Primary Prevention of Lead Exposure: The Philadelphia Lead Safe Homes Study

Abstract

Objective. Lead exposure in children can lead to neuropsychological impairment. This study tested whether primary prevention interventions in the newborn period prevent elevated blood lead levels (BLLs).Methods. The Philadelphia Lead Safe Homes (LSH) Study offered parental education, home evaluation, and lead remediation to the families of urban newborns. Households were randomized to a standard lead education group or maintenance education group. We conducted home visits at baseline, six months, and 12 months. To compare BLLs, we identified a matched comparison group.Results. We enrolled and randomized 314 newborns in the intervention component; 110 completed the study. There were few significant differences between the randomized groups. In the combined intervention groups, positive results on visual inspection declined from baseline to 12 months (97.0% to 90.6%, p0.007). At baseline, 36.9% of homes were above the U.S. Environmental Protection Agency's lead dust standard, compared with 26.9% at 12 months (p0.032), mainly due to a drop in windowsill dust levels. Both groups showed a significant increase in parental scores on a lead education test. Children in the intervention and matched control groups had similar geometric mean initial BLLs (2.6 vs. 2.7, p0.477), but a significantly higher percentage of children in the intervention group had an initial blood lead screening compared with those in the matched group (88.9% vs. 84.4%, p0.032). Conclusions.A study of primary prevention of lead exposure showed a higher blood lead screening rate for the combined intervention groups and mean BLLs at one year of age not statistically different from the comparison group. Most homes had lead hazards. Lead education significantly increased knowledge.

Life after Lead: Effects of Early Interventions for Children Exposed to Lead

“…Reduction could also be due to 47 While an important aspect of the lower intensity interventions is parental education about ways to control household exposure, they also provide nutritional information and a referral to remediation services. Thus, these estimated (imprecise) benefits are not inconsistent with previous randomized control trials that do not find large or significant BLL reductions when evaluating parental education and "household dust control" interventions (Campbell et al 2011;Yeoh et al 2009;Brown et al 2006;Jordan et al 2003;Lanphear et al 1999). Table 4.…”

A Case Study of Environmental Injustice: The Failure in Flint

“…It damages children’s brains, erodes intelligence, diminishes creativity and the ability to weigh consequences and make good decisions, impairs language skills, shortens attention span, and predisposes to hyperactive and aggressive behavior. Lead exposure in early childhood is linked to later increased risk for dyslexia and school failure.” [11] Other articles and reports have also confirmed these adverse effects [12,13,14,15,16,17,18,19,20]. …”

“…There is not. Many authors have weighed in on this question recently [11,12,13,15,17,19,57,58,59,60,61,62], some with very specific plans and ideas. Primary prevention of lead exposure has been particularly emphasized in almost all of them.…”

Validation of a Machine Learning Model to Predict Childhood Lead Poisoning

“…Regarding outreach, uptake will likely be limited in any voluntary lead inspection program. In the Philadelphia Lead Safe Homes Study, 29 uptake of completely subsidized lead remediation work for households of children without an EBLL was just 28%. The uptake of reactive inspections in Chicago in response to an EBLL during the study period was 58%, suggesting, unsurprisingly, that households are more likely to take up an inspection when notified by the CDPH that their child has an EBLL.…”