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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    AU - Howard, Cynthia

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    AU - Kolassa, John

    AU - Weitzman, Michael

    AU - Schaffer, Stanley J.

    AU - Alexander, Keith

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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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