County Health Rankings & Roadmaps, A Healthier Nation, County by County

The County Health Rankings models and measures

Our Approach

The County Health Rankings model of population health

What can I do?

Action Center

Explore guides and tools for improving health.

What Works for Health

Explore programs and policies that work!

What can I learn from others?


Key findings from the last four years of County Health Rankings and other national reports.

County-by-County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Household lead control education interventions

Evidence Rating

Evidence of Ineffectiveness

Health Factors

Household lead control education interventions inform parents about lead exposure pathways and explain cleaning and hygiene techniques, and may include temporary dust control measures such as specialized cleaning or minor repairs (). As of 2012, scientists indicate no safe blood lead level (BLL). The Centers for Disease Control and Prevention (CDC) blood lead reference level for initiating public health actions to prevent further exposure and mitigate health effects is 5 micrograms per deciliter (µg/dL); it is estimated that over 500,000 children have BLLs at or above this level (White 2015, NCHH-Lead 2014, CDC-Lead facts). Childhood lead poisoning occurs at higher rates among families with lower incomes, those living in older homes, and those residing in urban areas than their counterparts (White 2015, Korfmacher 2014, , NCHH-Lead 2014).

Evidence of Effectiveness

There is strong evidence that teaching parents about lead exposure pathways and specialized cleaning efforts alone does not prevent lead poisoning or reduce children’s blood lead levels (BLLs) (, Armstrong 2014). In some cases, dusting and cleaning can increase childhood lead exposure by dispersing lead dust, which can be inhaled or ingested when it settles on objects that children touch. Permanent lead abatement programs are needed to reduce lead dust exposure ().

Lead is often found in paint, dust, pipes, and soil in or around homes built before 1978. Lead paint on windows and doors is particularly hazardous as friction created by the opening and closing motion often releases lead dust (US EPA-Lead). Early recommendations regarding lead control suggested that continually cleaning lead dust could mitigate its negative effects; however, recent studies suggest such efforts are ineffective (, Armstrong 2014) and can significantly increase BLLs, especially for toddlers exhibiting mouthing behaviors ().

Impact on Disparities

No impact on disparities likely

Citations - Evidence

* Journal subscription may be required for access.

US EPA-Lead - US Environmental Protection Agency (US EPA). Lead: Lead poisoning is preventable.

Cochrane-Nussbaumer-Streit 2016* - Nussbaumer-Streit B, Yeoh B, Griebler U, et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database of Systematic Reviews. 2016;(12):CD006047.

Armstrong 2014 - Armstrong R, Anderson L, Synnot A, et al. Evaluation of evidence related to exposure to lead. Canberra: National Health and Medical Research Council; 2014.

Date Last Updated

Apr 25, 2017