Household lead control education interventions

Evidence Rating  
Evidence of Ineffectiveness
Evidence rating: Evidence of Ineffectiveness

Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results.

 

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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 repairs1. 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 level2, 3, 4. 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 counterparts2, 3, 5, 6.

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)1, 7. 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 exposure1.

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 dust8. Early recommendations regarding lead control suggested that continually cleaning lead dust could mitigate its negative effects; however, recent studies suggest such efforts are ineffective1, 7 and can significantly increase BLLs, especially for toddlers exhibiting mouthing behaviors1.

Impact on Disparities

No impact on disparities likely
Footnotes

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1 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.

2 White 2015 - White BM, Bonilha HS, Ellis C. Racial/ethnic differences in childhood blood lead levels among children <72 months of age in the United States: A systematic review of the literature. Journal of Racial and Ethnic Health Disparities. 2015:1-9.

3 NCHH-Lead 2014 - National Center for Healthy Housing (NCHH). Preventing lead exposure in US children: A blueprint for action. 2014.

4 CDC-Lead facts - Centers for Disease Control and Prevention (CDC). Lead: Facts, tips, tools, training, and resources for childhood lead poisoning prevention.

5 Korfmacher 2014 - Korfmacher KS, Malone J, Jacobs D. Local housing policy approaches to preventing childhood lead poisoning. Public Health Law Research: Making the Case for Laws that Improve Health. 2014.

6 Reed 2011a* - Reed W. Preventing childhood lead poisoning. In: Lemelle AJ, Reed W, Taylor S, eds. Handbook of African American Health: Social and Behavioral Interventions. New York: Springer; 2011:103-11.

7 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.

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

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