| Author, Year | Type of Intervention | N | Population/ Risk Factors | Lead Levels | Duration of followup | Results | Adverse Effects |
Aschengrau, 199485
Aschengrau, 199786 | Soil and interior dust abatement, and loose paint stabilization | 152 | Children <4 years | 7-24 µg/dL | 2 years | BLL and change (µg/dL)(95% CI)
Phase I, mixed interventions: pre 13.10, post 10.65; change -2.44 (CI -3.32, -1.57)
Phase II, soil abatement for homes not already deleaded:
Group A: pre 12.94, post 7.69; change -5.25 (CI -6.51, -3.99)
Group B: pre 10.54, post 9.15; change -1.30 (CI -4.03, +1.26)
All groups, all phases combined: pre 12.66, post 9.77; change -2.89 (CI -3.64, -2.13)
Soil lead reduction of 2,060 ppm is associated with a 2.25-2.70 µg/dL decline in BLL. Low levels of soil recontamination 1-2 years following abatement indicate the intervention is persistent.
Paint hazard remediation alone was associated with a BLL increase of 6.5 µg/dL (p=0.05). Paint hazard remediation combined with soil abatement suggested an insignificant increase of 0.9 µg/dL (p=0.36). | ND |
| Aschengrau, 199872 | Dust, domestic cleaning with HEPA vacuum, wash window surfaces, seal flaking paint, and repair holes in wall | 63 | Children <4 years | 16.9 µg/dL | 6 months | BLL and change (µg/dL)
Automatic intervention group (high risk): pre 17.5, post 9.1; change -8.4
Randomized intervention group: pre 17.6, post 11.5; change -6.2
Randomized control group: pre 16.3, post 10.4; change -5.9
Relative change, Treatment vs. Control: -0.3 (95% CI -3.8, +3.3)
Automatic Intervention vs. Control: -2.5 (CI -7.0, +2.1) | ND |
| Campbell, 200375 | Dust, second cleaning follows 18-21 months after TLC study cleaning | 73 treatment 86 control | Toddlers age 12-34 months | 20-44 µg/dL | 6 months | BLL declined in both treatment and control groups.
Geometric mean BLL, adjusted for month and child, declined monotonically among 73 children whose homes were cleaned a 2nd time. BLL of the 86 children whose homes did not receive a 2nd cleaning also declined over time, although there was an unexplained increase at the 3-mo post cleaning followup visit.
BLL before the cleaning were higher among children in high-exposure homes (GM 18.1 µg/dL), compared with those in low-exposure homes (GM 14.5 µg/dL). Stratified by randomized treatment, there were only small differences in BLL: 18.3 µg/dL and 17.1 µg/dL for children in chelation vs. placebo, in high exposure homes; and 14.5 vs. 13.5 µg/dL for chelation vs. placebo, in low-exposure homes. | ND |
| Clark, 200469 | Lead-based paint and dust hazard control program and survey | 869 children | HUD hazard control program participants in 14 states | ND | 6 weeks | Post-intervention, 81 (9.%) participants had BLL increases >5 µg/dL (range 5-25; average 8.4).
Logistic regression analysis indicated four factors were significantly associated with increases:
- Child's age at pre-intervention (p=0.006).
- Female caregiver's education (p=0.002).
- General exterior building condition (p=0.0071).
- Second season of blood-sample collection (p<0.001).
Odds ratio of BLL increase decreased sharply as child's age increased. Where female parent had not completed high school, likelihood of BLL increase was 2.5 times higher than families where female parent had completed high school. | ND |
| Farrell, 199880 | Soil | Enrolled 408 children in 263 houses;
187 completed study | Children age 6 months to 6 years | Baseline 11 µg/dL
54% of properties had soil samples >1000 ppm. | 1 year | 1 year post-abatement: BLL in both groups fell below baseline. Differences between treatment and control groups were not significant in any of the cross-sectional or longitudinal models.
2 years post-abatement: soil sampling showed significant lead re-accumulation. | ND |
| Galke, 200178 | Dust | 240 children
1,212 dwellings | Children age 6 months to 6 years | Median 10 µg/dL (range 2-48) | 12 months | 12 months post-intervention: BLL declined from 11.0 to 8.2 (-2.8) µg/dL, a 26% reduction. | ND |
| Haynes, 200274 | Dust, meta-analysis | 4 studies, total subjects= 533 | NR | 6.7-16.9 µg/dL | 6-48 months | Weighted mean change in BLL: -0.62 µg/dL (95% CI -1.55, 0.32). No significant difference between intervention and control groups, combined from educational dust control and professional dust control trials. | ND |
| Jordan, 200382 | Education | 594 mothers and 378 of their children | Inner-city, poor, ethnically diverse (78% non-Caucasian) | Before intervention, all levels were <10 µg/dL | 2 years | Intervention vs. Control
Maintained BLL <10 µg/dL: 81% vs. 73% (p=0.08).
>90% completed 19-20 sessions. Half completed first year of followup sessions; <5%
completed second year. | ND |
Lanphear, 199983;
Lanphear, 200034;
Lanphear, 200293 | Education | 275 | Children age 6 months | 2.9 µg/dL (95% CI 2.7-3.1) at age 6 months | 48 months | No significant difference in BLL by intervention status at 24 months or 48 months.
Intervention vs. Control BLL:
Age 24 months: 7.3 vs. 7.8 µg/dL
Age 48 months: 5.9 vs. 6.1 µg/dL
Dust lead levels declined sharply in both the treatment and control groups. There was no significant difference in dust lead levels at 24 months by group, nor a difference in change in dust lead levels from 6 to 24 months by group.
Other results (Lanphear, 2002): Dietary iron intake, but not calcium intake, was inversely associated with BLL (p<0.05). Also, BLL was over 50% higher in black than in white children (p=0.0001). | ND |
| Lanphear, 200387 | Soil | 198 in first survey; 215 in second survey | Children | Mean 5.6 µg/dL with soil >500 ppm (11% >10 µg/dL)
Mean 3.0 µg/dL with soil <500 ppm (3% >10 µg/dL) | N/A | BLL change (µg/dL) before and after soil abatement:
Intervention group: pre 5.6, post 3.0; change -3.6 (p=0.0001)
Nonintervention group: pre 3.0, post 2.6; change -1.4 (p=0.06)
Stratified by age, and adjusted for mouthing behavior score, and socioeconomic status:
Age 36-72 months: change -2.3 µg/dL (NS)
Age 6-36 months: change -2.5 µg/dL (p=0.03) | ND |
| Leighton, 200373 | Lead paint hazard remediation | 221 | Lead-poisoned children | 20-44 µg/dL | 10-14 months | BLL declined significantly for all groups, 24.3 µg/dL at baseline, to 12.3 µg/dL at 10-14 month followup: a 50% decline (p<0.01).
Intervention (n=146) vs. Nonintervention (N=75):
BLL reduction 53% vs. 41%, relative reduction ±20% (p<0.01). After adjusting for confounders, remediation effect was 11% (NS).
Race was the only factor that confounded the relationship. African American children had higher BLL in followup after remediation. Mean BLL for white and Asian children was 30% lower than African American children (p<0.01). Effect of remediation appeared to be stronger in younger children (10-36 months) than in older children (36-72 months) (p=0.06). Timing of remediation produced no significant effect on BLL. | ND |
| Rhoads, 199970 | Dust | 113 enrolled; final blood levels obtained from 99 | Children mean age 1.7 years | Intervention mean 12.4 µg/dL (SD 5.7)
Control mean 11.6 µg/dL (SD 6.2) | 1 year | Significant effect on BLL (µg/dL) change.
Intervention: pre 12.4, post 10.3; change -2.1 (17%)
Control: pre 11.6, post 11.6; change +0.1 (+1%)
Estimated intervention effect= -1.9 µg/dL (p<0.05).
Mother's final knowledge score was not a highly significant predictor of BLL change. The contribution of the educational intervention could not be clearly distinguished from the effects of cleaning. | ND |
| Schultz, 199984 | Education | 187 | African American, Caucasian, Native American, Asian, other | 20-24 µg/dL | 6 months | Intervention vs. Reference group BLL decline (µg/dL) significant: 4.2 (±21%) vs. 1.2 (±6%); net reduction 3.1 µg/dL (p<0.001). | ND |
| Strauss, 200579 | Paint | 1,179 | Children age <36 months | Pre-intervention means (µg/dL):
Untreated 4.5
Treated 7.0 | From 1 year pre-intervention to 3 years post-inter-vention | Comparison of case vs. control change in BLL (µg/dL) showed significant differences, adjusted for time, seasonality, age, and gender.
Controls matched on housing criteria only:
HUD-treated: 7.04 (42.7%) vs.3.54 (13.2%)
Untreated control: 4.57 (19.7%) vs. 3.45 (10.0%) (p<0.001)
Controls matched on combination of pre BLL and housing information:
HUD-treated: 7.07 (42.8%) vs. 3.57 (12.5%)
Untreated control: 5.76 (29.1%) vs. 3.96 (15.9%) (p=0.116)
Controls matched on pre-intervention BLL information:
HUD-treated: 7.07 (42.9%) vs. 3.59 (12.6%)
Untreated control: 6.62 (36.9%) vs. 4.28 (16.0%) (p=0.015) | ND |
| Swindell, 199476 | Paint; dust | 132 | Children with high BLL, mean age 35 months, range 12-91 months
52% boys | Pre-abatement level = 26.0 (±6.5) µg/dL | 2 wks to 6 months following abatement | BLL declined significantly: 26.0 µg/dL to 21.2 µg/dL (p<0.001). BLL reduction varied by baseline BLL:
97% with BLL >30 µg/dL had reductions within 1 year.
81% with BLL 20-29 µg/dL had reductions.
35% with BLL <20 µg/dL had reductions; in this group, BLL increased following abatement, 16.7 to 19.2 µg/dL (p=0.053)
There was no meaningful change in pre- to post-abatement levels by calendar year of abatement. | ND |
| Taha, 199971 | Paint; dust | 42 eligible, data analyzed for 37 | Children age 1-3 years | 28.8 µg/dL | ±69 days after abatement | Post-treatment, mean BLL 24.6 µg/dL represented a 6.2 µg/dL reduction (22%). Adjusted for season and age of child, the BLL reduction was 6.0 µg/dL (18%).
Adjusted BLL (µg/dL) initial/ followup/ change/ percentage change
Intervention (n=37): pre 28.8, post 22.8; change -6.0 (-18%) (p=0.05)
Control (n=65): pre 31.1, post 29.5; change -1.6 (-1.8%) (NS) | ND |
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