MARYLAND DEPARTMENT OF THE ENVIRONMENT

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland Annual Report 2009 August, 2010

MARYLAND CHILDHOOD LEAD REGISTRY ANNUAL SURVEILLANCE REPORT 2009 EXECUTIVE SUMMARY The Maryland Department of the Environment s statewide Childhood Lead Registry (CLR) performs childhood blood lead surveillance for Maryland. The CLR receives the reports of all blood lead tests done on Maryland children 0-18 years of age, and the CLR provides blood lead test results to the Department of Health and Mental Hygiene including Medicaid and local health departments as needed for case management and planning. Since 1995, the CLR has released a comprehensive annual report on statewide childhood blood lead testing. This current report presents the childhood blood lead test results for calendar year 2009 (CY 2009). All numbers are based on blood lead testing (venous or capillary) on children. The CLR does not receive any reports on lead screening based on the lead risk assessment questionnaire. With few exceptions all numbers referred to children 0-72 months of age. CY 2009 Surveillance Highlights: A total of 124,471 blood lead tests from 119,714 children 0-18 years were received and processed by the CLR in 2009, of which 111,890 tests were from 107,416 children 0-72 months. The overall blood lead testing for children 0-72 months for 2009 was the same as for 2008 (22.4%). The highest testing rates for children 0-72 months were found in Baltimore City (33.7%) followed by Caroline County (33.3%), Somerset County (32.4%), and Dorchester and Wicomico Counties (31.9%). The highest testing rates for children 0-35 months were found in Caroline County (56.4%), Somerset county (52.6%), Dorchester County (50.2%), and Talbot County (48.2%). Statewide, the testing rate for this age group for 2009 was almost the same as for 2008 (31.7% vs. 31.6%). Close to 90% of addresses were geocodable at the longitude, latitude level. The county assignment however is based on: 1) census tract as determined by geocoding, 2) child s zip code address, and 3) the original county name if it were included in the address information. In 2009, more than 92% of blood lead tests were reported electronically. Two new laboratories started reporting in 2009 and two laboratories stopped doing blood lead analysis. Two laboratories changed reporting format from mailing diskette to on line reporting. The average reporting time, from the time sample is drawn to the time the 2

result enters the CLR database is about 6 days. The average time for elevated blood lead results ( 10 μg/dl) is approximately 30 hours. Out of 107,416 children 0-72 months tested for lead statewide in 2009, 553 (0.5%) were found to have blood lead level 10 μg/dl (prevalent cases) of whom 379 had their very first EBL test (incident cases) in 2009. In 2009, 54% of the children statewide with an EBL lived in other than pre-1950 residential rental dwelling units. In Baltimore City, 40% of the children with an EBL lived in other than pre-1950 residential dwelling units. 3

Overview Exposure to lead is still the most significant and widespread environmental hazards for children in Maryland. Children are at the greatest risk from birth to age six while their neurological systems are being developed. Exposure to lead can cause long-term neurological damage that may be associated with learning and behavioral problems and with decreased intelligence. Sources of Childhood Lead Exposure Lead paint dust from deteriorated lead paint or from renovation is the major source of exposure for children in Maryland. Out of estimated of 2,317,334 residential houses in Maryland 432,092 (18.7%) are built before 1950 (95% likely to contain lead paint) and 945,739 (40.8%) built between 1950-1979 (75% likely to have lead paint. (Source: US Census Bureau, American Community Survey, 2006-2008 American Community Survey 3-Year Estimates) Terms and Definitions There is no evidence of a blood lead level below which there are no health effects. The Centers for Disease Control and Prevention (CDC) concurs that the evidence shows that there is no threshold level for blood lead that can be considered safe. CDC s current blood lead level of concern of 10 µg/dl is based on: 1) lack of successful clinical or public health interventions with BLLs below 10 µg/dl, 2) likelihood of misclassification errors due to uncertainty associated with Water, air, and soil, may provide low-level, background exposure, but rarely may cause childhood lead poisoning. Imported products, parental occupations, hobbies, and imported traditional medicines occasionally may cause lead exposure among children. In-utero exposure to lead may affect fetal development. This can be of more significance among certain subgroup populations who may be more at risk of environmental lead exposure. laboratory testing at levels <10 µg/dl, and 3) the need to prioritize public health resources for children with BLL 10 μg/dl. Based on these facts, the CLR dropped the term Lead Poisoning as was initially defined: a venous blood lead level 25 μg/dl and later dropped the level to 20 μg/dl. Instead, to better reflect the extent of the work and to direct program activities to the more at-risk areas, from 2005 forward new terms incidence and prevalence with the following definitions were included in annual report. EBL (Elevated Blood Lead level): A blood lead level 10 μg/dl, currently defined by CDC as Level of Concern. The highest venous, in the absence of venous test the highest capillary test was the bases of determination. Prevalence: Any child with an EBL for the calendar year is the basis of this selection. Prevalence reflects the existing load of children with EBL who may be new to the program or may have been carried-over from previous years (continuously or after some remission.) Incidence: Any child with the very first EBL is basis of this selection. Incidence reflects the load of the children with EBL who may have never been tested for lead before or the result of all their blood lead tests were all below 10 µg/dl. Incidence is a better indicator for primary prevention. It is expected that the expansion of primary prevention activities results in less exposure and fewer new cases. The old cases, because of the extent and severity of the past exposure may remain internally exposed and continue to have EBL for months or even years. The procedures to locate new cases were discussed in detail in previous reports (Annual reports 2005, 2006). 4

Statistical Report In calendar year 2009, a total of 107,416 children 0-72 months were tested for lead exposure statewide. Table One provides a summary of statewide statistics of blood lead testing in 2009. Table One Calendar Year (CY) 2009 Statistical Report 1 Item Number Percent (%) All Children Number of tests 124,471 Number of children 119,714 Children 0-72 Months Number of tests 111,790 Number of children 107,416 100.0 Age Under One 11,678 10.8 One Year 36,122 33.6 Two Years 29,433 27.4 Three Years 11,804 11.0 Four Years 10,926 10.3 Five Years 7,453 6.9 Sex Female 52,272 48.7 Male 54,316 50.6 Undetermined 828 0.7 Highest 4 102,280 95.2 5-9 4,583 4.3 10-14 374 0.3 15-19 103 0.1 20 76 0.1 Mean BLL (Geometric mean) 1.60 Blood Specimen Capillary 15,247 14.2 Venous 78.950 73.5 Undetermined 2 13,219 12.3 1. For detailed analysis and breakdown of numbers refer to Supplementary Data Tables 1-5. 2. In supplementary data tables blood tests with sample type unknown were counted as capillary. 5

Findings Childhood lead exposure further declined in 2009 (Figure One). There was 22.4% drop in both prevalence and incidence. The reduction has occurred both statewide and in areas of highest risk such as Baltimore City. Figure One Number of Children 0-72 Months Tested for Lead and Number Reported to Have Blood Lead Level 10 μg/dl: 1995-2009 Number o f Chid lren Tested 120,000 100,000 80,000 60,000 40,000 20,000 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Children Tested Children with BLL >=10 12,000 10,000 8,000 6,000 4,000 2,000 0 Number of children with BLL >=10 µg/d L The drop in both extent and severity of lead poisoning continued from 2008 to 2009 (Figure Two). Figure Two Blood Lead Distribution of Children 0-72 Months Tested for Lead in 2008 and 2009 % of Children with BLL at Given Level 100 90 80 70 60 50 40 30 20 10 0 94.6 95.2 2008 Data 2009 4.8 4.3 0.4 0.3 0.1 0.1 0.1 0.1 <=4 5-9 10-14 15-19 >=20 6

Table Two provides the breakdown of blood lead testing and the status of children with respect to lead exposure by jurisdiction in 2009. Table Two Blood Lead Testing of Children 0-72 Months by Jurisdiction in 2009 Population Children Tested Old Cases 2 Cases 3 Cases 4 New (Incident) Total (Prevalent) County of Children 1 Number Percent Number Percent Number Percent Number Percent Allegany 5,007 1,371 27.4 2 0.15 13 0.9 15 1.1 Anne Arundel 44,471 7,333 16.5 2 0.03 5 0.1 7 0.1 Baltimore 61,053 16,139 26.4 7 0.04 21 0.1 28 0.2 Baltimore City 56,431 19,043 33.7 133 0.70 214 1.1 347 1.8 Calvert 6,920 698 10.1 0 0.00 1 0.1 1 0.1 Caroline 2,516 839 33.3 2 0.24 5 0.6 7 0.8 Carroll 13,988 1,342 9.6 1 0.07 6 0.4 7 0.5 Cecil 8,030 1,212 15.1 2 0.17 2 0.2 4 0.3 Charles 12,101 1,836 15.2 0 0.00 4 0.2 4 0.2 Dorchester 2,287 730 31.9 1 0.14 2 0.3 3 0.4 Frederick 19,349 3,181 16.4 4 0.13 7 0.2 11 0.3 Garrett 2,490 473 19.0 0 0.00 2 0.4 2 0.4 Harford 21,180 3,184 15.0 0 0.00 2 0.1 2 0.1 Howard 24,990 2,503 10.0 0 0.00 1 0.0 1 0.0 Kent 1,253 323 25.8 2 0.62 0 0.0 2 0.6 Montgomery 80,950 18,200 22.5 5 0.03 20 0.1 25 0.1 Prince George's 78,279 19,594 25.0 5 0.03 45 0.2 50 0.3 Queen Anne's 3,614 607 16.8 0 0.00 4 0.7 4 0.7 Saint Mary's 8,618 1,527 17.7 1 0.07 3 0.2 4 0.3 Somerset 1,533 497 32.4 1 0.20 3 0.6 4 0.8 Talbot 2,417 675 27.9 1 0.15 3 0.4 4 0.6 Washington 11,207 3,006 26.8 0 0.00 9 0.3 9 0.3 Wicomico 7,058 2,248 31.9 4 0.18 6 0.3 10 0.4 Worcester 3,177 850 26.8 1 0.12 1 0.1 2 0.2 County Unknown 5 0 0 0 Statewide 478,919 107,416 22.4 174 0.16 379 0.4 553 0.5 1. Adapted from the Census Bureau: State Interim Population Projections by Age and Sex: 2000-2030 http://www.census.gov/population/www/projections/projectionsagesex.html. 2. Children with a history of an EBL (blood lead level 10 µg/dl). These children may have carried over from 2008 or had an EBL test in previous years. 3. Children with the very first EBL in 2009. These children were either not tested in the past or their blood lead levels were below 10 µg/dl. 4. All children with at least one blood lead test 10 μg/dl in 2009. The selection is based on the highest venous or the highest capillary in the absence of any venous test. 7

Appendix A provides numbers of children by age groups of 0-35 months and 36-72 months, and Appendix B provides summary results for the past eight (8) years at the State, Baltimore City and Counties levels. For detailed breakdown of blood lead data the reader is referred to supplementary data tables: Supplements 1-5. Statewide activities to reduce (eliminate) childhood lead poisoning The State Elimination Plan calls for zero new cases of EBL by 2010. The plan focuses on primary prevention (removal and elimination of lead hazards) while maintaining well-established secondary prevention (identifying children who may be at risk of lead exposure) and tertiary prevention (case management of children exposed to lead) efforts in the state. Primary Prevention: Much of the decline in blood lead levels is the result of implementation and enforcement of Maryland s Reduction of Lead Risk in Housing law. The law requires each pre-1950 rental dwelling to be issued a Full Risk Reduction certificate at tenant turnover. In 2001, at least 50% of the owner's affected properties were required to be in compliance with the Full Risk Reduction Standard, 100% compliance was required in 2006. Effective October 1, 2004, the law requires rent court judges and local housing registry officials to not accept cases and applications from pre-1950 rental property owners who can not present lead certificates that indicate that their rental properties are in compliance with the Reduction of Lead Risk in Housing law. Although children living in pre-1950 housing units are much more likely to have EBL, the severity of exposure in such housing declined significantly over the years (Figures Three, Four). Figure Three Percent of Children 0-72 Months with Blood Lead Level 10 µg/dl and Age of the Housing 45 40 40.6 35 30 Perc ent 25 20 15 10 5 0 8.2 4.8 3.2 1.1 0.9 0.2 0.6 0.2 Pre 1950 1950-1979 1980+ 1995 2002 2009 8

Figure Four Mean Blood Lead Level of Children 0-72 Months and Age of the Housing 12 10 Blo od Lead Level (µg /dl) 8 6 4 2 0 Pre 1950 1950-1979 1980+ 1995 2002 2009 State laws and regulations with impact on childhood lead poisoning Requirements to perform lead hazard reduction at each turnover in rental housing built before 1950. [Environment Article (EA) 6-8] Outreach programs to parents, health care providers, and property owners, especially in at-risk areas. [EA 6-8, Health Article 18-106] Secondary Prevention: The second element of the Elimination Plan is to identify children who may be at risk of lead exposure, so that preventive action can be implemented. Children age one and two, because of their mouthing behavior are most likely to be exposed to lead. To that end, State of Maryland requires that children at ages one and two years be tested. The percentage of one and two year old children tested for lead has increased substantially since 2004 (Figure Five). Furthermore, children living in at-risk areas, areas with high proportion of pre 1950 housing units are more likely to be exposed to lead than children living in other areas. State has a targeted plan that identifies at-risk areas. Universal blood lead testing applies to Baltimore City children (City Ordinance 20 effective July 2000). Table Three presents blood lead testing in the At-risk and Not At-risk areas of the state. At-risk area includes Baltimore city, and Caroline, Dorchester, Frederick, Garrett, Somerset, Talbot, Washington, and Wicomico counties Another group of children at risk of lead poisoning are children on Medical Assistance programs. Upon memorandum of understanding between MDE Lead Program and the office of Medicaid Administration of the Maryland Department of Health and Mental Hygiene (DHMH), childhood 9

blood lead data is provided, on quarterly and annual basis, to Medicaid program to be matched with the list of children on Medical Assistance Program. The Medicaid Program prepares and distributes the reports of blood lead testing of children under Medicaid program for the state and local jurisdictions. For information and access to the reports refer to the office of Medicaid Administration at DHMH. Figure Five Percent of Children One and Two Years Old Tested for Lead vs. Children of Other Ages Percent 50 45 40 35 30 25 20 15 10 5 0 One Year Two Years 3-5 Years 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Calendar Year Table Three Blood Lead Testing in At-Risk and Not At-Risk areas in 2009 Children with Children Tested BLL 10 µg/dl Area Population Number Percent Number Percent At-Risk 113,470 32,913 29.0 414 1.3 Not At-Risk 365,449 74,503 20.4 139 0.2 Statewide 478,919 107,416 22.4 553 0.5 Another group of children who may be at risk of lead exposure are immigrant and asylum children. To determine lead exposure in these children and to fulfill one of the CDC grant requirement, the Lead Program made an agreement with the DHMH Office of Immigrant Health for the exchange of data. Based on this agreement, the Lead Program receives, on biannual basis, records of refugee and migrant children who settled in Maryland. The records are then matched with CLR records to determine the blood lead test status of these children. The outcome of matching is provided to the Office of Immigrant Health for proper follow up. For calendar year 2009, the list of migrant and asylum children included 552 records of which 267 were matched with childhood lead registry data (Table Four). Of 267 matched children 118 were under age five at the time blood lead test. Table Five presents comparison of blood lead level between migrants/asylum children and the statewide childhood blood lead level 10

Table Four Matching of Migrant/Asylum Children Who Settled in Maryland with the Maryland Statewide Blood Lead Data (CY 2009) Matching level Number of match Complete name (last, first) and date of birth 176 Complete name (last, first) only 23 First five letters of name (last, first) and date of birth 24 First five letters of name (last, first) only 10 Reverse match * 4 No match found 285 The order of last and first name in refugee file were matched against the order of first and last name in CLR file. Table Five Blood Lead Level of Migrant/Asylum Children vs. Statewide Childhood Blood lead Level Blood Lead Refugee/Asylum Children Statewide data Lead (µg/dl) Number Percent Number Percent 4 90 76.3 102,280 95.2 5-9 26 22.0 4,583 4.3 10 2 1.7 553 0.5 Total 118 100.0 107,416 100.0 Identifying Children with Lead Exposure The critical issue in childhood lead poisoning is early detection. Because there are no specific clinical symptoms, a blood lead test is the most reliable technique to identify children with elevated blood lead levels. If there is any suspicion that a child is exposed to lead, a health care provider should do a blood lead test. Tertiary Prevention: Maryland s Lead Poisoning Prevention Program has well-established case management guidance and environmental investigation protocols for follow-up of children with elevated blood lead level. As of February 24, 2006, one venous or two capillary blood lead tests 10 μg/dl trigger the Notice of EBL under the Reduction of Lead Risk in Housing Law. A venous blood lead test 10 μg/dl in Baltimore City or a venous blood lead test 15 μg/dl in Maryland counties initiates environmental investigation. Tables Six and Seven outline the State s protocol for diagnostic and follow up blood lead testing. Tables adapted from: Centers for Disease Control and Prevention. Managing Elevated Blood Lead Levels Among Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta: CDC, 2002. 11

Table Six Blood Lead Diagnostic and Follow-Up: Confirmation of a Capillary Blood Lead Test BLL (µg/dl) 9 10 19 3 months Confirm with venous blood lead test within Routine blood lead test according to protocol 20 44 1 week to 1 month* 45 59 48 hours 60-69 24 hours 70 Immediately as an emergency lab test * The higher the BLL on the screening test, the more urgent the need for confirmatory testing. * The higher the BLL, the more urgent the need for confirmatory testing. Table Seven Blood Lead Diagnostic and Follow-Up: Follow-Up for Venous Blood Lead Testing1 BLL (µg/dl)venous 9 Early follow-up(first 2-4 Late follow-up (After BLL begins tests after identification) to decline) Routine blood lead test according to protocol 10-14 3 months 2 6 9 months 15-19 1-3 months 2 3 6 months 20-24 1-3 months 2 1 3 months 25-44 2 weeks 1 month 1 month 45 As soon as possible Chelation with subsequent follow-up 1. Seasonal variation of BLLs exists and may be more apparent in colder climate areas. Greater exposure in the summer months may necessitate more frequent follow-up. 2. Some case managers or health care providers may choose to repeat blood lead tests on all new patients within a month to ensure that their BLL level is not rising more quickly than anticipated. Educational Burden of Childhood Lead Exposure Childhood lead exposure at early ages (before age 5) may negatively affect children s neurobehavioral development and their later educational achievements. The effect may not show up until the child enters school (kindergarten). Table Eight presents the extent of history of EBL among children who were tested for lead and would be at kindergarten age on September 1, 2010. 12

Table Eight Blood Lead Testing, and Childhood Lead Exposure of Kindergarten Population Children who would be 5 to 6 years old (kindergarten age) on September 1, 2010 and were tested for lead and had BLL >=10 µg/dl Children Children with EBL County Tested Number Percent Allegany 671 10 1.5 Anne Arundel 4,616 13 0.3 Baltimore 9,490 61 0.6 Baltimore City 9,408 382 4.1 Calvert 559 5 0.9 Caroline 481 4 0.8 Carroll 988 4 0.4 Cecil 851 3 0.4 Charles 1,287 1 0.1 Dorchester 374 3 0.8 Frederick 2,246 8 0.4 Garrett 306 1 0.3 Harford 1,917 8 0.4 Howard 1,585 3 0.2 Kent 181 2 1.1 Montgomery 10,626 31 0.3 Prince George's 11,126 36 0.3 Queen Anne's 449 1 0.2 Saint Mary's 996 1 0.1 Somerset 294 4 1.4 Talbot 376 1 0.3 Washington 1,747 12 0.7 Wicomico 1,427 19 1.3 Worcester 574 3 0.5 County Unknown 66 1 1.5 Statewide 62,641 617 1.0 Data Quality The CLR is maintained in the Systematic Tracking of Elevated Lead Levels and Remediation (STELLAR) surveillance system, obtained from CDC Lead Poisoning Prevention Program. CLR staff makes all efforts to further improve data quality with respect to completeness, timeliness, and accuracy. Staff keep daily track of laboratory reporting to make sure laboratories are reporting all blood lead tests no later than biweekly. The law requires blood lead results 20 μg/dl to be reported (fax) within 24 hours after result is known. However, upon CLR request, laboratories agreed to report (fax) the result of all blood lead test 10 μg/dl within 24 hours. 13

For all blood lead tests 10 μg/dl, staff checks the completeness of data in particular with respect to child s and guardian s name, address, and telephone number. In 2009, more than 92% of blood lead tests were reported to the registry electronically. The average reporting time, from the time sample is drawn to time the result enters the CLR database is approximately 6 days. The average time for elevated blood lead results ( 10 μg/dl) is approximately 30 hours. Table Nine provides the summary reports for completeness of data as required by law. Table Nine Completeness of Data for 2009 Item Child s name 1 Date of Birth 1 Sex/Gender Race Guardian s name Sample type Blood lead level Address (geocoded) Telephone Number 2 % Complete 100.0 100.0 99.1 52.8 51.8 87.4 100.0 89.9 92.5 1. Reports with missing (wrong) name and/or date of birth are held by the program until they are corrected. 2. Quality control for telephone number started in 2009. Migration into New System While the staff continues to work with Stellar, work is underway to migrate data into the new CDC data processing package: Healthy Housing and Lead Poisoning Surveillance System (HHLPSS). Because of the complexity of HHLPSS requirements, it does not fit well within current MDE IT establishment. On the other hand, the Maryland Department of Health and Mental Hygiene (DHMH) by the nature of its functionality has well established IT personnel and equipment to handle and process medical and health related reports. DHMH is in the process to centralize statewide reporting of all health related events including laboratory tests. To take advantage of DHMH facilities, and to speed up the process of migration into HHLPSS, the Lead Program at MDE has been coordinating with DHMH on this matter. The preliminary agreement 14

is that the DHMH IT personnel will be in-charge of receiving, downloading, and maintaining all laboratory blood lead reporting at their physical location and the MDE Lead Program personnel will be responsible for the registry s day to day operation, data quality control, data analyses, and data distribution. It is expected that the agreement will be finalized by late summer and the Lead Program will be ready for migration into HHLPSS by the fourth quarter of 2010. Blood Lead Laboratory Reporting Requirement The amended law and regulations * of 2001 and 2002 require that: 1-The following child s demographic data should be included in each blood lead test reported: Date of Birth Sex Race Address Test date Sample type Blood lead level 2-Blood lead results 20 μg/dl to be reported (fax) within 24 hours after result is known. All other results to be reported every two weeks. 3-Reporting format should comply with the format designed and provided by the Registry. 4-Data should be provided electronically. * EA 6-303, Blood lead test reporting (COMAR 26.02.01, Blood lead test reporting) 15

Appendix A Blood Lead Testing of Children 0-72 Months by Major Age Group and Jurisdiction in 2009 Children Tested Prevalent Cases Incident Cases Population Number Percent Number Percent Number Percent Allegany County 0-35 Months 2,567 1,152 44.9 12 1.0 11 1.0 36-72 Months 2,440 219 9.0 3 1.4 2 0.5 Total 5,007 1,371 27.4 15 1.1 13 0.9 Anne Arundel County 0-35 Months 22,799 5,501 24.1 4 0.1 3 0.1 36-72 Months 21,672 1,832 8.5 3 0.2 2 0.1 Total 44,471 7,333 16.5 7 0.1 5 0.1 Baltimore County 0-35 Months 30,214 12,361 40.9 19 0.2 16 0.1 36-72 Months 30,839 3,778 12.3 9 0.2 5 0.1 Total 61,053 16,139 26.4 28 0.2 21 0.1 Baltimore City 0-35 Months 29,375 13,864 47.2 235 1.7 182 1.3 36-72 Months 27,056 5,179 19.1 112 2.2 32 0.6 Total 56,431 19,043 33.7 347 1.8 214 1.1 Calvert County 0-35 Months 3,334 546 16.4 1 0.2 1 0.2 36-72 Months 3,586 152 4.2 0 0.0 0 0.0 Total 6,920 698 10.1 1 0.1 1 0.1 Caroline County 0-35 Months 1,236 697 56.4 6 0.9 5 0.7 36-72 Months 1,280 142 11.1 1 0.7 0 0.0 Total 2,516 839 33.3 7 0.8 5 0.6 Carroll County 0-35 Months 6,800 967 14.2 5 0.5 5 0.5 36-72 Months 7,188 375 5.2 2 0.5 1 0.3 Total 13,988 1,342 9.6 7 0.5 6 0.4 Cecil County 0-35 Months 4,173 785 18.8 2 0.3 2 0.3 36-72 Months 3,857 427 11.1 2 0.5 0 0.0 Total 8,030 1,212 15.1 4 0.3 2 0.2 16

Appendix A Blood Lead Testing of Children 0-72 Months by Major Age Group and Jurisdiction in 2009 Children Tested Prevalent Cases Incident Cases Population Number Percent Number Percent Number Percent Charles County 0-35 Months 5,728 1,324 23.1 4 0.3 4 0.3 36-72 Months 6,373 512 8.0 0 0.0 0 0.0 Total 12,101 1,836 15.2 4 0.2 4 0.2 Dorchester County 0-35 Months 1,151 577 50.2 2 0.3 1 0.3 36-72 Months 1,136 153 13.5 1 0.7 1 0.7 Total 2,287 730 31.9 3 0.4 2 0.3 Frederick County 0-35 Months 9,756 2,253 23.1 9 0.4 7 0.3 36-72 Months 9,593 928 9.7 2 0.2 0 0.0 Total 19,349 3,181 16.4 11 0.3 7 0.2 Garrett County 0-35 Months 1,335 326 24.4 1 0.3 1 0.3 36-72 Months 1,155 147 12.7 1 0.7 1 0.7 Total 2,490 473 19.0 2 0.4 2 0.4 Harford County 0-35 Months 10,859 2,334 21.5 1 0.0 1 0.0 36-72 Months 10,321 850 8.2 1 0.1 1 0.1 Total 21,180 3,184 15.0 2 0.1 2 0.1 Howard County 0-35 Months 12,479 1,765 14.1 1 0.1 1 0.1 36-72 Months 12,511 738 5.9 0 0.0 0 0.0 Total 24,990 2,503 10.0 1 0.0 1 0.0 Kent County 0-35 Months 657 267 40.6 1 0.4 0 0.0 36-72 Months 596 56 9.4 1 1.8 0 0.0 Total 1,253 323 25.8 2 0.6 0 0.0 Montgomery County 0-35 Months 41,684 12,918 31.0 16 0.1 15 0.1 36-72 Months 39,266 5,282 13.5 9 0.2 5 0.1 Total 80,950 18,200 22.5 25 0.1 20 0.1 17

Appendix A Blood Lead Testing of Children 0-72 Months by Major Age Group and Jurisdiction in 2009 Children Tested Prevalent Cases Incident Cases Population Number Percent Number Percent Number Percent Prince George's County 0-35 Months 39,994 12,518 31.3 29 0.2 27 0.2 36-72 Months 38,285 7,076 18.5 21 0.3 18 0.3 Total 78,279 19,594 25.0 50 0.3 45 0.2 Queen Anne's County 0-35 Months 1,842 470 25.5 4 0.9 4 0.9 36-72 Months 1,772 137 7.7 0 0.0 0 0.0 Total 3,614 607 16.8 4 0.7 4 0.7 Saint Mary's County 0-35 Months 4,255 1,294 30.4 4 0.3 3 0.2 36-72 Months 4,363 233 5.3 0 0.0 0 0.0 Total 8,618 1,527 17.7 4 0.3 3 0.2 Somerset County 0-35 Months 767 403 52.6 2 0.5 2 0.5 36-72 Months 766 94 12.3 2 2.1 1 1.1 Total 1,533 497 32.4 4 0.8 3 0.6 Talbot County 0-35 Months 1,174 566 48.2 4 0.7 3 0.5 36-72 Months 1,243 109 8.8 0 0.0 0 0.0 Total 2,417 675 27.9 4 0.6 3 0.4 Washington County 0-35 Months 5,695 2,022 35.5 5 0.2 5 0.2 36-72 Months 5,512 984 17.9 4 0.4 4 0.4 Total 11,207 3,006 26.8 9 0.3 9 0.3 Wicomico County 0-35 Months 3,704 1,671 45.1 5 0.3 5 0.3 36-72 Months 3,354 577 17.2 5 0.9 1 0.2 Total 7,058 2,248 31.9 10 0.4 6 0.3 Worcester County 0-35 Months 1,684 650 38.6 2 0.3 1 0.3 36-72 Months 1,493 200 13.4 0 0.0 0 0.0 Total 3,177 850 26.8 2 0.2 1 0.1 18

Appendix A Blood Lead Testing of Children 0-72 Months by Major Age Group and Jurisdiction in 2009 Children Tested Prevalent Cases Incident Cases Population Number Percent Number Percent Number Percent County Unknown 0-35 Months 2 0 0 36-72 Months 3 0 0 Total 5 0 0 Statewide 0-35 Months 243,260 77233 31.7 374 0.5 305 0.4 36-72 Months 235,659 30183 12.8 179 0.6 74 0.2 Total 478,919 107416 22.4 553 0.5 379 0.4 19

Appendix B Blood Lead Testing of Children 0-72 Months: 2001-2008 Calendar Blood Lead Tests. BLL 10 μg/dl Lead Poisoning. Year Population Number Percent Number Percent Number Percent 2002 Baltimore City 52,744 16,595 31.5 1,558 9.4 183 1.1 Counties 384,073 62,822 16.4 737 1.2 77 0.1 Unknown 90 2 0 Total 436,817 79,507 18.2 2,297 2.9 260 0.3 2003 Baltimore City 51,892 18,242 35.2 1,166 6.4 160 0.9 Counties 386,076 58,470 15.1 552 0.9 77 0.1 Unknown 9 1 0 Total 437,968 76,721 17.5 1,719 2.2 237 0.3 2004 Baltimore City 52,796 18,970 35.9 1183 6.2 147 0.8 Counties 395,310 83,002 21.0 573 0.7 83 0.1 Unknown 3,577 55 Total 448,106 105,549 23.6 1,811 1.7 230 0.2 2005 Prevalent cases Incident cases Baltimore City 53,626 17,943 33.5 854 4.8 534 3.0 Counties 401,888 80,848 20.1 463 0.6 382 0.5 Unknown 357 14 0 Total 455,514 99,148 21.8 1,331 1.3 916 0.9 2006 2007 Baltimore City 54,547 18,363 33.7 843 4.6 573 3.1 Counties 408,784 84,611 20.7 431 0.5 363 0.4 Unknown 199 21 20 Total 463,331 102,974 22.2 1,274 1.2 936 0.9 Baltimore City 55,142 17,670 32.0 624 3.5 435 2.5 Counties 413,248 87,760 21.2 267 0.3 218 0.2 Unknown 278 1 1 Total 468,390 105,708 22.6 892 0.8 654 0.6 2008 2009 Baltimore City 55,959 18,622 33.3 468 2.5 302 1.6 Counties 418,941 87,830 21.0 245 0.3 187 0.2 Unknown 69 0 0 Total 474,900 106,452 22.4 713 0.7 489 0.5 Baltimore City 56,431 19,043 33.7 347 1.8 214 1.1 Counties 422,488 88,368 20.9 206 0.2 165 0.1 Unknown 5 Total 468,390 107,416 22.4 553 0.5 379 0.4 20

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland 2009 Annual Report Blood Lead Level (increment of 5 μg/dl) by age, and county of residence Supplementary Data Tables: Supplement #1 August, 2010

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Allegany County Criteria: The highest venous or highest capillary in the absence of venous test Under One 24 1 1 26 One Year 560 35 2 2 599 Two Years 478 43 3 1 2 527 Three Years 71 8 79 Four Years 80 4 1 85 Five Years 53 1 1 55 Total 1,266 90 7 5 3 0 1,371 6-17 Years 47 4 1 52 Under One 9 1 1 11 One Year 133 15 1 2 151 Two Years 133 16 3 1 2 155 Three Years 36 5 41 Four Years 38 1 39 Five Years 24 1 25 Total 373 37 4 5 3 0 422 6-17 Years 30 1 1 32 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 2

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Anne Arundel County Criteria: The highest venous or highest capillary in the absence of venous test Under One 630 12 642 One Year 2,957 46 4 3,007 Two Years 1,814 38 1,852 Three Years 694 11 2 707 Four Years 611 13 624 Five Years 491 9 1 501 Total 7,197 129 4 3 0 0 7,333 6-17 Years 580 8 1 1 590 Under One 387 1 388 One Year 2,391 27 4 2,422 Two Years 1,438 22 1,460 Three Years 602 7 2 611 Four Years 521 7 528 Five Years 412 7 1 420 Total 5,751 71 4 3 0 0 5,829 6-17 Years 472 4 1 1 478 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 3

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Baltimore County Criteria: The highest venous or highest capillary in the absence of venous test Under One 1,708 34 1 1,743 One Year 5,347 156 3 1 1 2 5,510 Two Years 4,928 169 6 4 1 5,108 Three Years 1,584 53 1 1 1,639 Four Years 1,219 29 3 1 1,252 Five Years 860 24 1 2 887 Total 15,646 465 13 8 2 5 16,139 6-17 Years 1384 24 5 1 1414 Under One 995 10 1 1,006 One Year 3,620 73 3 1 1 2 3,700 Two Years 3,184 82 6 4 1 3,277 Three Years 1,176 27 1 1 1,205 Four Years 934 16 3 1 954 Five Years 632 15 1 2 650 Total 10,541 223 13 8 2 5 10,792 6-17 Years 1,008 16 5 1 1,030 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 4

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Baltimore City Criteria: The highest venous or highest capillary in the absence of venous test Under One 1,594 118 6 1,718 One Year 5,842 683 64 19 8 5 6,621 Two Years 4,633 759 96 25 7 5 5,525 Three Years 1,856 322 30 7 3 4 2,222 Four Years 1,508 223 33 6 1 4 1,775 Five Years 1,009 149 19 3 2 1,182 Total 16,442 2,254 248 60 19 20 19,043 6-17 Years 3299 217 20 7 2 1 3546 Under One 870 53 4 927 One Year 4,002 429 62 19 7 5 4,524 Two Years 3,161 494 90 25 7 5 3,782 Three Years 1,313 218 26 7 3 4 1,571 Four Years 1,106 144 29 6 1 4 1,290 Five Years 742 92 16 3 2 855 Total 11,194 1,430 227 60 18 20 12,949 6-17 Years 2,421 138 17 6 2 1 2,585 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 5

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Calvert County Criteria: The highest venous or highest capillary in the absence of venous test Under One 131 2 133 One Year 270 8 1 279 Two Years 129 5 134 Three Years 70 2 72 Four Years 50 2 52 Five Years 28 28 Total 678 19 1 0 0 0 698 6-17 Years 75 3 78 Under One 35 35 One Year 128 6 1 135 Two Years 67 3 70 Three Years 43 2 45 Four Years 36 1 37 Five Years 24 24 Total 333 12 1 0 0 0 346 6-17 Years 61 3 64 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 6

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Caroline County Criteria: The highest venous or highest capillary in the absence of venous test Under One 19 1 20 One Year 349 15 2 1 367 Two Years 282 25 2 1 310 Three Years 51 1 52 Four Years 62 3 65 Five Years 22 3 25 Total 785 47 4 2 1 0 839 6-17 Years 19 2 21 Under One 15 15 One Year 228 11 2 1 242 Two Years 187 20 2 1 210 Three Years 43 1 44 Four Years 50 3 53 Five Years 14 3 17 Total 537 37 4 2 1 0 581 6-17 Years 14 2 16 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 7

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Carroll County Criteria: The highest venous or highest capillary in the absence of venous test Under One 131 9 140 One Year 521 19 1 1 1 543 Two Years 268 14 2 284 Three Years 132 132 Four Years 129 2 1 132 Five Years 109 1 1 111 Total 1,290 45 3 2 1 1 1,342 6-17 Years 109 2 111 Under One 93 5 98 One Year 417 14 1 1 433 Two Years 202 9 2 213 Three Years 118 118 Four Years 118 2 1 121 Five Years 94 1 1 96 Total 1,042 31 2 2 1 1 1,079 6-17 Years 95 1 96 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 8

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Cecil County Criteria: The highest venous or highest capillary in the absence of venous test Under One 110 4 114 One Year 458 16 1 475 Two Years 185 10 1 196 Three Years 162 5 1 168 Four Years 136 3 139 Five Years 118 1 1 120 Total 1,169 39 3 1 0 0 1,212 6-17 Years 112 1 113 Under One 32 1 33 One Year 123 4 1 128 Two Years 44 1 1 46 Three Years 42 3 1 46 Four Years 29 1 30 Five Years 41 1 1 43 Total 311 11 3 1 0 0 326 6-17 Years 25 25 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 9

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Charles County Criteria: The highest venous or highest capillary in the absence of venous test Under One 210 2 1 1 214 One Year 555 6 1 1 563 Two Years 539 8 547 Three Years 234 3 237 Four Years 165 1 166 Five Years 109 109 Total 1,812 20 1 1 1 1 1,836 6-17 Years 120 120 Under One 146 1 1 1 149 One Year 510 6 1 1 518 Two Years 482 5 487 Three Years 221 3 224 Four Years 151 1 152 Five Years 104 104 Total 1,614 16 1 1 1 1 1,634 6-17 Years 106 106 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 10

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Dorchester County Criteria: The highest venous or highest capillary in the absence of venous test Under One 21 21 One Year 295 21 1 317 Two Years 224 14 1 239 Three Years 72 11 1 84 Four Years 37 1 38 Five Years 31 31 Total 680 47 3 0 0 0 730 6-17 Years 26 26 Under One 17 17 One Year 187 16 1 204 Two Years 140 12 1 153 Three Years 67 11 1 79 Four Years 29 1 30 Five Years 17 17 Total 457 40 3 0 0 0 500 6-17 Years 20 20 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 11

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Frederick County Criteria: The highest venous or highest capillary in the absence of venous test Under One 147 1 1 149 One Year 1,384 22 4 1 1,411 Two Years 662 28 2 1 693 Three Years 348 8 1 357 Four Years 335 10 1 346 Five Years 225 225 Total 3,101 69 8 1 0 2 3,181 6-17 Years 158 3 1 1 163 Under One 120 1 1 122 One Year 1,142 18 3 1 1,164 Two Years 537 22 2 1 562 Three Years 296 7 1 304 Four Years 288 9 1 298 Five Years 192 192 Total 2,575 57 7 1 0 2 2,642 6-17 Years 130 3 1 1 135 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 12

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Garret County Criteria: The highest venous or highest capillary in the absence of venous test Under One 16 16 One Year 136 8 144 Two Years 154 11 1 166 Three Years 44 7 1 52 Four Years 52 1 53 Five Years 40 2 42 Total 442 29 2 0 0 0 473 6-17 Years 30 30 Under One 5 5 One Year 50 3 53 Two Years 58 3 61 Three Years 27 4 1 32 Four Years 39 39 Five Years 24 24 Total 203 10 1 0 0 0 214 6-17 Years 20 20 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 13

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Harford County Criteria: The highest venous or highest capillary in the absence of venous test Under One 509 15 524 One Year 986 23 1 1,010 Two Years 768 32 800 Three Years 276 10 1 287 Four Years 301 2 303 Five Years 256 4 260 Total 3,096 86 2 0 0 0 3,184 6-17 Years 276 5 281 Under One 336 7 343 One Year 754 14 1 769 Two Years 527 10 537 Three Years 221 5 1 227 Four Years 239 1 240 Five Years 202 2 204 Total 2,279 39 2 0 0 0 2,320 6-17 Years 225 1 226 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 14

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Howard County Criteria: The highest venous or highest capillary in the absence of venous test Under One 285 4 289 One Year 855 12 867 Two Years 599 9 1 609 Three Years 289 7 296 Four Years 237 7 244 Five Years 192 6 198 Total 2,457 45 1 0 0 0 2,503 6-17 Years 521 7 528 Under One 221 1 222 One Year 724 8 732 Two Years 505 8 1 514 Three Years 267 6 273 Four Years 212 5 217 Five Years 175 5 180 Total 2,104 33 1 0 0 0 2,138 6-17 Years 479 6 485 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 15

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Kent County Criteria: The highest venous or highest capillary in the absence of venous test Under One 32 32 One Year 140 2 142 Two Years 86 6 1 93 Three Years 23 2 25 Four Years 20 1 21 Five Years 9 1 10 Total 310 11 2 0 0 0 323 6-17 Years 6 6 Under One 21 21 One Year 95 1 96 Two Years 65 6 1 72 Three Years 20 1 21 Four Years 14 1 15 Five Years 8 1 9 Total 223 9 2 0 0 0 234 6-17 Years 4 4 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 16

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Montgomery County Criteria: The highest venous or highest capillary in the absence of venous test Under One 3,393 40 3 3,436 One Year 4,776 66 3 1 1 4,847 Two Years 4,563 64 6 1 1 4,635 Three Years 1,879 33 2 1,914 Four Years 2,019 25 4 1 2,049 Five Years 1,297 20 1 1 1,319 Total 17,927 248 17 4 1 3 18,200 6-17 Years 1,761 20 4 2 1,787 Under One 1,859 16 2 1,877 One Year 3,707 44 3 1 1 3,756 Two Years 2,901 33 6 1 1 2,942 Three Years 1,509 21 2 1,532 Four Years 1,709 17 4 1 1,731 Five Years 1,087 15 1 1 1,104 Total 12,772 146 16 4 1 3 12,942 6-17 Years 1,528 13 4 2 1,547 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 17

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Prince George s County Criteria: The highest venous or highest capillary in the absence of venous test Under One 1,890 34 1 1,925 One Year 5,757 116 10 4 4 5,891 Two Years 4,592 100 5 5 4,702 Three Years 2,490 47 5 2 1 2 2,547 Four Years 2,709 34 5 1 2 2,751 Five Years 1,752 23 3 1,778 Total 19,190 354 29 12 3 6 19,594 6-17 Years 2,626 45 6 3 2,680 Under One 1,448 21 1,469 One Year 5,048 96 10 3 4 5,161 Two Years 3,976 82 5 5 4,068 Three Years 2,293 33 5 2 1 2 2,336 Four Years 2,491 25 5 1 2 2,524 Five Years 1,573 16 1 1,590 Total 16,829 273 26 11 3 6 17,148 6-17 Years 2,345 38 6 3 2,392 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 18

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Queen Anne s County Criteria: The highest venous or highest capillary in the absence of venous test Under One 37 1 1 39 One Year 231 4 1 1 237 Two Years 184 9 1 194 Three Years 54 2 56 Four Years 59 1 60 Five Years 21 21 Total 586 17 3 1 0 0 607 6-17 Years 44 1 45 Under One 26 1 27 One Year 182 4 1 1 188 Two Years 144 4 1 149 Three Years 45 45 Four Years 46 1 47 Five Years 17 17 Total 460 9 3 1 0 0 473 6-17 Years 35 1 36 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 19

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Saint Mary s County Criteria: The highest venous or highest capillary in the absence of venous test Under One 227 227 One Year 545 23 2 1 571 Two Years 474 21 1 496 Three Years 97 4 101 Four Years 79 79 Five Years 51 2 53 Total 1,473 50 3 1 0 0 1,527 6-17 Years 74 1 75 Under One 38 38 One Year 96 6 2 1 105 Two Years 109 6 1 116 Three Years 42 1 43 Four Years 47 47 Five Years 27 1 28 Total 359 14 3 1 0 0 377 6-17 Years 57 1 58 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 20

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Somerset County Criteria: The highest venous or highest capillary in the absence of venous test Under One 31 1 32 One Year 203 5 2 210 Two Years 155 6 161 Three Years 44 4 1 49 Four Years 29 1 1 31 Five Years 14 14 Total 476 17 4 0 0 0 497 6-17 Years 32 1 33 Under One 30 1 31 One Year 177 4 2 183 Two Years 136 3 139 Three Years 42 4 1 47 Four Years 28 1 29 Five Years 13 13 Total 426 12 4 0 0 0 442 6-17 Years 27 1 28 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 21

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Talbot County Criteria: The highest venous or highest capillary in the absence of venous test Under One 15 1 16 One Year 294 10 1 305 Two Years 233 9 2 1 245 Three Years 43 43 Four Years 35 35 Five Years 30 1 31 Total 650 21 3 0 0 1 675 6-17 Years 31 31 Under One 8 8 One Year 161 8 1 170 Two Years 107 6 2 1 116 Three Years 41 41 Four Years 28 28 Five Years 22 1 23 Total 367 15 3 0 0 1 386 6-17 Years 26 26 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 22

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Washington County Criteria: The highest venous or highest capillary in the absence of venous test Under One 67 17 84 One Year 936 121 2 1,059 Two Years 757 119 1 1 1 879 Three Years 286 37 1 324 Four Years 336 39 1 1 377 Five Years 253 29 1 283 Total 2,635 362 5 0 3 1 3,006 6-17 Years 149 7 156 Under One 50 11 61 One Year 710 90 1 801 Two Years 529 85 1 1 616 Three Years 274 35 1 310 Four Years 327 39 1 1 368 Five Years 246 28 1 275 Total 2,136 288 4 0 2 1 2,431 6-17 Years 145 7 152 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 23

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Wicomico County Criteria: The highest venous or highest capillary in the absence of venous test Under One 105 4 109 One Year 792 27 1 1 821 Two Years 703 35 2 1 741 Three Years 246 16 1 1 264 Four Years 177 8 1 1 187 Five Years 121 4 1 126 Total 2,144 94 6 2 0 2 2,248 6-17 Years 271 6 1 278 Under One 95 3 98 One Year 689 25 1 1 716 Two Years 603 33 2 1 639 Three Years 225 15 1 1 242 Four Years 170 8 1 1 180 Five Years 117 4 1 122 Total 1,899 88 6 2 0 2 1,997 6-17 Years 262 6 1 269 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 24

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Worcester County Criteria: The highest venous or highest capillary in the absence of venous test Under One 28 1 29 One Year 312 11 1 324 Two Years 288 8 1 297 Three Years 92 2 94 Four Years 60 2 62 Five Years 43 1 44 Total 823 25 2 0 0 0 850 6-17 Years 131 2 133 Under One 25 1 26 One Year 270 9 1 280 Two Years 251 7 1 259 Three Years 82 1 83 Four Years 55 2 57 Five Years 39 1 40 Total 722 21 2 0 0 0 745 6-17 Years 123 2 125 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 25

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence County Unknown Criteria: The highest venous or highest capillary in the absence of venous test Under One One Year 2 2 Two Years Three Years 3 3 Four Years Five Years Total 5 0 0 0 0 0 5 6-17 Years 1 1 Under One One Year 1 1 Two Years Three Years 2 2 Four Years Five Years Total 3 0 0 0 0 0 3 6-17 Years 1. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 2. Blood lead tests with sample type unknown were counted as capillary. 26

Blood Lead Test of Children 0-72 Months in increment of 5 µg/dl by Age and County of Residence Statewide Criteria: The highest venous or highest capillary in the absence of venous test Under One 11,360 301 13 1 3 11,678 One Year 34,503 1455 107 32 9 16 36,122 Two Years 27,698 1542 134 40 10 9 29,433 Three Years 11,140 594 41 15 6 8 11,804 Four Years 10,445 411 51 7 6 6 10,926 Five Years 7,134 280 28 8 3 7,453 Total 102,280 4583 374 103 34 42 107,416 6-17 Years 11,882 357 40 14 2 3 12,298 Under One 6,881 133 9 1 3 7,027 One Year 25,545 931 101 31 8 16 26,632 Two Years 19,486 972 127 40 9 9 20,643 Three Years 9,047 409 37 15 6 8 9,522 Four Years 8,705 284 46 7 6 6 9,054 Five Years 5,846 193 22 8 3 6,072 Total 75,510 2,922 342 102 32 42 78,950 6-17 Years 9,658 242 37 13 2 3 9,955 3. County assignment, in the order of available address information, is based on census tract or the zip code of the address. 4. Blood lead tests with sample type unknown were counted as capillary. 27

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland 2009 Annual Report Number and percentage of children with Blood Lead Level 5, 10, 15, 20, and 25 μg/dl By age, and county of residence Supplementary Data Tables: Supplement #2 August, 2010

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Allegany County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 26 2 7.7 2 7.7 2 7.7 1 3.8 0 0.0 One Year 599 39 6.5 4 0.7 2 0.3 0 0.0 0 0.0 Two Years 527 49 9.3 6 1.1 3 0.6 2 0.4 0 0.0 Three Years 79 8 10.1 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 85 5 5.9 1 1.2 0 0.0 0 0.0 0 0.0 Five Years 55 2 3.6 2 3.6 1 1.8 0 0.0 0 0.0 Total 1,371 105 7.7 15 1.1 8 0.6 3 0.2 0 0.0 6-17 Years 52 5 9.6 1 1.9 0 0.0 0 0.0 0 0.0 Under One 11 2 18.2 2 18.2 2 18.2 1 9.1 0 0.0 One Year 151 18 11.9 3 2.0 2 1.3 0 0.0 0 0.0 Two Years 155 22 14.2 6 3.9 3 1.9 2 1.3 0 0.0 Three Years 41 5 12.2 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 39 1 2.6 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 25 1 4.0 1 4.0 1 4.0 0 0.0 0 0.0 Total 422 49 11.6 12 2.8 8 1.9 3 0.7 0 0.0 6-17 Years 32 2 6.3 1 3.1 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 2

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Anne Arundel County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 642 12 1.9 0 0.0 0 0.0 0 0.0 0 0.0 One Year 3,007 50 1.7 4 0.1 0 0.0 0 0.0 0 0.0 Two Years 1,852 38 2.1 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 707 13 1.8 2 0.3 2 0.3 0 0.0 0 0.0 Four Years 624 13 2.1 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 501 10 2.0 1 0.2 1 0.2 0 0.0 0 0.0 Total 7,333 136 1.9 7 0.1 3 0.0 0 0.0 0 0.0 6-17 Years 590 10 1.7 2 0.3 1 0.2 0 0.0 0 0.0 Under One 388 1 0.3 0 0.0 0 0.0 0 0.0 0 0.0 One Year 2,422 31 1.3 4 0.2 0 0.0 0 0.0 0 0.0 Two Years 1,460 22 1.5 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 611 9 1.5 2 0.3 2 0.3 0 0.0 0 0.0 Four Years 528 7 1.3 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 420 8 1.9 1 0.2 1 0.2 0 0.0 0 0.0 Total 5,829 78 1.3 7 0.1 3 0.1 0 0.0 0 0.0 6-17 Years 478 6 1.3 2 0.4 1 0.2 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 3

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Baltimore County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 1,743 35 2.0 1 0.1 1 0.1 1 0.1 0 0.0 One Year 5,510 163 3.0 7 0.1 4 0.1 3 0.1 2 0.0 Two Years 5,108 180 3.5 11 0.2 5 0.1 1 0.0 1 0.0 Three Years 1,639 55 3.4 2 0.1 2 0.1 1 0.1 1 0.1 Four Years 1,252 33 2.6 4 0.3 1 0.1 1 0.1 1 0.1 Five Years 887 27 3.0 3 0.3 2 0.2 0 0.0 0 0.0 Total 16,139 493 3.1 28 0.2 15 0.1 7 0.0 5 0.0 6-17 Years 1,414 30 2.1 6 0.4 1 0.1 0 0.0 0 0.0 Under One 1,006 11 1.1 1 0.1 1 0.1 1 0.1 0 0.0 One Year 3,700 80 2.2 7 0.2 4 0.1 3 0.1 2 0.1 Two Years 3,277 93 2.8 11 0.3 5 0.2 1 0.0 1 0.0 Three Years 1,205 29 2.4 2 0.2 2 0.2 1 0.1 1 0.1 Four Years 954 20 2.1 4 0.4 1 0.1 1 0.1 1 0.1 Five Years 650 18 2.8 3 0.5 2 0.3 0 0.0 0 0.0 Total 10,792 251 2.3 28 0.3 15 0.1 7 0.1 5 0.0 6-17 Years 1,030 22 2.1 6 0.6 1 0.1 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 4

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Baltimore City Criteria: The highest venous or the highest capillary in the absence of venous test Under One 1,718 124 7.2 6 0.3 0 0.0 0 0.0 0 0.0 One Year 6,621 779 11.8 96 1.4 32 0.5 13 0.2 5 0.1 Two Years 5,525 892 16.1 133 2.4 37 0.7 12 0.2 5 0.1 Three Years 2,222 366 16.5 44 2.0 14 0.6 7 0.3 4 0.2 Four Years 1,775 267 15.0 44 2.5 11 0.6 5 0.3 4 0.2 Five Years 1,182 173 14.6 24 2.0 5 0.4 2 0.2 2 0.2 Total 19,043 2,601 13.7 347 1.8 99 0.5 39 0.2 20 0.1 6-17 Years 3,546 247 7.0 30 0.8 10 0.3 3 0.1 1 0.0 Under One 927 57 6.1 4 0.4 0 0.0 0 0.0 0 0.0 One Year 4,524 522 11.5 93 2.1 31 0.7 12 0.3 5 0.1 Two Years 3,782 621 16.4 127 3.4 37 1.0 12 0.3 5 0.1 Three Years 1,571 258 16.4 40 2.5 14 0.9 7 0.4 4 0.3 Four Years 1,290 184 14.3 40 3.1 11 0.9 5 0.4 4 0.3 Five Years 855 113 13.2 21 2.5 5 0.6 2 0.2 2 0.2 Total 12,949 1,755 13.6 325 2.5 98 0.8 38 0.3 20 0.2 6-17 Years 2,585 164 6.3 26 1.0 9 0.3 3 0.1 1 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 5

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Calvert County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 133 2 1.5 0 0.0 0 0.0 0 0.0 0 0.0 One Year 279 9 3.2 1 0.4 0 0.0 0 0.0 0 0.0 Two Years 134 5 3.7 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 72 2 2.8 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 52 2 3.8 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 28 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 698 20 2.9 1 0.1 0 0.0 0 0.0 0 0.0 6-17 Years 78 3 3.8 0 0.0 0 0.0 0 0.0 0 0.0 Under One 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 135 7 5.2 1 0.7 0 0.0 0 0.0 0 0.0 Two Years 70 3 4.3 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 45 2 4.4 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 37 1 2.7 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 346 13 3.8 1 0.3 0 0.0 0 0.0 0 0.0 6-17 Years 64 3 4.7 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 6

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Caroline County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 20 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 367 18 4.9 3 0.8 1 0.3 0 0.0 0 0.0 Two Years 310 28 9.0 3 1.0 1 0.3 0 0.0 0 0.0 Three Years 52 1 1.9 1 1.9 1 1.9 1 1.9 0 0.0 Four Years 65 3 4.6 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 25 3 12.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 839 54 6.4 7 0.8 3 0.4 1 0.1 0 0.0 6-17 Years 21 2 9.5 0 0.0 0 0.0 0 0.0 0 0.0 Under One 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 242 14 5.8 3 1.2 1 0.4 0 0.0 0 0.0 Two Years 210 23 11.0 3 1.4 1 0.5 0 0.0 0 0.0 Three Years 44 1 2.3 1 2.3 1 2.3 1 2.3 0 0.0 Four Years 53 3 5.7 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 17 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 Total 581 44 7.6 7 1.2 3 0.5 1 0.2 0 0.0 6-17 Years 16 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 7

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Carroll County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 140 9 6.4 0 0.0 0 0.0 0 0.0 0 0.0 One Year 543 22 4.1 3 0.6 2 0.4 1 0.2 1 0.2 Two Years 284 16 5.6 2 0.7 0 0.0 0 0.0 0 0.0 Three Years 132 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 132 3 2.3 1 0.8 1 0.8 1 0.8 0 0.0 Five Years 111 2 1.8 1 0.9 1 0.9 0 0.0 0 0.0 Total 1,342 52 3.9 7 0.5 4 0.3 2 0.1 1 0.1 6-17 Years 111 2 1.8 0 0.0 0 0.0 0 0.0 0 0.0 Under One 98 5 5.1 0 0.0 0 0.0 0 0.0 0 0.0 One Year 433 16 3.7 2 0.5 2 0.5 1 0.2 1 0.2 Two Years 213 11 5.2 2 0.9 0 0.0 0 0.0 0 0.0 Three Years 118 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 121 3 2.5 1 0.8 1 0.8 1 0.8 0 0.0 Five Years 96 2 2.1 1 1.0 1 1.0 0 0.0 0 0.0 Total 1,079 37 3.4 6 0.6 4 0.4 2 0.2 1 0.1 6-17 Years 96 1 1.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 8

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Cecil County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 114 4 3.5 0 0.0 0 0.0 0 0.0 0 0.0 One Year 475 17 3.6 1 0.2 0 0.0 0 0.0 0 0.0 Two Years 196 11 5.6 1 0.5 1 0.5 0 0.0 0 0.0 Three Years 168 6 3.6 1 0.6 0 0.0 0 0.0 0 0.0 Four Years 139 3 2.2 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 120 2 1.7 1 0.8 0 0.0 0 0.0 0 0.0 Total 1,212 43 3.5 4 0.3 1 0.1 0 0.0 0 0.0 6-17 Years 113 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 Under One 33 1 3.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 128 5 3.9 1 0.8 0 0.0 0 0.0 0 0.0 Two Years 46 2 4.3 1 2.2 1 2.2 0 0.0 0 0.0 Three Years 46 4 8.7 1 2.2 0 0.0 0 0.0 0 0.0 Four Years 30 1 3.3 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 43 2 4.7 1 2.3 0 0.0 0 0.0 0 0.0 Total 326 15 4.6 4 1.2 1 0.3 0 0.0 0 0.0 6-17 Years 25 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 9

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Charles County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 214 4 1.9 2 0.9 1 0.5 1 0.5 0 0.0 One Year 563 8 1.4 2 0.4 2 0.4 1 0.2 1 0.2 Two Years 547 8 1.5 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 237 3 1.3 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 166 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 109 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 1,836 24 1.3 4 0.2 3 0.2 2 0.1 1 0.1 6-17 Years 120 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Under One 149 3 2.0 2 1.3 1 0.7 1 0.7 0 0.0 One Year 518 8 1.5 2 0.4 2 0.4 1 0.2 1 0.2 Two Years 487 5 1.0 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 224 3 1.3 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 152 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 104 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 1,634 20 1.2 4 0.2 3 0.2 2 0.1 1 0.1 6-17 Years 106 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 10

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Dorchester County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 317 22 6.9 1 0.3 0 0.0 0 0.0 0 0.0 Two Years 239 15 6.3 1 0.4 0 0.0 0 0.0 0 0.0 Three Years 84 12 14.3 1 1.2 0 0.0 0 0.0 0 0.0 Four Years 38 1 2.6 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 31 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 730 50 6.8 3 0.4 0 0.0 0 0.0 0 0.0 6-17 Years 26 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Under One 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 204 17 8.3 1 0.5 0 0.0 0 0.0 0 0.0 Two Years 153 13 8.5 1 0.7 0 0.0 0 0.0 0 0.0 Three Years 79 12 15.2 1 1.3 0 0.0 0 0.0 0 0.0 Four Years 30 1 3.3 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 500 43 8.6 3 0.6 0 0.0 0 0.0 0 0.0 6-17 Years 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 11

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Frederick County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 149 2 1.3 1 0.7 0 0.0 0 0.0 0 0.0 One Year 1,411 27 1.9 5 0.4 1 0.1 1 0.1 1 0.1 Two Years 693 31 4.5 3 0.4 1 0.1 0 0.0 0 0.0 Three Years 357 9 2.5 1 0.3 1 0.3 1 0.3 1 0.3 Four Years 346 11 3.2 1 0.3 0 0.0 0 0.0 0 0.0 Five Years 225 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 3,181 80 2.5 11 0.3 3 0.1 2 0.1 2 0.1 6-17 Years 163 5 3.1 2 1.2 1 0.6 1 0.6 1 0.6 Under One 122 2 1.6 1 0.8 0 0.0 0 0.0 0 0.0 One Year 1,164 22 1.9 4 0.3 1 0.1 1 0.1 1 0.1 Two Years 562 25 4.4 3 0.5 1 0.2 0 0.0 0 0.0 Three Years 304 8 2.6 1 0.3 1 0.3 1 0.3 1 0.3 Four Years 298 10 3.4 1 0.3 0 0.0 0 0.0 0 0.0 Five Years 192 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 2,642 67 2.5 10 0.4 3 0.1 2 0.1 2 0.1 6-17 Years 135 5 3.7 2 1.5 1 0.7 1 0.7 1 0.7 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 12

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Garrett County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 144 8 5.6 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 166 12 7.2 1 0.6 0 0.0 0 0.0 0 0.0 Three Years 52 8 15.4 1 1.9 0 0.0 0 0.0 0 0.0 Four Years 53 1 1.9 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 42 2 4.8 0 0.0 0 0.0 0 0.0 0 0.0 Total 473 31 6.6 2 0.4 0 0.0 0 0.0 0 0.0 6-17 Years 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Under One 5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 53 3 5.7 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 61 3 4.9 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 32 5 15.6 1 3.1 0 0.0 0 0.0 0 0.0 Four Years 39 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 214 11 5.1 1 0.5 0 0.0 0 0.0 0 0.0 6-17 Years 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 13

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Harford County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 524 15 2.9 0 0.0 0 0.0 0 0.0 0 0.0 One Year 1,010 24 2.4 1 0.1 0 0.0 0 0.0 0 0.0 Two Years 800 32 4.0 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 287 11 3.8 1 0.3 0 0.0 0 0.0 0 0.0 Four Years 303 2 0.7 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 260 4 1.5 0 0.0 0 0.0 0 0.0 0 0.0 Total 3,184 88 2.8 2 0.1 0 0.0 0 0.0 0 0.0 6-17 Years 281 5 1.8 0 0.0 0 0.0 0 0.0 0 0.0 Under One 343 7 2.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 769 15 2.0 1 0.1 0 0.0 0 0.0 0 0.0 Two Years 537 10 1.9 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 227 6 2.6 1 0.4 0 0.0 0 0.0 0 0.0 Four Years 240 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 204 2 1.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 2,320 41 1.8 2 0.1 0 0.0 0 0.0 0 0.0 6-17 Years 226 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 14

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Howard County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 289 4 1.4 0 0.0 0 0.0 0 0.0 0 0.0 One Year 867 12 1.4 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 609 10 1.6 1 0.2 0 0.0 0 0.0 0 0.0 Three Years 296 7 2.4 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 244 7 2.9 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 198 6 3.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 2,503 46 1.8 1 0.0 0 0.0 0 0.0 0 0.0 6-17 Years 528 7 1.3 0 0.0 0 0.0 0 0.0 0 0.0 Under One 222 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 One Year 732 8 1.1 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 514 9 1.8 1 0.2 0 0.0 0 0.0 0 0.0 Three Years 273 6 2.2 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 217 5 2.3 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 180 5 2.8 0 0.0 0 0.0 0 0.0 0 0.0 Total 2,138 34 1.6 1 0.0 0 0.0 0 0.0 0 0.0 6-17 Years 485 6 1.2 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 15

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Kent County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 142 2 1.4 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 93 7 7.5 1 1.1 0 0.0 0 0.0 0 0.0 Three Years 25 2 8.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 21 1 4.8 1 4.8 0 0.0 0 0.0 0 0.0 Five Years 10 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 323 13 4.0 2 0.6 0 0.0 0 0.0 0 0.0 6-17 Years 6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Under One 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 96 1 1.0 0 0.0 0 0.0 0 0.0 0 0.0 Two Years 72 7 9.7 1 1.4 0 0.0 0 0.0 0 0.0 Three Years 21 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 15 1 6.7 1 6.7 0 0.0 0 0.0 0 0.0 Five Years 9 1 11.1 0 0.0 0 0.0 0 0.0 0 0.0 Total 234 11 4.7 2 0.9 0 0.0 0 0.0 0 0.0 6-17 Years 4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 16

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Montgomery County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 3,436 43 1.3 3 0.1 0 0.0 0 0.0 0 0.0 One Year 4,847 71 1.5 5 0.1 2 0.0 1 0.0 1 0.0 Two Years 4,635 72 1.6 8 0.2 2 0.0 1 0.0 1 0.0 Three Years 1,914 35 1.8 2 0.1 2 0.1 0 0.0 0 0.0 Four Years 2,049 30 1.5 5 0.2 1 0.0 1 0.0 0 0.0 Five Years 1,319 22 1.7 2 0.2 1 0.1 1 0.1 1 0.1 Total 18,200 273 1.5 25 0.1 8 0.0 4 0.0 3 0.0 6-17 Years 1,787 26 1.5 6 0.3 2 0.1 0 0.0 0 0.0 Under One 1,877 18 1.0 2 0.1 0 0.0 0 0.0 0 0.0 One Year 3,756 49 1.3 5 0.1 2 0.1 1 0.0 1 0.0 Two Years 2,942 41 1.4 8 0.3 2 0.1 1 0.0 1 0.0 Three Years 1,532 23 1.5 2 0.1 2 0.1 0 0.0 0 0.0 Four Years 1,731 22 1.3 5 0.3 1 0.1 1 0.1 0 0.0 Five Years 1,104 17 1.5 2 0.2 1 0.1 1 0.1 1 0.1 Total 12,942 170 1.3 24 0.2 8 0.1 4 0.0 3 0.0 6-17 Years 1,547 19 1.2 6 0.4 2 0.1 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 17

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Prince George s County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 1,925 35 1.8 1 0.1 0 0.0 0 0.0 0 0.0 One Year 5,891 134 2.3 18 0.3 8 0.1 4 0.1 4 0.1 Two Years 4,702 110 2.3 10 0.2 5 0.1 0 0.0 0 0.0 Three Years 2,547 57 2.2 10 0.4 5 0.2 3 0.1 2 0.1 Four Years 2,751 42 1.5 8 0.3 3 0.1 2 0.1 0 0.0 Five Years 1,778 26 1.5 3 0.2 0 0.0 0 0.0 0 0.0 Total 19,594 404 2.1 50 0.3 21 0.1 9 0.0 6 0.0 6-17 Years 2,680 54 2.0 9 0.3 3 0.1 0 0.0 0 0.0 Under One 1,469 21 1.4 0 0.0 0 0.0 0 0.0 0 0.0 One Year 5,161 113 2.2 17 0.3 7 0.1 4 0.1 4 0.1 Two Years 4,068 92 2.3 10 0.2 5 0.1 0 0.0 0 0.0 Three Years 2,336 43 1.8 10 0.4 5 0.2 3 0.1 2 0.1 Four Years 2,524 33 1.3 8 0.3 3 0.1 2 0.1 0 0.0 Five Years 1,590 17 1.1 1 0.1 0 0.0 0 0.0 0 0.0 Total 17,148 319 1.9 46 0.3 20 0.1 9 0.1 6 0.0 6-17 Years 2,392 47 2.0 9 0.4 3 0.1 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 18

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Queen Anne s County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 39 2 5.1 1 2.6 0 0.0 0 0.0 0 0.0 One Year 237 6 2.5 2 0.8 1 0.4 0 0.0 0 0.0 Two Years 194 10 5.2 1 0.5 0 0.0 0 0.0 0 0.0 Three Years 56 2 3.6 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 60 1 1.7 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 607 21 3.5 4 0.7 1 0.2 0 0.0 0 0.0 6-17 Years 45 1 2.2 0 0.0 0 0.0 0 0.0 0 0.0 Under One 27 1 3.7 1 3.7 0 0.0 0 0.0 0 0.0 One Year 188 6 3.2 2 1.1 1 0.5 0 0.0 0 0.0 Two Years 149 5 3.4 1 0.7 0 0.0 0 0.0 0 0.0 Three Years 45 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 47 1 2.1 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 473 13 2.7 4 0.8 1 0.2 0 0.0 0 0.0 6-17 Years 36 1 2.8 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 19

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Saint Mary s County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 227 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 571 26 4.6 3 0.5 1 0.2 0 0.0 0 0.0 Two Years 496 22 4.4 1 0.2 0 0.0 0 0.0 0 0.0 Three Years 101 4 4.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 79 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 53 2 3.8 0 0.0 0 0.0 0 0.0 0 0.0 Total 1,527 54 3.5 4 0.3 1 0.1 0 0.0 0 0.0 6-17 Years 75 1 1.3 1 1.3 1 1.3 1 1.3 1 1.3 Under One 38 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 105 9 8.6 3 2.9 1 1.0 0 0.0 0 0.0 Two Years 116 7 6.0 1 0.9 0 0.0 0 0.0 0 0.0 Three Years 43 1 2.3 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 47 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 28 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 Total 377 18 4.8 4 1.1 1 0.3 0 0.0 0 0.0 6-17 Years 58 1 1.7 1 1.7 1 1.7 1 1.7 1 1.7 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 20

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Somerset County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 32 1 3.1 0 0.0 0 0.0 0 0.0 0 0.0 One Year 210 7 3.3 2 1.0 0 0.0 0 0.0 0 0.0 Two Years 161 6 3.7 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 49 5 10.2 1 2.0 0 0.0 0 0.0 0 0.0 Four Years 31 2 6.5 1 3.2 0 0.0 0 0.0 0 0.0 Five Years 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 497 21 4.2 4 0.8 0 0.0 0 0.0 0 0.0 6-17 Years 33 1 3.0 1 3.0 0 0.0 0 0.0 0 0.0 Under One 31 1 3.2 0 0.0 0 0.0 0 0.0 0 0.0 One Year 183 6 3.3 2 1.1 0 0.0 0 0.0 0 0.0 Two Years 139 3 2.2 0 0.0 0 0.0 0 0.0 0 0.0 Three Years 47 5 10.6 1 2.1 0 0.0 0 0.0 0 0.0 Four Years 29 1 3.4 1 3.4 0 0.0 0 0.0 0 0.0 Five Years 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Total 442 16 3.6 4 0.9 0 0.0 0 0.0 0 0.0 6-17 Years 28 1 3.6 1 3.6 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 21

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Talbot County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 16 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 One Year 305 11 3.6 1 0.3 0 0.0 0 0.0 0 0.0 Two Years 245 12 4.9 3 1.2 1 0.4 1 0.4 1 0.4 Three Years 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 31 1 3.2 0 0.0 0 0.0 0 0.0 0 0.0 Total 675 25 3.7 4 0.6 1 0.1 1 0.1 1 0.1 6-17 Years 31 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Under One 8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 170 9 5.3 1 0.6 0 0.0 0 0.0 0 0.0 Two Years 116 9 7.8 3 2.6 1 0.9 1 0.9 1 0.9 Three Years 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 28 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 23 1 4.3 0 0.0 0 0.0 0 0.0 0 0.0 Total 386 19 4.9 4 1.0 1 0.3 1 0.3 1 0.3 6-17 Years 26 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 22

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Washington County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 84 17 20.2 0 0.0 0 0.0 0 0.0 0 0.0 One Year 1,059 123 11.6 2 0.2 0 0.0 0 0.0 0 0.0 Two Years 879 122 13.9 3 0.3 2 0.2 2 0.2 1 0.1 Three Years 324 38 11.7 1 0.3 1 0.3 1 0.3 0 0.0 Four Years 377 41 10.9 2 0.5 1 0.3 1 0.3 0 0.0 Five Years 283 30 10.6 1 0.4 0 0.0 0 0.0 0 0.0 Total 3,006 371 12.3 9 0.3 4 0.1 4 0.1 1 0.0 6-17 Years 156 7 4.5 0 0.0 0 0.0 0 0.0 0 0.0 Under One 61 11 18.0 0 0.0 0 0.0 0 0.0 0 0.0 One Year 801 91 11.4 1 0.1 0 0.0 0 0.0 0 0.0 Two Years 616 87 14.1 2 0.3 1 0.2 1 0.2 1 0.2 Three Years 310 36 11.6 1 0.3 1 0.3 1 0.3 0 0.0 Four Years 368 41 11.1 2 0.5 1 0.3 1 0.3 0 0.0 Five Years 275 29 10.5 1 0.4 0 0.0 0 0.0 0 0.0 Total 2,431 295 12.1 7 0.3 3 0.1 3 0.1 1 0.0 6-17 Years 152 7 4.6 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 23

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Wicomico County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 109 4 3.7 0 0.0 0 0.0 0 0.0 0 0.0 One Year 821 29 3.5 2 0.2 1 0.1 1 0.1 1 0.1 Two Years 741 38 5.1 3 0.4 1 0.1 0 0.0 0 0.0 Three Years 264 18 6.8 2 0.8 1 0.4 0 0.0 0 0.0 Four Years 187 10 5.3 2 1.1 1 0.5 1 0.5 1 0.5 Five Years 126 5 4.0 1 0.8 0 0.0 0 0.0 0 0.0 Total 2,248 104 4.6 10 0.4 4 0.2 2 0.1 2 0.1 6-17 Years 278 7 2.5 1 0.4 0 0.0 0 0.0 0 0.0 Under One 98 3 3.1 0 0.0 0 0.0 0 0.0 0 0.0 One Year 716 27 3.8 2 0.3 1 0.1 1 0.1 1 0.1 Two Years 639 36 5.6 3 0.5 1 0.2 0 0.0 0 0.0 Three Years 242 17 7.0 2 0.8 1 0.4 0 0.0 0 0.0 Four Years 180 10 5.6 2 1.1 1 0.6 1 0.6 1 0.6 Five Years 122 5 4.1 1 0.8 0 0.0 0 0.0 0 0.0 Total 1,997 98 4.9 10 0.5 4 0.2 2 0.1 2 0.1 6-17 Years 269 7 2.6 1 0.4 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 24

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Worcester County Criteria: The highest venous or the highest capillary in the absence of venous test Under One 29 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 One Year 324 12 3.7 1 0.3 0 0.0 0 0.0 0 0.0 Two Years 297 9 3.0 1 0.3 0 0.0 0 0.0 0 0.0 Three Years 94 2 2.1 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 62 2 3.2 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 44 1 2.3 0 0.0 0 0.0 0 0.0 0 0.0 Total 850 27 3.2 2 0.2 0 0.0 0 0.0 0 0.0 6-17 Years 133 2 1.5 0 0.0 0 0.0 0 0.0 0 0.0 Under One 26 1 3.8 0 0.0 0 0.0 0 0.0 0 0.0 One Year 280 10 3.6 1 0.4 0 0.0 0 0.0 0 0.0 Two Years 259 8 3.1 1 0.4 0 0.0 0 0.0 0 0.0 Three Years 83 1 1.2 0 0.0 0 0.0 0 0.0 0 0.0 Four Years 57 2 3.5 0 0.0 0 0.0 0 0.0 0 0.0 Five Years 40 1 2.5 0 0.0 0 0.0 0 0.0 0 0.0 Total 745 23 3.1 2 0.3 0 0.0 0 0.0 0 0.0 6-17 Years 125 2 1.6 0 0.0 0 0.0 0 0.0 0 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 25

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence County Unkown Criteria: The highest venous or the highest capillary in the absence of venous test Under One One Year 2 Two Years Three Years 3 Four Years Five Years Total 5 6-17 Years 1 Under One One Year 1 Two Years Three Years 2 Four Years Five Years Total 3 6-17 Years 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 26

Number and percent of children 0-72 months with blood lead level at or above specific level (µg/dl) By age and county of residence Statewide Criteria: The highest venous or the highest capillary in the absence of venous test Under One 11,678 318 2.7 17 0.1 4 0.0 3 0.0 0 0.0 One Year 36,122 1,619 4.5 164 0.5 57 0.2 25 0.1 16 0.0 Two Years 29,433 1,735 5.9 193 0.7 59 0.2 19 0.1 9 0.0 Three Years 11,804 664 5.6 70 0.6 29 0.2 14 0.1 8 0.1 Four Years 10,926 481 4.4 70 0.6 19 0.2 12 0.1 6 0.1 Five Years 7,453 319 4.3 39 0.5 11 0.1 3 0.0 3 0.0 Total 107,416 5,136 4.8 553 0.5 179 0.2 76 0.1 42 0.0 6-17 Years 12,298 416 3.4 59 0.5 19 0.2 5 0.0 3 0.0 Under One 7,027 146 2.1 13 0.2 4 0.1 3 0.0 0 0.0 One Year 26,632 1,087 4.1 156 0.6 55 0.2 24 0.1 16 0.1 Two Years 20,643 1,157 5.6 185 0.9 58 0.3 18 0.1 9 0.0 Three Years 9,522 475 5.0 66 0.7 29 0.3 14 0.1 8 0.1 Four Years 9,054 349 3.9 65 0.7 19 0.2 12 0.1 6 0.1 Five Years 6,072 226 3.7 33 0.5 11 0.2 3 0.0 3 0.0 Total 78,950 3,440 4.4 518 0.7 176 0.2 74 0.1 42 0.1 6-17 Years 9,955 297 3.0 55 0.6 18 0.2 5 0.1 3 0.0 1. County assignment, in the order of available address information, is based on census tract or zip code of the address 2. Blood tests with sample type unknown were counted as capillary 27

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland Annual Report 2009 Number and percentage of prevalence and incidence cases by age and county of residence Supplementary Data Tables: Supplement #3 August, 2010

Number and percentage of prevalence and incidence cases by age and county of residence Allegany County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 868 26 3.0 2 7.7 2 7.7 One Year 782 599 76.6 4 0.7 4 0.7 Two Years 918 527 57.4 6 1.1 5 0.9 Three Years 888 79 8.9 0 0.0 0 0.0 Four Years 788 85 10.8 1 1.2 1 1.2 Five Years 764 55 7.2 2 3.6 1 1.8 Total 5,007 1,371 27.4 15 1.1 13 0.9 6-17 Years 10,842 52 0.5 1 1.9 Anne Arundel County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 7,609 642 8.4 0 0.0 0 0.0 One Year 7,959 3,007 37.8 4 0.1 3 0.1 Two Years 7,231 1,852 25.6 0 0.0 0 0.0 Three Years 7,347 707 9.6 2 0.3 1 0.1 Four Years 7,157 624 8.7 0 0.0 0 0.0 Five Years 7,168 501 7.0 1 0.2 1 0.2 Total 44,471 7,333 16.5 7 0.1 5 0.1 6-17 Years 82,741 590 0.7 2 0.3 Baltimore County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 9,829 1,743 17.7 1 0.1 1 0.1 One Year 10,405 5,510 53.0 7 0.1 7 0.1 Two Years 9,980 5,108 51.2 11 0.2 8 0.2 Three Years 10,470 1,639 15.7 2 0.1 1 0.1 Four Years 10,352 1,252 12.1 4 0.3 2 0.2 Five Years 10,018 887 8.9 3 0.3 2 0.2 Total 61,053 16,139 26.4 28 0.2 21 0.1 6-17 Years 122,658 1,414 1.2 6 0.4 Refer to page 10 for terms and definitions. 2

Number and percentage of prevalence and incidence cases by age and county of residence Baltimore City Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 10,618 1,718 16.2 6 0.3 6 0.3 One Year 9,779 6,621 67.7 96 1.4 85 1.3 Two Years 8,978 5,525 61.5 133 2.4 91 1.6 Three Years 9,131 2,222 24.3 44 2.0 12 0.5 Four Years 9,229 1,775 19.2 44 2.5 12 0.7 Five Years 8,696 1,182 13.6 24 2.0 8 0.7 Total 56,431 19,043 33.7 347 1.8 214 1.1 6-17 Years 109,778 3,546 3.2 30 0.8 Calvert County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 1,043 133 12.7 0 0.0 0 0.0 One Year 1,191 279 23.4 1 0.4 1 0.4 Two Years 1,100 134 12.2 0 0.0 0 0.0 Three Years 1,141 72 6.3 0 0.0 0 0.0 Four Years 1,192 52 4.4 0 0.0 0 0.0 Five Years 1,253 28 2.2 0 0.0 0 0.0 Total 6,920 698 10.1 1 0.1 1 0.1 6-17 Years 15,721 78 0.5 0.0 Caroline County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 369 20 5.4 0 0.0 0 0.0 One Year 393 367 93.4 3 0.8 3 0.8 Two Years 474 310 65.4 3 1.0 2 0.6 Three Years 464 52 11.2 1 1.9 0 0.0 Four Years 396 65 16.4 0 0.0 0 0.0 Five Years 420 25 5.9 0 0.0 0 0.0 Total 2,516 839 33.3 7 0.8 5 0.6 6-17 Years 5,691 21 0.4 0 0.0 Refer to page 10 for terms and definitions. 3

Number and percentage of prevalence and incidence cases by age and county of residence Carroll County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 2,018 140 6.9 0 0.0 0 0.0 One Year 2,347 543 23.1 3 0.6 3 0.6 Two Years 2,435 284 11.7 2 0.7 2 0.7 Three Years 2,321 132 5.7 0 0.0 0 0.0 Four Years 2,409 132 5.5 1 0.8 1 0.8 Five Years 2,458 111 4.5 1 0.9 0 0.0 Total 13,988 1,342 9.6 7 0.5 6 0.4 6-17 Years 28,970 111 0.4 0.0 Cecil County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 1,243 114 9.2 0 0.0 0 0.0 One Year 1,470 475 32.3 1 0.2 1 0.2 Two Years 1,460 196 13.4 1 0.5 1 0.5 Three Years 1,027 168 16.4 1 0.6 0 0.0 Four Years 1,538 139 9.0 0 0.0 0 0.0 Five Years 1,292 120 9.3 1 0.8 0 0.0 Total 8,030 1,212 15.1 4 0.3 2 0.2 6-17 Years 16,459 1,325 8.1 4 0.3 Charles County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 2,057 214 10.4 2 0.9 2 0.9 One Year 1,690 563 33.3 2 0.4 2 0.4 Two Years 1,980 547 27.6 0 0.0 0 0.0 Three Years 2,148 237 11.0 0 0.0 0 0.0 Four Years 1,971 166 8.4 0 0.0 0 0.0 Five Years 2,255 109 4.8 0 0.0 0 0.0 Total 12,101 1,836 15.2 4 0.2 4 0.2 6-17 Years 23,604 120 0.5 0 0.0 Refer to page 10 for terms and definitions. 4

Number and percentage of prevalence and incidence cases by age and county of residence Dorchester County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 402 21 5.2 0 0.0 0 0.0 One Year 404 317 78.4 1 0.3 1 0.3 Two Years 344 239 69.4 1 0.4 0 0.0 Three Years 402 84 20.9 1 1.2 1 1.2 Four Years 353 38 10.8 0 0.0 0 0.0 Five Years 381 31 8.1 0 0.0 0 0.0 Total 2,287 730 31.9 3 0.4 2 0.3 6-17 Years 5,071 26 0.5 0 0.0 Frederick County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 3,557 149 4.2 1 0.7 1 0.7 One Year 3,057 1,411 46.2 5 0.4 4 0.3 Two Years 3,142 693 22.1 3 0.4 2 0.3 Three Years 3,454 357 10.3 1 0.3 0 0.0 Four Years 2,853 346 12.1 1 0.3 0 0.0 Five Years 3,286 225 6.8 0 0.0 0 0.0 Total 19,349 3,181 16.4 11 0.3 7 0.2 6-17 Years 36,176 163 0.5 2 1.2 Garrett County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 519 16 3.1 0 0.0 0 0.0 One Year 368 144 39.1 0 0.0 0 0.0 Two Years 447 166 37.1 1 0.6 1 0.6 Three Years 359 52 14.5 1 1.9 1 1.9 Four Years 384 53 13.8 0 0.0 0 0.0 Five Years 412 42 10.2 0 0.0 0 0.0 Total 2,490 473 19.0 2 0.4 2 0.4 6-17 Years 5,263 30 0.6 0 0.0 Refer to page 10 for terms and definitions. 5

Number and percentage of prevalence and incidence cases by age and county of residence Harford County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 3,499 524 15.0 0 0.0 0 0.0 One Year 3,760 1,010 26.9 1 0.1 1 0.1 Two Years 3,600 800 22.2 0 0.0 0 0.0 Three Years 3,499 287 8.2 1 0.3 1 0.3 Four Years 3,464 303 8.7 0 0.0 0 0.0 Five Years 3,357 260 7.7 0 0.0 0 0.0 Total 21,180 3,184 15.0 2 0.1 2 0.1 6-17 Years 41,444 281 0.7 0 0.0 Howard County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 4,171 289 6.9 0 0.0 0 0.0 One Year 4,064 867 21.3 0 0.0 0 0.0 Two Years 4,244 609 14.4 1 0.2 1 0.2 Three Years 4,337 296 6.8 0 0.0 0 0.0 Four Years 3,786 244 6.4 0 0.0 0 0.0 Five Years 4,388 198 4.5 0 0.0 0 0.0 Total 24,990 2,503 10.0 1 0.0 1 0.0 6-17 Years 46,519 528 1.1 0 0.0 Kent County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 209 32 15.3 0 0.0 0 0.0 One Year 245 142 57.9 0 0.0 0 0.0 Two Years 202 93 46.0 1 1.1 0 0.0 Three Years 159 25 15.8 0 0.0 0 0.0 Four Years 190 21 11.1 1 4.8 0 0.0 Five Years 248 10 4.0 0 0.0 0 0.0 Total 1,253 323 25.8 2 0.6 0 0.0 6-17 Years 2,861 6 0.2 0 0.0 Refer to page 10 for terms and definitions. 6

Number and percentage of prevalence and incidence cases by age and county of residence Montgomery County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 14,047 3,436 24.5 3 0.1 3 0.1 One Year 13,585 4,847 35.7 5 0.1 5 0.1 Two Years 14,052 4,635 33.0 8 0.2 7 0.2 Three Years 12,807 1,914 14.9 2 0.1 1 0.1 Four Years 13,823 2,049 14.8 5 0.2 3 0.1 Five Years 12,637 1,319 10.4 2 0.2 1 0.1 Total 80,950 18,200 22.5 25 0.1 20 0.1 6-17 Years 146,886 1,787 1.2 6 0.3 Prince George s County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 13,637 1,925 14.1 1 0.1 1 0.1 One Year 13,448 5,891 43.8 18 0.3 16 0.3 Two Years 12,909 4,702 36.4 10 0.2 10 0.2 Three Years 12,850 2,547 19.8 10 0.4 8 0.3 Four Years 12,948 2,751 21.2 8 0.3 7 0.3 Five Years 12,486 1,778 14.2 3 0.2 3 0.2 Total 78,279 19,594 25.0 50 0.3 45 0.2 6-17 Years 143,194 2,680 1.9 9 0.3 Queen Anne s County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 618 39 6.3 1 2.6 1 2.6 One Year 605 237 39.2 2 0.8 2 0.8 Two Years 619 194 31.3 1 0.5 1 0.5 Three Years 704 56 8.0 0 0.0 0 0.0 Four Years 411 60 14.6 0 0.0 0 0.0 Five Years 658 21 3.2 0 0.0 0 0.0 Total 3,614 607 16.8 4 0.7 4 0.7 6-17 Years 6,955 45 0.6 0 0.0 Refer to page 10 for terms and definitions. 7

Number and percentage of prevalence and incidence cases by age and county of residence Saint Mary s County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 1,444 227 15.7 0 0.0 0 0.0 One Year 1,428 571 40.0 3 0.5 2 0.4 Two Years 1,383 496 35.9 1 0.2 1 0.2 Three Years 1,527 101 6.6 0 0.0 0 0.0 Four Years 1,315 79 6.0 0 0.0 0 0.0 Five Years 1,520 53 3.5 0 0.0 0 0.0 Total 8,618 1,527 17.7 4 0.3 3 0.2 6-17 Years 16,224 75 0.5 1 1.3 Somerset County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 288 32 11.1 0 0.0 0 0.0 One Year 195 210 * 2 1.0 2 1.0 Two Years 283 161 56.9 0 0.0 0 0.0 Three Years 266 49 18.4 1 2.0 0 0.0 Four Years 287 31 10.8 1 3.2 1 3.2 Five Years 213 14 6.6 0 0.0 0 0.0 Total 1,533 497 32.4 4 0.8 3 0.6 6-17 Years 3,185 33 1.0 1 3.0 Talbot County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 331 16 4.8 0 0.0 0 0.0 One Year 381 305 80.0 1 0.3 1 0.3 Two Years 462 245 53.1 3 1.2 2 0.8 Three Years 440 43 9.8 0 0.0 0 0.0 Four Years 377 35 9.3 0 0.0 0 0.0 Five Years 427 31 7.3 0 0.0 0 0.0 Total 2,417 675 27.9 4 0.6 3 0.4 6-17 Years 5,086 31 0.6 0 0.0 Refer to page 10 for terms and definitions. 8

Number and percentage of prevalence and incidence cases by age and county of residence Washington County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 1,916 84 4.4 0 0.0 0 0.0 One Year 1,729 1,059 61.2 2 0.2 2 0.2 Two Years 2,050 879 42.9 3 0.3 3 0.3 Three Years 1,740 324 18.6 1 0.3 1 0.3 Four Years 1,864 377 20.2 2 0.5 2 0.5 Five Years 1,908 283 14.8 1 0.4 1 0.4 Total 11,207 3,006 26.8 9 0.3 9 0.3 6-17 Years 20,763 156 0.8 0 0.0 Wicomico County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 1,278 109 8.5 0 0.0 0 0.0 One Year 1,233 821 66.6 2 0.2 2 0.2 Two Years 1,193 741 62.1 3 0.4 3 0.4 Three Years 1,309 264 20.2 2 0.8 0 0.0 Four Years 939 187 19.9 2 1.1 1 0.5 Five Years 1,105 126 11.4 1 0.8 0 0.0 Total 7,058 2,248 31.9 10 0.4 6 0.3 6-17 Years 14,553 278 1.9 1 0.4 Worcester County Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 554 29 5.2 0 0.0 0 0.0 One Year 518 324 62.5 1 0.3 0 0.0 Two Years 612 297 48.5 1 0.3 1 0.3 Three Years 469 94 20.0 0 0.0 0 0.0 Four Years 459 62 13.5 0 0.0 0 0.0 Five Years 564 44 7.8 0 0.0 0 0.0 Total 3,177 850 26.8 2 0.2 1 0.1 6-17 Years 6,676 133 2.0 0 0.0 Refer to page 10 for terms and definitions. 9

Number and percentage of prevalence and incidence cases by age and county of residence County Unknown Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 0 0 One Year 2 0 Two Years 0 0 Three Years 3 0 Four Years 0 0 Five Years 0 0 Total 5 0 6-17 Years 1 0 Statewide Population of Children Tested Prevalence Cases Incidence Cases Age Group Children Number Percent Number Percent Number Percent Under One 82,123 11,678 14.2 17 0.1 17 0.1 One Year 81,038 36,122 44.6 164 0.5 147 0.4 Two Years 80,099 29,433 36.7 193 0.7 141 0.5 Three Years 79,260 11,804 14.9 70 0.6 27 0.2 Four Years 78,484 10,926 13.9 70 0.6 30 0.3 Five Years 77,915 7,453 9.6 39 0.5 17 0.2 Total 478,919 107,416 22.4 553 0.5 379 0.4 6-17 Years 917,318 12,298 1.3 59 0.5 Terms and definitions: 1. County assignment in the order of available address information is based on census tract or zip code of the address. 2. Population of children has been adapted from US Census Bureau age-sex population projection at the state level for 2009. Because of inherent problems with projection, the projected population may not correspond to the number of children tested. In such cases, the percentages are removed and replaced with an *. 3. Prevalence is based on the number of children with blood lead level 10 μg/dl who may have had one or more EBL in the past. 4. Incidence is based on the number of children with the first blood lead level 10 μg/dl in 2009. Incidence data is not calculated for children 6-17 years old. 10

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland Annual Report 2009 Number and percentage of children tested for lead (2001-2009), with Elevated Blood Lead (EBL), and Lead Poisoning (2001-2004), with Prevalence and Incidence Cases (2005-2009) by county of residence Supplementary Data Tables: Supplement # 4 August, 2010

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2010 Allegany County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 4,529 1,025 22.6 32 3.1 4 0.4 2002 4,618 1,183 25.6 29 2.5 2 0.2 2003 4,234 1,315 31.1 30 2.3 5 0.4 2004 4,747 1,329 28.0 24 1.8 3 0.2 Prevalence Cases Incidence Cases 2005 4,821 1,037 21.5 32 3.1 25 2.4 2006 4,904 1,172 23.9 22 1.9 17 1.5 2007 4,957 1,231 24.8 12 1.0 11 0.9 2008 4,966 1,323 26.6 11 0.8 8 0.6 2009 5,007 1,371 27.4 15 1.1 13 0.9 Anne Arundel County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 39,998 5,221 13.1 40 0.8 3 0.1 2002 40,257 5,944 14.8 30 0.5 4 0.1 2003 40,844 5,029 12.3 20 0.4 1 0.0 2004 41,895 6,806 16.2 27 0.4 6 0.1 Prevalence Cases Incidence Cases 2005 42,575 6,631 15.6 20 0.3 18 0.3 2006 43,306 6,422 14.8 20 0.3 16 0.2 2007 43,779 6,615 15.1 19 0.3 16 0.2 2008 44,090 6,817 15.5 7 0.1 6 0.1 2009 44,471 7,333 16.5 7 0.1 5 0.1 Baltimore County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 54,630 7,090 13.0 99 1.4 6 0.1 2002 55,444 10,499 18.9 148 1.4 12 0.1 2003 54,933 10,427 19.0 120 1.2 18 0.2 2004 57,205 14,947 26.1 108 0.7 10 0.1 Prevalence Cases Incidence Cases 2005 58,150 14,505 24.9 110 0.8 84 0.6 2006 59,148 15,344 25.9 85 0.6 69 0.4 2007 59,794 16,255 27.2 62 0.4 52 0.3 2008 60,547 15,837 26.2 36 0.2 31 0.2 2009 61,053 16,139 26.4 28 0.2 21 0.1 2

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Baltimore City Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 50,380 21,231 42.1 2,027 9.5 230 1.1 2002 52,744 16,595 31.5 1,558 9.4 183 1.1 2003 51,892 18,242 35.2 1,166 6.4 160 0.9 2004 52,796 18,970 35.9 1,183 6.2 147 0.8 Prevalence Cases Incidence Cases 2005 53,626 17,943 33.5 854 4.8 534 3.0 2006 54,547 18,363 33.7 843 4.6 573 3.1 2007 55,142 17,670 32.0 624 3.5 435 2.5 2008 55,959 18,623 33.3 468 2.5 302 1.6 2009 56,431 19,043 33.7 347 1.8 214 1.1 Calvert County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 6,222 785 12.6 8 1.0 1 0.1 2002 6,252 899 14.4 8 0.9 2 0.2 2003 6,209 682 11.0 2 0.3 0 0.0 2004 6,504 838 12.9 0 0.0 0 0.0 Prevalence Cases Incidence Cases 2005 6,623 753 11.4 7 0.9 6 0.8 2006 6,737 749 11.1 9 1.2 9 1.2 2007 6,810 785 11.5 1 0.1 1 0.1 2008 6,864 768 11.2 0 0.0 0 0.0 2009 6,920 698 10.1 1 0.1 1 0.1 Caroline County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 2,275 513 22.5 39 7.6 4 0.8 2002 2,168 699 32.2 48 6.9 3 0.4 2003 2,270 796 35.1 14 1.8 3 0.4 2004 2,379 794 33.4 17 2.1 1 0.1 Prevalence Cases Incidence Cases 2005 2,422 849 35.1 11 1.3 10 1.2 2006 2,463 893 36.3 7 0.8 3 0.3 2007 2,490 856 34.4 8 0.9 5 0.6 2008 2,497 852 34.1 7 0.8 3 0.4 2009 2,516 839 33.3 7 0.8 5 0.6 3

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Carroll County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 12,376 970 7.8 17 1.8 0 0.0 2002 11,888 978 8.2 10 1.0 1 0.1 2003 11,801 1,040 8.8 14 1.3 2 0.2 2004 12,938 1,323 10.2 13 1.0 1 0.1 Prevalence Cases Incidence Cases 2005 13,173 1,460 11.1 5 0.3 3 0.2 2006 13,400 1,378 10.3 7 0.5 5 0.4 2007 13,546 1,404 10.4 3 0.2 2 0.1 2008 13,872 1,343 9.7 8 0.6 7 0.5 2009 13,988 1,342 9.6 7 0.5 6 0.4 Cecil County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 7,212 964 13.4 8 0.8 2 0.2 2002 7,104 1,018 14.3 9 0.9 2 0.2 2003 7,127 959 13.5 9 0.9 2 0.2 2004 7,548 1,073 14.2 6 0.6 0 0.0 Prevalence Cases Incidence Cases 2005 7,677 1,046 13.6 7 0.7 6 0.6 2006 7,808 1,058 13.5 6 0.6 6 0.6 2007 7,894 1,186 15.0 6 0.5 4 0.3 2008 7,965 1,265 15.9 6 0.5 4 0.3 2009 8,030 1,212 15.1 4 0.3 2 0.2 Charles County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 10,533 1,597 15.2 10 0.6 1 0.1 2002 10,812 1,790 16.6 8 0.4 0 0.0 2003 11,023 1,391 12.6 2 0.1 0 0.0 2004 11,019 2,040 18.5 9 0.4 1 0.0 Prevalence Cases Incidence Cases 2005 11,212 1,811 16.2 7 0.4 6 0.3 2006 11,404 1,919 16.8 1 0.1 1 0.1 2007 11,529 1,999 17.3 1 0.1 1 0.1 2008 12,001 2,032 16.9 1 0.0 1 0.0 2009 12,101 1,836 15.2 4 0.2 4 0.2 4

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Dorchester County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 2,011 248 17.3 44 12.6 5 1.4 2002 1,902 513 27.0 36 7.0 5 1.0 2003 1,952 540 27.7 26 4.8 5 0.9 2004 2,106 629 29.9 17 2.7 1 0.2 Prevalence Cases Incidence Cases 2005 2,141 609 28.5 11 1.8 8 1.3 2006 2,177 684 31.4 11 1.6 8 1.2 2007 2,201 676 30.7 9 1.3 7 1.0 2008 2,266 680 30.0 9 1.3 5 0.7 2009 2,287 730 31.9 3 0.4 2 0.3 Frederick County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 17,075 1,335 7.8 14 1.0 1 0.1 2002 17,434 1,584 9.1 22 1.4 2 0.1 2003 17,641 1,630 9.2 16 1.0 2 0.1 2004 17,865 2,796 15.7 22 0.8 2 0.1 Prevalence Cases Incidence Cases 2005 18,172 3,019 16.6 14 0.5 11 0.4 2006 18,484 3,108 16.8 10 0.3 7 0.2 2007 18,686 3,465 18.5 10 0.3 10 0.3 2008 19,184 3,376 17.6 16 0.5 13 0.4 2009 19,349 3,181 16.4 11 0.3 7 0.2 Garrett County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 2,222 283 12.7 4 1.4 0 0.0 2002 2,046 297 14.5 3 1.0 0 0.0 2003 2,020 429 21.2 3 0.7 0 0.0 2004 2,323 563 24.2 7 1.2 3 0.5 Prevalence Cases Incidence Cases 2005 2,365 532 22.5 4 0.8 3 0.6 2006 2,406 495 20.6 5 1.0 3 0.6 2007 2,432 541 22.2 2 0.4 2 0.4 2008 2,468 479 19.4 2 0.4 1 0.2 2009 2,490 473 19.0 2 0.4 2 0.4 5

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Harford County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 19,138 1,924 10.1 16 0.8 1 0.1 2002 18,530 2,216 12.0 26 1.2 2 0.1 2003 18,482 2,674 14.5 19 0.7 2 0.1 2004 20,032 3,170 15.8 24 0.8 3 0.1 Prevalence Cases Incidence Cases 2005 20,371 2,939 14.4 17 0.6 14 0.5 2006 20,721 3,041 14.7 15 0.5 14 0.5 2007 20,947 3,346 16.0 6 0.2 5 0.1 2008 21,005 3,258 15.5 5 0.2 5 0.2 2009 21,180 3,184 15.0 2 0.1 2 0.1 Howard County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 22,252 1,348 6.1 13 1.0 0 0.0 2002 22,090 1,796 8.1 16 0.9 2 0.1 2003 22,193 1,688 7.6 8 0.5 2 0.1 2004 23,278 2,338 10.0 13 0.6 1 0.0 Prevalence Cases Incidence Cases 2005 23,686 2,273 9.6 7 0.3 4 0.2 2006 24,092 2,188 9.1 8 0.4 6 0.3 2007 24,355 2,334 9.6 3 0.1 2 0.1 2008 24,777 2,493 10.1 5 0.2 4 0.2 2009 24,990 2,503 10.0 1 0.0 1 0.0 Kent County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 1,091 299 27.3 2 0.7 0 0.0 2002 1,095 149 13.6 1 0.7 0 0.0 2003 1,041 157 15.1 3 1.9 0 0.0 2004 1,144 208 18.2 6 2.9 4 1.9 Prevalence Cases Incidence Cases 2005 1,164 172 14.8 2 1.2 2 1.2 2006 1,184 257 21.7 4 1.6 4 1.6 2007 1,197 334 27.9 2 0.6 1 0.3 2008 1,242 303 24.4 5 1.7 3 1.0 2009 1,253 323 25.8 2 0.6 0 0.0 6

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Montgomery County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 72,419 12,148 16.8 66 0.5 3 0.0 2002 75,588 12,082 16.0 61 0.5 8 0.1 2003 76,648 10,163 13.3 53 0.5 9 0.1 2004 75,867 15,934 21.0 81 0.5 12 0.1 Prevalence Cases Incidence Cases 2005 77,085 16,353 21.2 65 0.4 55 0.3 2006 78,408 17,411 22.2 53 0.3 48 0.3 2007 79,264 18,274 23.1 35 0.2 31 0.2 2008 80,262 18,587 23.2 36 0.2 25 0.1 2009 80,950 18,200 22.5 25 0.1 20 0.1 Prince George's County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 70,191 13,735 19.6 100 0.7 7 0.1 2002 73,365 14,930 20.4 98 0.7 10 0.1 2003 73,788 12,426 16.8 77 0.6 7 0.1 2004 73,498 19,785 26.9 87 0.4 16 0.1 Prevalence Cases Incidence Cases 2005 74,714 17,906 24.0 68 0.4 61 0.3 2006 75,996 18,561 24.4 71 0.4 66 0.4 2007 76,826 18,071 23.5 38 0.2 35 0.2 2008 77,625 18,732 24.1 41 0.2 33 0.2 2990 78,279 19,594 25.0 50 0.3 45 0.2 Queen Anne's County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 3,163 312 9.9 7 2.2 0 0.0 2002 3,079 444 14.4 7 1.6 1 0.2 2003 3,123 495 15.8 5 1.0 2 0.4 2004 3,312 453 13.7 4 0.9 0 0.0 Prevalence Cases Incidence Cases 2005 3,367 484 14.4 0 0.0 0 0.0 2006 3,425 659 19.2 4 0.6 4 0.6 2007 3,462 703 20.3 4 0.6 2 0.3 2008 3,583 594 16.6 1 0.2 1 0.2 2009 3,614 607 16.8 4 0.7 4 0.7 7

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Saint Mary's County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 7,652 1,046 13.7 11 1.1 0 0.0 2002 7,533 1,059 14.1 10 0.9 0 0.0 2003 7,827 903 11.5 9 1.0 0 0.0 2004 8,006 1,390 17.4 2 0.1 0 0.0 Prevalence Cases Incidence Cases 2005 8,145 1,381 17.0 10 0.7 9 0.7 2006 8,285 1,517 18.3 11 0.7 11 0.7 2007 8,375 1,468 17.5 2 0.1 1 0.1 2008 8,548 1,517 17.7 4 0.3 3 0.2 2009 8,618 1,527 17.7 4 0.3 3 0.2 Somerset County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 1,441 539 37.4 48 8.9 2 0.4 2002 1,461 512 35.0 21 4.1 0 0.0 2003 1,457 544 37.3 18 3.3 5 0.9 2004 1,508 477 31.6 10 2.1 3 0.6 Prevalence Cases Incidence Cases 2005 1,534 488 31.8 8 1.6 3 0.6 2006 1,560 506 32.4 9 1.8 5 1.0 2007 1,577 529 33.5 2 0.4 2 0.4 2008 1,521 522 34.3 2 0.4 2 0.4 2009 1,533 497 32.4 4 0.8 3 0.6 Talbot County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 2,148 369 17.2 30 8.1 4 1.1 2002 2,173 441 20.3 19 4.3 4 0.9 2003 2,111 449 21.3 15 3.3 1 0.2 2004 2,244 488 21.7 6 1.2 0 0.0 Prevalence Cases Incidence Cases 2005 2,286 573 25.1 2 0.3 2 0.3 2007 2,326 636 27.3 5 0.8 5 0.8 2007 2,351 702 29.9 4 0.6 3 0.4 2008 2,399 612 25.5 5 0.8 5 0.8 2009 2,417 675 27.9 4 0.6 3 0.4 8

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 Washington County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 9,784 1,558 15.9 24 1.5 4 0.3 2002 9,552 1,500 15.7 19 1.3 4 0.3 2003 9,737 1,971 20.2 15 0.8 3 0.2 2004 10,252 3,029 29.5 39 1.3 10 0.3 Prevalence Cases Incidence Cases 2005 10,414 3,235 31.1 21 0.6 18 0.6 2006 10,593 3,012 28.4 18 0.6 15 0.5 2007 10,709 3,064 28.6 8 0.3 6 0.2 2008 11,113 3,041 27.4 13 0.4 11 0.4 2009 11,207 3,006 26.8 9 0.3 9 0.3 Wicomico County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 6,424 1,463 22.8 134 9.2 6 0.4 2002 6,714 1,747 26.0 74 4.2 9 0.5 2003 6,594 2,031 30.8 50 2.5 7 0.3 2004 6,736 1,917 28.5 40 2.1 4 0.2 Prevalence Cases Incidence Cases 2005 6,838 2,096 30.7 29 1.4 18 0.9 2006 6,955 2,440 35.1 22 0.9 16 0.7 2007 7,031 2,975 42.3 23 0.8 14 0.5 2008 6,998 2,420 34.6 20 0.8 13 0.5 2009 7,058 2,248 31.9 10 0.4 6 0.3 Worcester County Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 2,773 595 21.5 48 8.1 4 0.7 2002 2,968 542 18.3 34 6.3 4 0.7 2003 3,022 731 24.2 24 3.3 1 0.1 2004 2,904 675 23.2 11 1.6 2 0.3 Prevalence Cases Incidence Cases 2005 2,952 696 23.6 6 0.9 3 0.4 2006 3,002 962 32.0 7 0.7 5 0.5 2007 3,035 947 31.2 7 0.7 5 0.5 2008 3,148 910 28.9 5 0.5 3 0.3 2009 3,177 850 26.8 2 0.2 1 0.1 9

Number and percentage of children 0-72 months with Elevated Blood Lead level and Lead Poisoning by jurisdiction: 2001-2009 County Unknown Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 41 0 0 2002 90 2 0 2003 9 1 0 2004 3,577 55 0 Prevalence Cases Incidence Cases 2005 357 14 13 2006 199 21 20 2007 278 1 1 2008 69 0 0 2009 5 0 0 Statewide Blood Lead Tests Elevated Blood Lead Lead Poisoning Calendar Year Population Number Percent Number Percent Number Percent 2001 427,939 76,742 17.9 2,841 3.7 288 0.4 2002 436,817 79,507 18.2 2,297 2.9 260 0.3 2003 437,968 76,721 17.5 1,719 2.2 237 0.3 2004 448,106 105,549 23.6 1,811 1.7 230 0.2 Prevalence Cases Incidence Cases 2005 455,514 99,148 21.8 1,331 1.3 916 0.9 2006 463,331 102,974 22.2 1,274 1.2 936 0.9 2007 468,390 105,708 22.6 892 0.8 654 0.6 2008 474,900 106,453 22.4 713 0.7 489 0.5 2009 478,919 107,416 22.4 553 0.5 379 0.4 Terms and definitions 1. Population of children for 2001 is based on the Census 2000 population count. The Census Bureau had not released population estimate for 2001 when 2001 Annual Report was released. The 2002 and 2003 populations are adapted from the US Census Bureau five-year age-sex-county specific population estimate for 2002 and 2003. The 2004-2009 populations are adapted from US Census Bureau: State Interim Population Projection by Age and Sex: 2000-2030. 2. Elevated Blood Lead level (EBL) is defined as a venous or a capillary blood lead level 10 μg/dl 3. Lead Poisoning is defined as a venous blood lead level 20 μg/dl. 4. From 2005 forward the term Prevalence is introduced based on number of children with blood lead level 10 μg/dl who may have one or more EBL in the past, and term Incidence is introduced based on number of children with the very first EBL in that calendar year. 5. County assignment for 2001 is based on child's zip code address. In the absence of any information; the provider's zip code was the basis of county determination. For 2002 and 2003, the child s census tract was the first order of priority to assign county, followed by child s zip code address, and the provider s zip code address as the last. From 2004 forward county assignment is based on child s census tract or zip code of the address and reports with no child addresses were assumed to be from Maryland children with county unknown.

Lead Poisoning Prevention Program Childhood Blood Lead Surveillance in Maryland Annual Report 2009 Age-specific blood lead testing by jurisdiction: Five year data: 2005-2009 Supplementary Data Tables: Supplement #5 August, 2010