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Long-term effect of dust control on blood lead concentrations
B P Lanphear1, S Eberly, C R Howard
1Children's Hospital Medical Center, Cincinnati Ohio 45229-3039, USA. bruce.lanphear@chmcc.org
Insights
Home dust control interventions did not significantly lower children's blood lead levels by 48 months. This study found no long-term benefit of dust control for reducing childhood lead exposure from residential hazards.
Area of Science:
- Environmental health
- Pediatric toxicology
- Public health interventions
Background:
- Residential lead exposure poses a significant risk to children's health.
- Current recommendations emphasize dust control to mitigate lead hazards.
- The long-term efficacy of dust control on children's environmental lead exposure remains unclear.
Purpose of the Study:
- To evaluate the impact of dust control measures on children's blood lead concentrations at 48 months of age.
- To determine if a comprehensive dust control intervention can reduce long-term lead exposure in urban children.
Main Methods:
- A randomized controlled trial was conducted in Rochester, New York.
- 275 urban children were randomized at 6 months; 189 completed follow-up.
- The intervention group received cleaning supplies and advisory visits, while the control group did not.
Main Results:
- No significant difference in geometric mean blood lead concentration was observed at 48 months between groups (5.9 vs 6.1 microg/dL).
- Prevalence of elevated blood lead levels (>/=10 microg/dL) was similar in both groups (19% vs 19%).
- Lower, but still comparable, percentages of children had levels >/=15 microg/dL and >/=20 microg/dL in both groups.
Conclusions:
- Dust control, when performed by families without addressing the source of contamination, is ineffective in preventing children's residential lead exposure.
- The study highlights the need for more comprehensive lead hazard control strategies beyond basic dust control.
- Further research is needed to identify effective interventions for reducing long-term childhood lead exposure.
Background:
Dust control is recommended to prevent children's exposure to residential lead hazards, but the long-term effect of dust control on children's exposure to environmental lead is unknown.
Objective:
To determine the effect of dust control on children's exposure to lead, as measured by blood lead concentration at 48 months of age.
Design:
A randomized, controlled trial. Setting. Rochester, New York.
Participants:
A total of 275 urban children were randomized at 6 months of age; 189 (69%) were available for the 48-month follow-up blood test. Intervention. Children and their families were randomly assigned to an intervention group that received cleaning equipment and up to 8 visits by a trained lead hazard control advisor or to a control group. The intervention was terminated when the children were 24 months of age.
Outcome Measures:
Geometric mean blood lead concentration and prevalence of elevated blood lead concentration (ie, >/=10 microg/dL, >/=15 microg/dL, and >/=20 microg/dL), by group assignment.
Results:
For children with 48-month blood tests, baseline geometric mean blood lead concentrations were 2.8 microg/dL (95% confidence interval [CI]: 2.6, 3.0); there were no significant differences in baseline characteristics or lead exposure by group assignment. At 48 months of age, the geometric mean blood lead was 5.9 microg/dL (95% CI: 5.3, 6.7) for the intervention group and 6.1 microg/dL (95% CI: 5.5,6.9) for the control group. The percentage of children with a 48-month blood lead >/=10 microg/dL, >/=15 microg/dL, and >/=20 microg/dL was 19% versus 19%, 2% versus 9%, and 1% versus 2% in the intervention and control groups, respectively.
Conclusions:
We conclude that dust control, as performed by families and in the absence of lead hazard controls to reduce ongoing contamination from lead-based paint, was not effective in preventing children's exposure to residential lead hazards.