A Review of the Effectiveness of Lead Abatement Strategies in Reducing Lead Exposure Among Children.
By Shaaban Kitindi Fundi,
Despite the growing recognition of lead abatement as an intervention for reducing the risk of lead exposure to children, very few scientists have attempted to review data on its effectiveness. This study reviews the current information on residential lead abatement procedures in order to determine whether these abatement strategies are an effective method to prevent lead exposure in children, as measured by blood lead levels.
A standardized protocol for searching, acquiring, and extracting study data and synthesizing results across studies was used. The criteria for studies to be included in the review were: (1) includes children under the age of 6 years, (2) conducted in the United States, (3) published between January 1990 and March 2004, and (4) have a pre/post or multi arm study design. Nineteen studies were found that met the inclusion criteria.
Three of the nineteen identified studies looked at soil abatement, four looked at paint abatement, ten looked at dust abatement, and two studies used a mixture of soil and dust abatement. No studies looking at the effect of monitoring tap water for lead on children’s lead exposure were identified in this review. The studies varied greatly in terms of their sample size, study design, and methods of data collection.
A review of studies looking at the effectiveness of residential lead abatement strategies at reducing blood lead levels in children found mixed results. Soil abatement strategies appear to be most effective when the soil concentration is quite high (>1000ppm) and when children’s exposure to lead is primarily through contaminated soil and not household dust.
The studies regarding lead paint abatement also show mixed results. Amitai, et al. found that doing abatement while children were living in the home actually caused a short term increase in mean blood lead levels. For this reason, it may be more effective to do primary prevention by abating homes before occupancy than to wait to do abatement after the children have already been exposed. There is also evidence that lead paint abatement may be most effective for children with very high lead blood levels (>25μg/dL) suggesting that this strategy may make more sense as a targeted intervention.
Finally, the data suggest that residential dust abatement strategies are most effective when done multiple times as household dust tends to re-accumulate after short periods of time. In addition, carpets and upholstery remain important reservoirs for lead exposure and new techniques need to be developed to better clean these potential sources of lead exposure.