Outreach Core and Community Partners Implement Preventive Intervention Programs in Children's Environmental Health

Superfund Basic Research Program

Duke University's Superfund Center Outreach Core is successfully partnering with community-based organizations in Durham County, North Carolina to implement preventive intervention programs in children's environmental health. In conversations with community-based organizations regarding their sense of community needs and interests, it became apparent that childhood lead poisoning was a special concern. Multiple Duke SBRP investigators have expertise in this Superfund chemical, including Richard Di Giulio, Jonathan Freedman, Dharni Vasudevan, and Marie Lynn Miranda.

Duke's in-house SBRP GIS expertise allowed for the development of lead exposure risk priority maps. Maps drawn from a GIS project were developed for Durham County, North Carolina. These maps used spatial analysis of county tax assessor, U.S. Census, and North Carolina blood lead screening data to categorize lead risk levels at the individual tax parcel unit level. The maps predict the most likely parcels to contain lead paint hazards. Areas that are least likely to contain lead paint hazards were also identified. Compared to South and Northeast Durham, the map predicts that Central Durham has a heavier concentration of higher risk parcels.

Durham Congregations, Associations, and Neighborhoods (Durham CAN) and the Durham Affordable Housing Coalition (DAHC), have been using this model as the basis for targeting communities in an ongoing effort to increase blood lead screening among high risk children. Outreach Core staff have partnered with Durham CAN and DAHC in presentations to parent-teacher associations (PTAs), childcare centers, and churches. Other maps zoom in on specific neighborhoods and are printed in large-scale format for use in community events and presentations. The Durham County Health Department's decision in 2003 to base its screening strategy on this model resulted in a 600% increase in its capture rate of children with elevated blood lead levels. The maps are also being used by the Durham Department of Housing and Community Development to prioritize housing rehabilitation resources.

The broader expertise of Duke's SBRP investigators also allowed the Outreach Core to develop a summary of the most recent research on neurological effects associated with low level lead exposure in response to a joint request from the Durham County Health Department, a series of community-based groups (Durham CAN, the Durham Affordable Housing Coalition, PEACH), and local health care providers. The request was received through the Outreach Core staff's participation in the Durham County Lead Action Team. This document was mailed to every pediatrician and community and family health practitioner in Durham and Orange Counties; it has also been used as the basis for Continuing Medical Education Training in other North Carolina counties.

These successful interactions focused on lead have helped to better establish the expertise and availability of Duke's SBRP generally and the Outreach Core more specifically. The Outreach Core is now engaged in discussions with community groups and local health departments to use SBRP expertise to help identify groundwater contamination risk associated with Superfund sites, underground storage tanks, and Toxics Release Inventory (TRI)-reported discharges.