with BLLs of 5–9 µg/ dL. Therefore, this finding might also point to inadequacies in the screening process Predictive Density for Non-White Children <6 Years With Blood Lead Levels of 5–9 µg/dL in the Targeted County by Region in Georgia, 2015 # of Children Probability by Region North East South West Central 0 0.204 0.007 0 0 0.265 1 0.313 0.035 0 0 0.352 2 0.251 0.085 0 0 0.233 3 0.140 0.139 0 0 0.104 4 0.061 0.171 0 0 0.035 5 0.022 0.170 0.001 0 0.009 6 0.007 0.143 0.003 0 0.002 7 0.002 0.104 0.007 0 0 8 0 0.067 0.013 0 0 9 0 0.039 0.021 0 0 10 0 0.020 0.032 0 0 11 0 0.010 0.045 0 0 12 0 0.004 0.058 0 0 13 0 0.002 0.070 0 0 14 0 0.001 0.080 0.001 0 15 0 0 0.087 0.002 0 TABLE 6 Observed and Estimated Mean Number of Children <6 Years With Blood Lead Levels (BLLs) of 5–9 µg/dL and 95% Credible Interval in the Targeted County by Region in Georgia, 2015 Region Mean # of Children <6 Years With BLLs of 5–9 µg/dL All White Non-White North Observed 0 0 0 Estimated 3.8 2.0 1.9 95% credible interval [0, 9.3] [0, 5.9] [0, 5.6] East Observed 2 1 1 Estimated 11.9 8.4 5.3 95% credible interval [5.1, 20.2] [2.5, 17.1] [1.1, 11.1] South Observed 15 4 11 Estimated 34.6 16.2 17.9 95% credible interval [21.5, 50.8] [7.8, 28.7] [8.8, 30.0] West Observed 14 1 13 Estimated 46.0 11.8 35.0 95% credible interval [30.7, 65.3] [4.5, 22.4] [21.9, 51.6] Central Observed 1 0 1 Estimated 2.1 0.8 1.3 95% credible interval [0, 5.9] [0, 3.3] [0, 4.1] TABLE 7

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