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 (Cochrane-Nussbaumer-Streit 2016*). 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, Reed 2011a*, 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) (Cochrane-Nussbaumer-Streit 2016*, 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 (Cochrane-Nussbaumer-Streit 2016*).
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 (Cochrane-Nussbaumer-Streit 2016*, Armstrong 2014) and can significantly increase BLLs, especially for toddlers exhibiting mouthing behaviors (Cochrane-Nussbaumer-Streit 2016*).
Impact on Disparities
Citations - Evidence
* Journal subscription may be required for access.
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.
US EPA-Lead - US Environmental Protection Agency (US EPA). Lead: Lead poisoning is preventable.
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