493 - Characterizing Dermatological Concerns Among Children Affected by the Flint Water Crisis

Poster Number: 493
Publication Number: 493.344

Yvonne Nong, Michigan State University College of Human Medicine, MORRIS PLAINS, NJ, United States; Aleena Hajek, Michigan State University College of Human Medicine, Columbiaville, MI, United States; Jenny Lachance, Hurley Medical Center, Flint, MI, United States; Nicole M. Jones, Michigan State University College of Human Medicine, Flint, MI, United States; Lauren Seale, Henry Ford Health System, Detroit, MI, United States; Mona Hanna-Attisha, Michigan State University College of Human Medicine, Flint, MI, United States

Background: During the Flint water crisis, residents were exposed to a myriad of contaminants and irritants in the water, including lead, bacteria, excessive chlorine, total trihalomethanes, legionella, and increased corrosivity. Early manifestations of the water crisis included skin conditions such as rashes and hair loss, yet few studies have examined the burden of dermatological conditions in Flint children. The Flint Registry, a Centers for Disease Control and Prevention–supported public health program, was established to understand the impact of the crisis and connect participants to public health-promoting resources.

Objective: To understand the extent of caregiver-reported dermatological issues in Flint children through population-level data.

Design/Methods: From January 2020 through April 2021, 4,388 children were enrolled in the Flint Registry. After consent and eligibility questionnaires, a child’s caregiver completed a comprehensive survey to assess a child’s health and development status, ongoing environmental exposures, and service utilization. Quantitative and qualitative analyses were done using SPSS and Nvivo, respectively, for questions pertaining to dermatological concerns.

Results: A majority identified as Black/African American (67.5%) and/or from socioeconomically disadvantaged backgrounds. 30.7% of children reported a healthcare provider–diagnosed skin condition. Among those with a diagnosed skin condition, nearly 50% reported the condition onset after the Flint water crisis (April 2014) and 86.5% reported still having the condition at the time of Flint Registry enrollment. Analysis of open-ended survey responses to queries about new or worsened health concerns revealed various skin, hair, and nail issues as beginning or worsening with the water exposure.Conclusion(s): Dermatologic concerns are commonly reported in children enrolled in the Flint Registry and are temporally related to the Flint water crisis. Future studies should explore variations in the severity of cutaneous conditions and their relationships to reported water exposure. With a high percentage of ongoing concerns, treatment resources, including access to pediatric dermatologists who are familiar with caring for children of color, should be prioritized for Flint children.