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Colorado lead resources

CDPHE: Lead Poisoning Prevention
CDPHE: Lead Services Directory
Colorado Lead Coalition: Protect your family when you repaint or remodel
Rocky Mountain Region Pediatric Environmental Health Specialty Unit: Lead information and resources
CDPHE: Preventing lead poisoning in indoor firing ranges in Colorado

National lead resources

CDC: Lead
CDC: Childhood Lead Poisoning Prevention Program
CDC: Update on Blood Lead Levels in Children
EPA: Lead in Paint, Dust and Soil
National Toxicology Program: Health Effects of Low-level Lead new



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Home >  Health Topics > Childhood lead poisoning 
 
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Data Set details for childhood lead poisoning by cohort

Interpreting the data
 

What these data tell us:
  • These data provide information about blood lead testing and blood lead levels among children born in the same year (for example, all children born in 2007). A group of children all born in the same year is called a birth cohort. For example, the 2007 blood lead testing birth cohort includes all children born in 2007 and tested by their third birthday, which would occur for all children in the cohort by December 31, 2010.
  • The
     
    Birth Cohort
    A group of people born during a specific period of time, such as a particular year.
    birth cohort indicator evaluates screening practices and success at achieving the recommended practice of testing children before their third birthday. These data tells us the number and percentage of children born the same year who were tested for lead poisoning before their third birthday. These data, showing the
     
    Screening rate
    A measure of how many people are screened for a particular condition per population unit. For example, the number of low-income children under the age of six who were tested for elevated blood lead levels out of all the low-income children under the age of six.
    screening rate, are available at the state level and for each county.
  • These data give an estimate of how many children born in a certain year have lead poisoning Lead poisoning is define as the current CDC
     
    Intervention Level
    The level at which action is suggested to protect public health. For example, the current Centers for Disease Control and Prevention (CDC) intervention level for blood lead is 10 micrograms per deciliter (10µg/dL). Specific case management steps, such as education about exposure prevention, nutritional guidance, medical testing or treatment may be recommended. The recommended intervention depends on the level of lead found.
    intervention level of 10 or more micrograms of lead per deciliter of blood (≥10 µg/dL). These data include the number of
     
    Confirmed elevated blood lead test
    An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
    confirmed elevated blood lead tests , the number of unconfirmed elevated blood lead tests, and the number of blood lead tests that are not considered elevated. The
     
    Unconfirmed elevated blood lead test
    An elevated blood lead test is considered unconfirmed if there is one elevated capillary test with no additional elevated test within a 12 week period.
    unconfirmed elevated blood lead tests indicate the number of children who are lost to follow-up and don’t receive a confirmatory test.
What these data do not tell us:
  • They do not tell us the blood lead levels of all children in Colorado. The Colorado Department of Public Health and Environment recommends testing only children who are at increased risk of lead poisoning.
  • These data do not tell us what health effects, if any, children who were found to have elevated blood lead levels experienced.
  • These data do not tell us how Colorado compares to other states because childhood blood lead testing practices vary between states. Some states recommend
     
    Universal testing
    Universal testing (also called universal screening) is when everyone is targeted for testing, including people at higher risk and those at lower risk. For example, universal testing for childhood lead poisoning might recommend screening all children before they reach six years of age.
    universal testing , while others, including Colorado, recommend
     
    Targeted testing
    Targeted testing is when only those at higher risk are targeted for testing. For example, targeted testing for childhood lead poisoning might recommend screening all low-income children before they reach six years of age.
    targeted testing .
  • Data may not allow for direct comparison between counties due to limitations such as variations in reporting practices and screening rates.
 

Numerator/Denominator Information
 

Event/numerator data:
Blood lead test results that are reported to the Colorado Department of Public Health and Environment. If more than one test is reported for a child only one of the tests is used in the calculation, so only one test per child is used in the calculation.

Population/denominator data:
Population estimates, State Demography Office, Colorado Department of Local Affairs.

 

Limitations of the data
 
Quality assurance activities have not been performed to determine the completeness of blood lead test reporting in Colorado.
This means that we do not know how many records may be missing from this data set, or how complete a picture this gives us of lead testing in Colorado. Over 20,000 blood lead test results are reported to Colorado Department of Public Health and Environment each year.


Approximately 10 percent of records reported do not have sufficient address information to assign county of residence.
These records are included and listed as “unknown county”.


Denominator data are based on population estimates of the total number of children in a specific age category.
Because Colorado does not recommend universal testing for all children, this method overestimates the number of children targeted for lead testing. Children targeted for testing in Colorado would be more accurately represented by the total number of low-income children living in the state.

 

Data not included
 
Blood lead tests that occur at the point of care, and are not processed through a laboratory or reported electronically to the Colorado Department of Public Health and Environment, are not included in these data prior to August 2011. Point of care testing uses capillary blood specimens and ESA Lead Care II equipment. Approximately 40 clinics throughout Colorado use ESA equipment. Voluntary paper reporting began in August 2011 and those records are included beginning with 2011 data.
 

Calculation methods
 
Number and percentage of children born in the same year and tested for lead before their third birthday
The number of children born in the same year who had a reported lead test before their third birthday, divided by the total number of children born in that year
Example:

Number of children born in the same year with a reported blood lead test before their third birthday
Total number of children born in that same year


Number and percentage of children born in the same year and tested for lead before their third birthday, with confirmed elevated blood lead levels
The number of children born in the same year who had a confirmed elevated blood lead test reported before their third birthday, divided by the number of children born in the same year who had any lead test reported before their third birthday

Number of children born in the same year with a confirmed elevated blood lead test reported before their third birthday
Number of children born in the same year with any blood lead test reported before their third birthday


According to current CDC guidelines, a blood lead level is considered elevated if the laboratory finds 10 or more micrograms of lead per deciliter of blood (≥10 µg/dL).

An elevated blood lead test is considered confirmed if there is either one elevated
 
Venous test
A venous blood test is when the blood to be tested is drawn directly from a vein.
venous test or two elevated
 
Capillary test
A capillary blood test is when the blood to be tested is collected by pricking a finger or a baby’s heel, then collecting blood from the puncture site into a tube. Capillary blood sampling is useful when small amounts of blood are needed or when blood is very difficult to obtain, such as from infants.
capillary tests which are done less than 12 weeks apart. If a report does not specify if a test was a venous test or a capillary test it is treated as a capillary test. A poorly collected capillary test can be contaminated by lead in the environment, so it is recommended that elevated capillary tests be confirmed with a venous test.


Number and percentage of children born in the same year and tested for lead before their third birthday, with unconfirmed elevated blood lead levels
The number of children born in the same year who had an unconfirmed elevated blood lead test reported before their third birthday, divided by the number of children born in the same year who had any lead test reported before their third birthday

Number of children born in the same year with an unconfirmed elevated blood lead test reported before their third birthday
Number of children born in the same year with any blood lead test reported before their third birthday


A blood lead level is considered elevated if the laboratory finds 10 or more micrograms of lead per deciliter of blood (≥10 µg/dL).

An elevated blood lead test is considered unconfirmed if there is one elevated
 
Capillary test
A capillary blood test is when the blood to be tested is collected by pricking a finger or a baby’s heel, then collecting blood from the puncture site into a tube. Capillary blood sampling is useful when small amounts of blood are needed or when blood is very difficult to obtain, such as from infants.
capillary tests with no additional elevated test within a 12 week period. If a report does not specify if a test was a
 
Venous test
A venous blood test is when the blood to be tested is drawn directly from a vein.
venous test or a capillary test it is treated as a capillary test. A poorly collected capillary test can be contaminated by lead in the environment, so it is recommended that elevated capillary tests be confirmed with a venous test.
Unconfirmed elevated tests are reported as an indicator of the number of children who are lost to follow-up and don’t receive a confirmatory test.

 

Metadata
 

 

Data Set details for childhood lead poisoning by year

Interpreting the data
 

What these data tell us:
  • The annual blood lead indicator provides a snapshot of the number of children with an elevated blood lead level in the selected age group in a specific year by geography (for example, all children up to 6 years of age in 2007 in your county). Looking at this data over time helps identify risk factors for lead exposure and vulnerable populations in Colorado.
  • These data provide an indication of the burden of lead poisoning and case management by county.
  • These data tell us the number and percentage of children tested each year by age group. These data are available at the state level, and for each county.
  • These data give an estimate of how many children have lead poisoning. These data include the number of
     
    Confirmed elevated blood lead test
    An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
    confirmed elevated blood lead tests, the number of
     
    Unconfirmed elevated blood lead test
    An elevated blood lead test is considered unconfirmed if there is one elevated capillary test with no additional elevated test within a 12 week period.
    unconfirmed elevated blood lead tests, and the number of blood lead tests that are not considered elevated. The unconfirmed elevated blood lead tests indicate the number of children who are lost to follow-up and don’t receive a confirmatory test.
What these data do not tell us:
  • They do not tell us the blood lead levels of all children in Colorado. The Colorado Department of Public Health and Environment recommends testing only children who are at increased risk of lead poisoning.
  • These data do not tell us what health effects, if any, children who were found to have elevated blood lead levels experienced.
  • These data do not tell us how Colorado compares to other states because childhood blood lead testing practices vary between states. Some states recommend
     
    Universal testing
    Universal testing (also called universal screening) is when everyone is targeted for testing, including people at higher risk and those at lower risk. For example, universal testing for childhood lead poisoning might recommend screening all children before they reach six years of age.
    universal testing , while others, including Colorado, recommend
     
    Targeted testing
    Targeted testing is when only those at higher risk are targeted for testing. For example, targeted testing for childhood lead poisoning might recommend screening all low-income children before they reach six years of age.
    targeted testing .
  • Data may not allow for direct comparison between counties due to limitations such as variations in reporting practices and screening rates.
 

Numerator/Denominator Information
 

Event/numerator data:
Blood lead test results that are reported to the Colorado Department of Public Health and Environment. If more than one test is reported for a child only one of the tests is used in the calculation, so only one test per child is used in the calculation.

Population/denominator data:
Population estimates, State Demography Office, Colorado Department of Local Affairs.

 

Limitations of the data
 
Quality assurance activities have not been performed to determine the completeness of blood lead test reporting in Colorado.
This means that we do not know how many records may be missing from this data set, or how complete a picture this gives us of lead testing in Colorado. Over 20,000 blood lead test results are reported to Colorado Department of Public Health and Environment each year.


Approximately 10 percent of records reported do not have sufficient address information to assign county of residence.
These records are included and listed as “unknown county”.


Denominator data are based on population estimates of the total number of children in a specific age category.
Because Colorado does not recommend universal testing for all children, this method overestimates the number of children targeted for lead testing. Children targeted for testing in Colorado would be more accurately represented by the total number of low-income children living in the state.

 

Data not included
 
Blood lead tests that occur at the point of care, and are not processed through a laboratory or reported electronically to the Colorado Department of Public Health and Environment, are not included in these data prior to August 2011. Point of care testing uses capillary blood specimens and ESA Lead Care II equipment. Approximately 40 clinics throughout Colorado use ESA equipment. Voluntary paper reporting began in August 2011 and those records are included beginning with 2011 data.
 

Calculation methods
 
Annual number and percentage of children tested for lead, by age group
The number of children in the selected age group who had a reported lead test during the selected year, divided by the number of children in that age group that year
Example:

of children up to 6 years of age with a reported blood lead test in 2007
Total number of children up to 6 years of age in 2007


Annual number and percentage of children tested for lead with confirmed elevated blood lead levels, by age group
The number of children in the selected age group who had a confirmed elevated blood lead test reported during the selected year, divided by the number of children in that age group that year who had any lead test reported during the selected year

of children up to 6 years of age with a confirmed elevated blood lead test reported in 2007
Number of children up to 6 years of age with any blood lead test reported in 2007


According to current CDC guidelines, a blood lead level is considered elevated if the laboratory finds 10 or more micrograms of lead per deciliter of blood (≥10 µg/dL).

An elevated blood lead test is considered confirmed if there is either one elevated
 
Venous test
A venous blood test is when the blood to be tested is drawn directly from a vein.
venous test or two elevated
 
Capillary test
A capillary blood test is when the blood to be tested is collected by pricking a finger or a baby’s heel, then collecting blood from the puncture site into a tube. Capillary blood sampling is useful when small amounts of blood are needed or when blood is very difficult to obtain, such as from infants.
capillary tests which are done less than 12 weeks apart. If a report does not specify if a test was a venous test or a capillary test it is treated as a capillary test. A poorly collected capillary test can be contaminated by lead in the environment, so it is recommended that elevated capillary tests be confirmed with a venous test.


Annual number and percentage of children tested for lead with unconfirmed elevated blood lead levels, by age group
The number of children in the selected age group who had an unconfirmed elevated blood lead test reported during the selected year, divided by the number of children in that age group that year who had any lead test reported during the selected year

Number of children up to 6 years of age with an unconfirmed elevated blood lead test reported in 2007
Number of children up to 6 years of age with any blood lead test reported in 2007


A blood lead level is considered elevated if the laboratory finds 10 or more micrograms of lead per deciliter of blood (≥10 µg/dL).

An elevated blood lead test is considered unconfirmed if there is one elevated
 
Capillary test
A capillary blood test is when the blood to be tested is collected by pricking a finger or a baby’s heel, then collecting blood from the puncture site into a tube. Capillary blood sampling is useful when small amounts of blood are needed or when blood is very difficult to obtain, such as from infants.
capillary tests with no additional elevated test within a 12 week period. If a report does not specify if a test was a
 
Venous test
A venous blood test is when the blood to be tested is drawn directly from a vein.
venous test or a capillary test it is treated as a capillary test. A poorly collected capillary test can be contaminated by lead in the environment, so it is recommended that elevated capillary tests be confirmed with a venous test.
Unconfirmed elevated tests are reported as an indicator of the number of children who are lost to follow-up and don’t receive a confirmatory test.

 


Data Set details for percent of homes built before 1950

Interpreting the data
 

What these data tell us:
  • The number and percent of houses built prior to 1950.
  • The year the house was built refers to when the building was first constructed, not when it was remodeled, added to, or converted.
  • The data relate to the number of houses built prior to 1950 that were still in existence at the time of the survey.
What these data do not tell us:
  • These data do not tell us the condition of the house or if the house has lead-based paint.
  • The data does not tell us what was going on at any single year during the 5 year interval of aggregated data
 

Numerator/Denominator Information
 

Numerator data:
Total number of housing units built prior to 1950, American Community Survey 5-year estimate (2006-2010), U.S. Census Bureau www.census.gov/acs/www/)

Denominator data:
Total number of housing units, American Community Survey 5-year estimate (2006-2010), U.S. Census Bureau www.census.gov/acs/www/)
The American Community Survey is an annual survey produced by the U.S. Census Bureau. It collects detailed information on demographics, social, housing, and economics for geographic locations varying from neighborhoods to nationwide. The American Community Survey focuses on up-to-date data on how people live in an effort to provide results used for deciding community resources such as schools, hospitals, programs, etc. Data is updated annually and adjusted after the completion of every decennial census or as years are aggregated for analysis.

 

Limitations of the data
 
Housing data from the American Community Survey are collected from a representative sample and therefore are estimates of the actual figures that would have been obtained from a complete count.

Using number of pre-1950s housing from American Community Survey does not account for houses that have been renovated or have had lead removed.

 

Calculation methods
 
Percent of total housing units built prior to 1950= (Total number of housing units built prior to 1950/ Total number of housing units)*100


 
What is lead?
 
Lead is a heavy, soft metal that occurs naturally in the earth. It is toxic to humans, and can get into our bodies when we breathe or swallow something that has lead in it or on it. Young children are most vulnerable to the effects of lead.

Lead was once used in products found in and around homes such as paints, gasoline and lead solder used for plumbing and food cans. It is still used to make batteries, ammunition, devices to shield X-rays and some metal pipes. Lead is released into the environment when burning fossil fuels such as coal, oil and natural gas and during some mining and manufacturing activities.
 

Why is lead a concern?
 

Lead poisoning is entirely preventable, but in Colorado approximately 50-60 children are confirmed to have lead poisoning each year. Other children may have an elevated blood lead screening test but do not return for a retest so this elevation cannot be confirmed.

Lead poisoning often goes unrecognized because it might not cause any obvious signs or symptoms. But lead poisoning can cause long-term health problems, including learning disabilities, behavioral problems, and, at very high levels, seizures, coma and even death.

 

Can lead make me sick?
 

No level of lead in the body is considered safe. The health effects of lead depend on how much lead a person has been exposed to, how often the person is exposed (such as daily or weekly, for weeks or years) and the age of the person. Young children below the age of 3 are at the greatest risk because their brains are developing rapidly and they are crawling, teething and putting objects in their mouths. These activities put them at increased risk of coming into contact with lead in their environment just at the time the growing brain is most vulnerable to the harmful effects of lead exposure.

Lead poisoning is usually due to repeated exposure to small amounts of lead over time, though lead poisoning can occur if a single lead-containing object, such as a trinket, is swallowed. Lead affects almost every system in the body, and is particularly harmful to the
 
Central Nervous System
The main organs of the nervous system, including the brain and the spinal cord.
central nervous system.

Lead exposure can harm young children and babies even before they are born.
If not detected early, high levels of lead in children can cause:
  • Damage to the brain and nervous system
  • Speech, language, behavior and learning problems
  • Slowed growth
  • Hearing problems
  • Digestive problems, loss of appetite
Lead poisoning can have long-term health effects, even into adulthood. If you suspect that you or your child may be exposed to lead, consult your health care provider. Some low-cost health clinics also provide lead testing.
 

Who is at risk?
 
Children are at greater risk of lead poisoning if they:
  • live in poverty
  • live in or regularly visit a home built before 1978 that is in poor condition (lead-based paint was used in homes before 1978)
  • live in or regularly visit a home built before 1978, that is being renovated, or has been worked on in the past without proper safety precautions
  • travel in and out of the United States often
  • are exposed to products from countries that do not regulate lead as strictly as it is regulated in the United States (these products often include spices, candies, herbal remedies, cosmetics and toys)
  • have poor nutrition (children are more likely to absorb lead if they are lacking certain nutrients in their diet)
  • have frequent contact with an adult who has a job or a hobby that involves lead exposure
Pregnant women should also be careful to avoid lead exposure because it can harm babies before they are born.
 

Who should be tested for lead?
 
The only way to know if a child has lead poisoning is to have the child tested for lead, because often no symptoms are visible. Lead poisoning is diagnosed using a blood test that measures how much lead is in a person’s blood. All children with increased risk of lead exposure should be tested.

Colorado does not recommend
 
Universal testing
Universal testing (also called universal screening) is when everyone is targeted for testing, including people at higher risk and those at lower risk. For example, universal testing for childhood lead poisoning might recommend screening all children before they reach six years of age.
universal testing for all young children. Instead Colorado recommends
 
Targeted testing
Targeted testing is when only those at higher risk are targeted for testing. For example, targeted testing for childhood lead poisoning might recommend screening all low-income children before they reach six years of age.
targeted testing for blood lead testing. Colorado guidelines currently recommend that all low-income children in Colorado should be tested for lead at 12 months and 24 months of age, using either a capillary or venous blood specimen. See Colorado’s lead screening recommendations for further guidance on who should be tested.

It is important to test children when they are young so they can get the appropriate treatment if they have been exposed to lead. Children under the age of three are at greatest risk from lead poisoning. Health care providers can provide blood lead testing. Some low-cost health clinics also provide lead testing. If a child has a blood lead level of 5 µg/dL or higher, then the child’s family works with a health care provider to get the medical care needed and make the necessary changes to the child’s environment to prevent further lead exposure. Guidelines for childhood blood lead case management are provided by the Colorado Department of Public Health and Environment.

You can learn more about lead testing in Colorado by reading the recommendations for lead testing from the Colorado Department of Public Health and Environment, and lead regulations from the Colorado Board of Health.
 

How can risk be reduced?
 
Lead poisoning is a preventable disease. There are many things you can do to protect yourself and your family from exposure to lead.

If you live in a house or apartment that was built before 1978, or frequently visit a house that was built before 1978 (for example, grandparents, in-home day care), there are things you can do right away to protect young children from exposure to lead:
  • Make sure children cannot get to peeling paint or chewable surfaces covered with lead-based paint, such as window sills.
  • If you see any peeling paint chips or dust, clean it up immediately. If you rent, notify your landlord of peeling or chipping paint.
  • Wipe down floors and other household surfaces with a damp cloth or mop at least once a week to reduce possible exposure to lead dust. Thoroughly rinse cloths and mops when you are done.
  • Regularly wash children’s hands and toys to remove dust and dirt. Household dust and outdoor dirt can both contain lead.
Protect your family when you do home improvements.
Learn how with this fact sheet from the Colorado Lead Coalition.

Use only cold water from the tap for cooking, drinking, and mixing baby formula.
Most lead in household tap water usually comes from lead in the piping of the house, not from the water supply. Hot water is more likely to pick up lead from water pipes.

Avoid regularly using products from countries that do not have lead regulations as strict as those in the United States.

Some imported food products, such as spices and candies, have been associated with elevated levels of blood lead in children in Colorado. Some toys have been found to have levels of lead that can put a child at risk if the child chews on the toy. These toys are often imported from other countries. Learn more about keeping kids safe from toys contaminated with lead.

Avoid traditional remedies that contain lead.

Lead has been found in some traditional (folk) medicines used by East Indian, Indian, Middle Eastern, West Asian, and Hispanic cultures. Azarcon and Greta are traditional Hispanic remedies that are sometimes given to teething babies, and are also used to treat upset stomach. Ba-baw-san is a Chinese herbal remedy used to treat colic pain or to pacify young children. It also contains lead. Learn more about lead in traditional medicines from the Centers for Disease Control.

Take precautions to protect yourself and your family if you have a job or a hobby that involves lead.

Shower and change your clothes and shoes after finishing an activity that involves working with lead, such as using a firing range or working with stained glass. Children can be exposed to lead from these activities when lead dust is brought into the house. The National Institute for Occupational Safety and Health (NIOSH) has more information on how to protect yourself and your family if you work with lead.
 

How is lead poisoning tracked?
 
For children, an elevated blood lead test result has been defined by the Centers for Disease Control and Prevention (CDC) as 10 micrograms of lead per deciliter of blood (10 µg/dL) or higher since 1991. Childhood blood lead data available on this website are currently limited to display of
 
Confirmed elevated blood lead test
An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
confirmed elevated results at or above 10 µg/dL. Recently CDC recommended adopting a new reference level of 5 µg/dL and identifies this as the level at which steps should be taken to reduce lead exposure in children under age 6. CDC and state EPHT partners are working to determine how best to compile, display and describe childhood blood lead levels from 5 to 10 µg/dL. Once consistent guidelines are developed, Colorado will update the available data to display these results on the Tracking web site. COEPHT is also working to compile and display the number of
 
Unconfirmed elevated blood lead test
An elevated blood lead test is considered unconfirmed if there is one elevated capillary test with no additional elevated test within a 12 week period.
unconfirmed screening tests by county.

Clinical laboratories are required to report all blood lead test results for children 18 years of age and younger. For people older than 18, laboratories are required to report test results if they find that the person has an elevated level of lead in their blood. Elevated blood lead for someone over the age of 18 is defined as 10 micrograms of lead per deciliter of blood (10 µg/dL) or higher. These blood lead test results must be reported to the Colorado Department of Public Health and Environment as specified in the Colorado Board of Health Regulations (6 CCR 1009-7).

Test results are received daily, and elevated results from children are reported to local health agencies on a weekly basis. Local health agencies follow up on reports of elevated lead test results as resources allow. This may include an investigation to determine the source of lead exposure and to recommend actions for stopping the exposure.

The Tracking program analyzes, summarizes and reports the results of blood lead testing from children less than six years of age. These yearly data are available by county. These data do not tell us how Colorado compares to other states because childhood blood lead testing practices vary between states. Some states recommend
 
Universal testing
Universal testing (also called universal screening) is when everyone is targeted for testing, including people at higher risk and those at lower risk. For example, universal testing for childhood lead poisoning might recommend screening all children before they reach six years of age.
universal testing, while others, including Colorado, recommend
 
Targeted testing
Targeted testing is when only those at higher risk are targeted for testing. For example, targeted testing for childhood lead poisoning might recommend screening all low-income children before they reach six years of age.
targeted testing.
 
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