Primary prevention of childhood lead exposure

A randomized trial of dust control

Bruce P. Lanphear, Cynthia Howard, Shirley Eberly, Peggy Auinger, John Kolassa, Michael Weitzman, Stanley J. Schaffer, Keith Alexander

Research output: Contribution to journalArticle

Abstract

Background. Dust control is recommended as one of the primary strategies to prevent or control children's exposure to residential lead hazards, but the effect of dust control on children's blood lead levels is poorly understood. Objective. To determine the effectiveness of dust control in preventing children's exposure to lead, as measured by blood lead levels, during their peak age of susceptibility. Design. A randomized, controlled trial. Setting. Rochester, NY. Participants. A total of 275 urban children were randomized at 6 months of age, of whom 246 (90%) were available for the 24-month-old follow-up visit. Interventions. Children and their families were randomly assigned to an intervention group (n = 140), which received cleaning equipment and up to eight visits by a dust control advisor, or a control group (n = 135). Outcome Measures. Geometric mean blood lead levels and prevalence of elevated blood lead levels (ie, >10 μg/dL, 15 μg/dL, and 20 μg/dL). Results. At baseline, children's geometric mean blood lead levels were 2.9 μg/dL (95% confidence interval [CI] = 2.7, 3.1); there were no significant differences in characteristics or lead exposure by group assignment, with the exception of water lead levels. For children in the intervention group, the mean number of visits by a dust control advisor during the 18-month study period was 6.2; 51 (36%) had 4 to 7 visits, and 69 (49%) had 8 visits. At 24 months of age, the geometric mean blood lead was 7.3 μg/dL (95% CI = 6.6, 8.2) for the intervention group and 7.8 μg/dL (95% CI = 6.9, 8.7) for the control group. The percentage of children with a 24- month blood lead ≥10 μg/dL, ≥15 μg/dL, and ≥20 μg/dL was 31% versus 36%, 12% versus 14%, and 5% versus 7% 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, is not effective in the primary prevention of childhood lead exposure.

Original languageEnglish (US)
Pages (from-to)772-777
Number of pages6
JournalPediatrics
Volume103
Issue number4 I
DOIs
StatePublished - Jan 1 1999

Fingerprint

Primary Prevention
Dust
Confidence Intervals
Control Groups
Lead
Safety Management
Paint
Randomized Controlled Trials
Outcome Assessment (Health Care)
Equipment and Supplies
Water

Keywords

  • Blood lead
  • Children
  • Environmental exposure
  • Lead poisoning
  • Lead-contaminated house dust
  • Prevention
  • Primary prevention
  • Randomized trial

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Lanphear, B. P., Howard, C., Eberly, S., Auinger, P., Kolassa, J., Weitzman, M., ... Alexander, K. (1999). Primary prevention of childhood lead exposure: A randomized trial of dust control. Pediatrics, 103(4 I), 772-777. https://doi.org/10.1542/peds.103.4.772

Primary prevention of childhood lead exposure : A randomized trial of dust control. / Lanphear, Bruce P.; Howard, Cynthia; Eberly, Shirley; Auinger, Peggy; Kolassa, John; Weitzman, Michael; Schaffer, Stanley J.; Alexander, Keith.

In: Pediatrics, Vol. 103, No. 4 I, 01.01.1999, p. 772-777.

Research output: Contribution to journalArticle

Lanphear, BP, Howard, C, Eberly, S, Auinger, P, Kolassa, J, Weitzman, M, Schaffer, SJ & Alexander, K 1999, 'Primary prevention of childhood lead exposure: A randomized trial of dust control', Pediatrics, vol. 103, no. 4 I, pp. 772-777. https://doi.org/10.1542/peds.103.4.772
Lanphear BP, Howard C, Eberly S, Auinger P, Kolassa J, Weitzman M et al. Primary prevention of childhood lead exposure: A randomized trial of dust control. Pediatrics. 1999 Jan 1;103(4 I):772-777. https://doi.org/10.1542/peds.103.4.772
Lanphear, Bruce P. ; Howard, Cynthia ; Eberly, Shirley ; Auinger, Peggy ; Kolassa, John ; Weitzman, Michael ; Schaffer, Stanley J. ; Alexander, Keith. / Primary prevention of childhood lead exposure : A randomized trial of dust control. In: Pediatrics. 1999 ; Vol. 103, No. 4 I. pp. 772-777.
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abstract = "Background. Dust control is recommended as one of the primary strategies to prevent or control children's exposure to residential lead hazards, but the effect of dust control on children's blood lead levels is poorly understood. Objective. To determine the effectiveness of dust control in preventing children's exposure to lead, as measured by blood lead levels, during their peak age of susceptibility. Design. A randomized, controlled trial. Setting. Rochester, NY. Participants. A total of 275 urban children were randomized at 6 months of age, of whom 246 (90{\%}) were available for the 24-month-old follow-up visit. Interventions. Children and their families were randomly assigned to an intervention group (n = 140), which received cleaning equipment and up to eight visits by a dust control advisor, or a control group (n = 135). Outcome Measures. Geometric mean blood lead levels and prevalence of elevated blood lead levels (ie, >10 μg/dL, 15 μg/dL, and 20 μg/dL). Results. At baseline, children's geometric mean blood lead levels were 2.9 μg/dL (95{\%} confidence interval [CI] = 2.7, 3.1); there were no significant differences in characteristics or lead exposure by group assignment, with the exception of water lead levels. For children in the intervention group, the mean number of visits by a dust control advisor during the 18-month study period was 6.2; 51 (36{\%}) had 4 to 7 visits, and 69 (49{\%}) had 8 visits. At 24 months of age, the geometric mean blood lead was 7.3 μg/dL (95{\%} CI = 6.6, 8.2) for the intervention group and 7.8 μg/dL (95{\%} CI = 6.9, 8.7) for the control group. The percentage of children with a 24- month blood lead ≥10 μg/dL, ≥15 μg/dL, and ≥20 μg/dL was 31{\%} versus 36{\%}, 12{\%} versus 14{\%}, and 5{\%} versus 7{\%} 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, is not effective in the primary prevention of childhood lead exposure.",
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N2 - Background. Dust control is recommended as one of the primary strategies to prevent or control children's exposure to residential lead hazards, but the effect of dust control on children's blood lead levels is poorly understood. Objective. To determine the effectiveness of dust control in preventing children's exposure to lead, as measured by blood lead levels, during their peak age of susceptibility. Design. A randomized, controlled trial. Setting. Rochester, NY. Participants. A total of 275 urban children were randomized at 6 months of age, of whom 246 (90%) were available for the 24-month-old follow-up visit. Interventions. Children and their families were randomly assigned to an intervention group (n = 140), which received cleaning equipment and up to eight visits by a dust control advisor, or a control group (n = 135). Outcome Measures. Geometric mean blood lead levels and prevalence of elevated blood lead levels (ie, >10 μg/dL, 15 μg/dL, and 20 μg/dL). Results. At baseline, children's geometric mean blood lead levels were 2.9 μg/dL (95% confidence interval [CI] = 2.7, 3.1); there were no significant differences in characteristics or lead exposure by group assignment, with the exception of water lead levels. For children in the intervention group, the mean number of visits by a dust control advisor during the 18-month study period was 6.2; 51 (36%) had 4 to 7 visits, and 69 (49%) had 8 visits. At 24 months of age, the geometric mean blood lead was 7.3 μg/dL (95% CI = 6.6, 8.2) for the intervention group and 7.8 μg/dL (95% CI = 6.9, 8.7) for the control group. The percentage of children with a 24- month blood lead ≥10 μg/dL, ≥15 μg/dL, and ≥20 μg/dL was 31% versus 36%, 12% versus 14%, and 5% versus 7% 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, is not effective in the primary prevention of childhood lead exposure.

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