 |
|
Lead-Contaminated Soil Abatement and Urban Children's Blood Lead Levels
Michael Weitzman, MD;
Ann Aschengrau, ScD;
David Bellinger, PhD;
Ronald Jones;
Julie Shea Hamlin, MPH;
Alexa Beiser, PhD
JAMA. 1993;269(13):1647-1654.
Abstract
| |
Objective.
—To test the hypothesis that a reduction of 1000 ppm or more of lead in soil accessible to children would result in a decrease of at least 0.14 µmol/L (3 µg/dL) in blood lead levels.
Setting.
—Urban neighborhoods with a high incidence of childhood lead poisoning and high soil lead levels.
Design.
—Randomized controlled trial of the effects of lead-contaminated soil abatement on blood lead levels of children followed up for approximately 1 year after the intervention.
Patients.
—A total of 152 children less than 4 years of age with venous blood lead levels of 0.34 to 1.16 µmol/L (7 to 24 µg/dL). Children were largely poor and had a mean age at baseline of 32 months, a mean blood lead level of 0.60 µmol/L (12.5 µg/dL), and a median surface soil lead level of 2075 ppm.
Interventions.
—Children were randomized to one of three groups: the study group, whose homes received soil and interior dust abatement and loose paint removal; comparison group A, whose homes received interior dust abatement and loose paint removal; and comparison group B, whose homes received only interior loose paint removal.
Main Outcome Measures.
—Change in children's blood lead levels from preabatement levels to levels approximately 6 and 11 months after abatement.
Results.
—The mean decline in blood lead level between preabatement and 11 months after abatement was 0.12 µmol/L (2.44 µg/dL) in the study group (P=.001), 0.04 µmol/L (0.91 µg/dL) in group A (P=.04), and 0.02 µmol/L (0.52 µg/mL) in group B (P=.31). The mean blood lead level of the study group declined 0.07 µmol/L (1.53 µg/dL) more than that of group A (95% confidence interval [CI], -0.14 to -0.01 µmol/L [-2.87 to -0.19 µg/dL]) and 0.09 µmol/L (1.92 µg/dL) more than group B (95% CI, -0.16 to -0.03 µmol/L [-3.28 to -0.56 µg/dL]). When adjusted for preabatement lead level, the 11-month mean blood lead level was 0.06 µmol/L (1.28 µg/dL) lower in the study group as compared with group A (P=.02) and 0.07 µmol/L (1.49 µg/dL) lower than in group B (P=.01 ). The magnitude of the decline independently associated with soil abatement ranged from 0.04 to 0.08 µmol/L (0.8 to 1.6 µg/dL) when the impact of potential confounders, such as water, dust, and paint lead levels, children's mouthing behaviors, and other characteristics, was controlled for.
Conclusions.
—These results demonstrate that lead-contaminated soil contributes to the lead burden of urban children and that abatement of lead-contaminated soil around homes results in a modest decline in blood lead levels. The magnitude of reduction in blood lead level observed, however, suggests that lead-contaminated soil abatement is not likely to be a useful clinical intervention for the majority of urban children in the United States with low-level lead exposure.
(JAMA. 1993;269:1647-1654)
Author Affiliations
From the Department of Pediatrics, University of Rochester (NY) School of Medicine and Dentistry (Dr Weitzman); Department of Epidemiology and Biostatistics, Boston (Mass) University of Public Health (Drs Aschengrau and Beiser); Department of Neurology, Harvard School of Medicine, Boston (Dr Bellinger); Department of Public Health, Cleveland, Ohio (Mr Jones); and Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, Calif (Ms Hamlin). Dr Weitzman was a member of the Department of Pediatrics at Boston City Hospital/Boston University School of Medicine during much of this study.
Footnotes
These findings were reported to the Environmental Protection Agency in July 1992. This article has not been subjected to the agency's peer and administrative review and therefore may not necessarily reflect the views of the agency, and no official endorsement should be inferred.
Reprint requests to Department of Pediatrics, Rochester General Hospital, 1425 Portland Ave, Rochester, NY 14621 (Dr Weitzman).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Neurotoxicants, Micronutrients, and Social Environments: Individual and Combined Effects on Children's Development
Hubbs-Tait et al.
Psychological Science in the Public Interest 2005;6:57-121.
ABSTRACT
| FULL TEXT
A Randomized Trial of Calcium Supplementation for Childhood Lead Poisoning
Markowitz et al.
Pediatrics 2004;113:e34-39.
ABSTRACT
| FULL TEXT
Costs and Benefits of Enforcing Housing Policies to Prevent Childhood Lead Poisoning
Brown
Med Decis Making 2002;22:482-492.
ABSTRACT
Diagnostic Testing Unwarranted for Children With Blood Lead 10 to 14 µg/dL
Sargent et al.
Pediatrics 1999;103:51e-51.
ABSTRACT
| FULL TEXT
An Evaluation of the Baltimore Community Lead Education and Reduction Corps (CLEARCorps) Program
Duckart
Eval Rev 1998;22:373-402.
ABSTRACT
Lead Screening Practices of Pediatric Residents
Schaffer et al.
Arch Pediatr Adolesc Med 1998;152:185-189.
ABSTRACT
| FULL TEXT
New Lead Screening Guidelines From The Centers for Disease Control and Prevention: How Will They Affect Pediatricians?
Harvey
Pediatrics 1997;100:384-388.
FULL TEXT
The Critical Role of House Dust in Understanding the Hazards Posed by Contaminated Soils
Paustenbach et al.
International Journal of Toxicology 1997;16:339-362.
ABSTRACT
Rethinking the Threshold for an Abnormal Capillary Blood Lead Screening Test
Sargent and Dalton
Arch Pediatr Adolesc Med 1996;150:1084-1088.
ABSTRACT
Utility of a Risk Assessment Questionnaire in Identifying Children With Lead Exposure
Dalton et al.
Arch Pediatr Adolesc Med 1996;150:197-202.
ABSTRACT
Home Abatement and Blood Lead Changes in Children With Class III Lead Poisoning
Swindell et al.
CLIN PEDIATR 1994;33:536-541.
ABSTRACT
Blood Lead Levels in the US Population: Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991)
Brody et al.
JAMA 1994;272:277-283.
ABSTRACT
Costs and Benefits of Lead Screening
Pantell et al.
JAMA 1993;270:2054-2054.
ABSTRACT
Soil Abatement and Lead Levels in Children
Schlenker
JAMA 1993;270:829-829.
ABSTRACT
LEAD POISONING: TREATMENT AND PREVENTION
JWatch General 1993;1993:7-7.
FULL TEXT
Childhood Lead Poisoning: The Impact of Prevention
Binder and Matte
JAMA 1993;269:1679-1681.
ABSTRACT
|
