Primary prevention of lead poisoning in children: a cross-sectional study to evaluate state specific lead-based paint risk reduction laws in preventing lead poisoning in children

Abstract

BackgroundChildren younger than 72 months are most at risk of environmental exposure to lead from ingestion through normal mouthing behavior. Young children are more vulnerable to lead poisoning than adults because lead is absorbed more readily in a child’s gastrointestinal tract. Our focus in this study was to determine the extent to which state mandated lead laws have helped decrease the number of new cases of elevated blood-lead levels (EBLL) in homes where an index case had been identified.MethodsA cross-sectional study was conducted to compare 682 residential addresses, identified between 2000 and 2009, in two states with and one state without laws to prevent childhood lead poisoning among children younger than 72 months, to determine whether the laws were effective in preventing subsequent cases of lead poisoning detected in residential addresses after the identification of an index case. In this study, childhood lead poisoning was defined as the blood lead level (BLL) that would have triggered an environmental investigation in the residence. The two states with lead laws, Massachusetts (MA) and Ohio (OH), had trigger levels of ≥25 μg/dL and ≥15 μg/dL respectively. In Mississippi (MS), the state without legislation, the trigger level was ≥15 μg/dL.ResultsThe two states with lead laws, MA and OH, were 79% less likely than the one without legislation, MS, to have residential addresses with subsequent lead poisoning cases among children younger than 72 months, adjusted OR = 0.21, 95% CI (0.08-0.54).ConclusionsFor the three states studied, the evidence suggests that lead laws such as those studied herein effectively reduced primary exposure to lead among young children living in residential addresses that may have had lead contaminants.

Evaluating the effectiveness of state specific lead-based paint hazard risk reduction laws in preventing recurring incidences of lead poisoning in children

“…Previously published evidence using this data suggests that lead risk reduction laws were effective in primary prevention of lead poisoning among young children (Kennedy et al, 2014). The methods used in the acquisition of data used in this study have been described elsewhere (Kennedy et al, 2014). Briefly, data for this study were obtained through examination of records from the Childhood Blood Lead Surveillance (CBLS) database.…”

“…While there is evidence suggesting that state laws aimed at primary prevention of lead poisoning among children less than 72 months of age have been effective in achieving this goal (Brown et al, 2001; Kennedy et al, 2014), no evidence was available at the time of this study demonstrating these laws were also effective in preventing recurrent poisoning in children who were previously poisoned. This study therefore sought to determine whether state laws aimed at preventing lead poisoning among young children were also effective in preventing recurring lead poisoning among those poisoned previously.…”

“…Each case file was randomly selected to give each child an equal opportunity of being selected into the study. The specific method used for randomization has been described elsewhere (Kennedy et al, 2014). …”

“…Since male children compared to female children, are more likely to have EBLLs (Walter et al, 1980), sex specific proportions were determined separately. A specific description of how the formula was operationalized has been described elsewhere (Kennedy et al, 2014). Fig.…”

Is Central Europe Safe from Environmental Lead Intoxications? A Case Series

“…Remediation efforts typically result in a slow reduction of blood lead levels in exposed children, and the time required in children who were not treated with chelation drugs is about two years (8,9). There is little correlation between the blood lead level and total body lead burden, since blood concentration reflects only recent exposure.…”