Primary prevention and health outcomes: Treatment of residential lead-based paint hazards and the prevalence of childhood lead poisoning

Jones, David J.

doi:10.1016/j.jue.2011.06.002

Cited by 19 publications

(5 citation statements)

References 56 publications

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“…Most payers consider only the upfront expenses required for lead hazard control, because most of the benefits will occur in the future; therefore, there is no immediate return on the investment. However, the long-term returns are great: A more recent analysis conducted in the United States suggests that the estimated benefits deriving from treatment of residential lead-based paint hazards are 2–20 times higher than the estimated costs of remediation (Jones 2012). In one of the few studies conducted in the developing world, Ogunseitan and Smith (2007) estimated that lead exposure accounts for 7–25% of the disease burden among Nigerian children, and a 50% decrease in childhood BLL could save $1 billion per year.…”

Section: Discussionmentioning

confidence: 99%

Economic Costs of Childhood Lead Exposure in Low- and Middle-Income Countries

Attinà

Trasande²

2013

Environ Health Perspect

176

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Background: Children’s blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries.Objective: Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries.Methods: We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure.Results: We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6–1162.5 billion.Conclusions: We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries.Citation: Attina TM, Trasande L. 2013. Economic costs of childhood lead exposure in low- and middle-income countries. Environ Health Perspect 121:1097–1102; http://dx.doi.org/10.1289/ehp.1206424

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Section: Discussionmentioning

confidence: 99%

Economic Costs of Childhood Lead Exposure in Low- and Middle-Income Countries

Attinà

Trasande²

2013

Environ Health Perspect

176

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“…A higher participation rate for remediation work and/or study visits might have resulted in lower BLLs for the LSH Study cohort. A recent study looking at aggregate remediation efforts in Chicago attempted to derive estimates of the effect of remediation, working with census tract level data [ 17 ]. Since percentage of houses remediated is an indicator of old, poorly-maintained housing, this kind of research has to deal with numerous confounders, which can only be partially controlled even with individual-level data, let alone census tract-level data.…”

Section: Discussionmentioning

confidence: 99%

“…He also found that, citywide, 2.5 cases of lead poisoning were adverted for every housing unit remediated. Lastly, he found that benefits from decreased prevalence, such as increased expected lifetime earnings and decreased medical expenditures for poisoned children, were valued at 2–20 times the estimated costs of the home remediation [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Prevention of Lead Exposure—Blood Lead Results at Age Two Years

Campbell

Gracely

Tran

et al. 2012

IJERPH

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Objectives: The Philadelphia Lead Safe Homes (LSH) Study was designed to evaluate whether educational and environmental interventions in the first year of life for families of newborns increased knowledge of lead exposure prevention and were associated with less elevation of blood lead levels (BLLs) for these children, when compared to children receiving standard care. Methods: The current study performed descriptive statistics on the second-year BLL data for both groups and compared these using chi-square tests for proportions and unpaired t-tests for means. Results: A BLL result was found for 159 (50.6%) of the 314 LSH cohort children and 331 (52.7%) of the 628 control children (p = 0.1). Mean and standard deviation for age at draw was 23.8 (3.4) months versus 23.6 (3.1) months (P = 0.6). Geometric mean BLLs were 3.7 versus 3.5 µg/dL (P = 0.4). The percentages of the cohort group with a BLL of ≥20, ≥10 and ≥5 μg/dL, respectively, were 0.6%, 5% and 30%; for the controls 1.2%, 6.6%, and 25%. These percentages were not significantly different between groups. Conclusion: A comparison of geometric mean BLLs and percentages above several BLL cut points drawn at age two years in a group of urban newborns benefitting from study interventions versus a group of similar urban children did not yield statistically significant differences. Both groups had relatively lower lead levels when compared to historical cohort groups, which may reflect a continuing downward trend in BLLs in U.S. children. The interventions did result in benefits to the families such as an increase in parental knowledge about lead exposure prevention and in-home wet cleaning activity, and a decrease in lead dust levels in study homes.

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“…The most immediate (and expensive) way to reduce environmental exposure within residences identi ed to contain a lead hazard is through a remediation service. Prior evaluations of household lead remediation programs through randomized controlled trials document signi cant decreases in levels of household dust (Sandel et al, 2010) and the number of elevated BLL cases (Jones, 2012). If an inquiry or home investigation identi es a potential residence-based hazard for children exceeding the alert threshold, families are typically referred to lead-based paint removal programs.…”

Section: Mechanisms and Intensity Of Treatmentmentioning

confidence: 99%