Author, Year
(Quality) |
Study Design |
Type of Inter- vention |
Years Conducted |
N |
Age |
Duration of followup |
Baseline BLL |
BLL (µg/dL) Results
(Initial/Final/Change) |
Summary of Effect |
|---|
Aschengrau, 1994
85;
Aschengrau, 199786
(N/A) |
Randomized environmental intervention; no untreated
comparison group |
Soil |
1989-1990 |
152 |
<4 |
2 years |
7 to 24 µg/dL |
T1: 13.10 / 10.65 / -2.44 (95% CI -3.32, -1.57)
T2: 12.94 / 7.69 / -5.25 (95% CI -6.51, -3.99)
T3: 10.54 / 9.15 / -1.30 (95% CI -4.03. +1.26)
All Ts: 12.66 / 9.77 / -2.89 (95% CI -3.64. -2.13)
C: None |
N/A |
Aschengrau, 199872
(Fair) |
RCT |
Dust, paint |
1993-1995 |
63 |
<4 |
6 months |
16.9 µg/dL |
T1 (high BLL, not randomized): 17.5 / 9.1 / -8.4
T2 (random): 17.6 / 11.5 / -6.2
C (random): 16.3 / 10.4 / -5.9
T1 vs. C: -0.3 (95% CI -3.8, +3.3)
T2 vs. C: -2.5 (95% CI -7.0, +2.1) |
No effect |
Campbell, 200375
(Fair) |
Non- randomized controlled trial; followup at the
Philadelphia site of TLC, a chelation RCT |
Dust |
NR |
73 |
12-34 months |
3-6 months post-treatment |
20-44 µg/dL |
No significant difference mean BLL at any clinic
visit between children whose homes were cleaned vs. those whose homes were not cleaned.
BLL declined among both groups. |
No effect |
Clark, 200469
(N/A) |
Observational, no untreated comparison group |
Dust, paint |
NR |
869 children |
6 months to 6 years |
6 weeks |
ND |
Mean change after intervention +8.4 µg/dL
Predictors of BLL increase of >5 µg/dL:
Child's age at baseline (p=0.006)
Mother's education (p=0.002)
Exterior building condition (p=0.007)
Season of sample collection (p<0.001) |
N/A |
Farrell, 199880
(Fair) |
RCT |
Soil |
1990 |
408 enrolled in 263 houses;
187 completed the study |
6 months to 6 years |
1 year |
11 µg/dL |
T: 12.1 (1988) / 9.7 (1991)
C: 10.9 (1988) / 8.4 (1991)
Treatment effect, adjusted for effects of time, seasonality, SES, age, and
mouthing behavior:
T (pre - post): 0.030 (SE 0.034)
C (pre - post): 0.075 (SE 0.036)
T vs. C: -0.045 (SE 0.037) |
No effect |
Galke, 200178
(N/A) |
Descriptive study, no comparison group |
Dust |
1994-1997 |
240 children
1,212 dwellings |
6 months to 6 years |
12 months |
Median 10 µg/dL |
T: 11.0 / 8.2 / -2.8
C: none |
N/A |
Haynes, 200274
(Good) |
Meta-analysis |
Dust, paint; meta-analysis of RCTs |
NR |
4 studies, total subjects = 533 |
NR |
6 to 48 months |
6.7 to 16.9 µg/dL |
Weighted mean change, T vs. C (95%CI):
2 educational dust control trials: -0.33 (-1.4, 0.74)
2 professional dust control trials: -1.52 -3.41, 0.37
All trials:
% >10 µg/dL in T vs. C: similar
% >15 µg/dL in T vs. C: 6% vs. 14% (p=0.008)
% >20 µg/dL in T vs. C: 2 vs. 6% (p=0.024) |
No effect overall; effects seen at higher lead levels |
Jordan, 200382
(Fair) |
RCT |
Education |
NR |
594 mothers and 378 of their children |
Birth to 36 months |
2 years |
<10 µg/dL |
T vs. C
% who maintained BLL <10 µg/dL: 81 vs. 73% (p=ns)
% with BLL 10-19.99: 15 vs. 24% (p=ns)
% with BLL >20 µg/dL: 4 vs. 2% (p=ns) |
No effect |
Lanphear, 199983;
Lanphear, 200034;
Lanphear, 200293
(Fair) |
RCT |
Education |
NR |
275 |
6 months |
48 months |
2.9 µg/dL |
Change from age 6 to 24 months:
T: 2.8 / 7.3 / +5.6 (sic)
C: 2.9 / 7.8 / +6.3 (sic)
T vs. C: (p=ns) |
No effect |
Lanphear, 200387
(N/A) |
Two cross- sectional surveys before and after soil abatement |
Soil |
1993-1996 |
198 in first survey, 215 in second survey |
6-72 months |
N/A (cross- sectional) |
5.6 µg/dL |
T: 5.6 / 3.0 / -3.6, p=0.0001
C: 3.0 / 2.6 / -1.4, p=0.06
Stratifying by age, adjusted for mouthing behavior score and socioeconomic status:
Age 36-72 months: 2.3 µg/dL decline (p=ns)
Age 6-36 months: 2.5 µg/dL decline (p=0.03) |
Effect seen only in young children who had not been exposed |
Leighton, 200373
(Good) |
Retrospective cohort study |
Dust, paint |
1994-1997 |
221 |
6 months to 6 years |
10-14 months |
20-44 µg/dL |
Decline occurred regardless of remediation: 24.3 / 12.3 / -12 (p<0.01)
T: 24.6 / 11.6 -53%
C: 23.8 / 13.9 -41%
Remediation effect adjusted for race: 11% (p=ns)
Effect of remediation tended to be stronger in younger children (10 to <36 months) vs. 36-72 months (p=0.06) |
No effect |
Rhoads, 199970
(Fair) |
RCT |
Dust |
NR |
113; final BLL obtained from 99 |
6-36 months |
1 year |
12 µg/dL |
T: 12.4 / 10.3 / -2.1
C: 11.6 / 11.6 / +0.1
T vs. C: -1.9 µg/dL (p<0.05)
Adjustment for baseline BLL |
+ |
Schultz, 199984
(Fair) |
Retrospective cohort study |
Education |
1994 |
187 |
Mean age 3.35 |
6 months |
20-24 µg/dL |
Change in BLL, T vs. C: -4.2 vs. -1.2 (p<0.001) |
+ |
Strauss, 200579
(Fair) |
Retrospective cohort study |
Dust, paint |
1993-2002 |
1179 |
<36 months |
3 years |
4.5-7.0 µg/dL |
T vs. C BLL reduction, adjusted for time, seasonality,
age, and gender.
Matched on pre-intervention BLL:
T: 7.07 / 3.59 / -3.48
C: 6.62 / 4.28 / -2.34 (p=0.015)
Matched on pre-intervention BLL and housing criteria:
T: 7.07 / 3.57 / -3.50
C: 5.76 / 3.96 / -1.80 (p=0.116) |
+ |
Swindell, 199476
(N/A) |
Retrospective chart review; no comparison group |
Dust, paint |
1987-1990 |
132 |
Mean 35 months Range 12-91 months |
2 weeks to 6 months following abatement |
26 µg/dL |
T: 26.0 / 21.2 / -4.8 (p<0.001)
T group with baseline <20 µg/dL: 16.7 / 19.2 / +2.5 (p=0.053)
C: none
Stratified by baseline BLL, reductions within 1 year occurred in
97% with baseline >30
81% with baseline 20-29
35% with baseline <20 |
+ only if baseline BLL >20 |
Taha, 199971
(Fair) |
Retrospective cohort study |
Dust, paint |
1994 |
42 eligible data analyzed for 37 |
6 months and 6 years |
Mean 69 days after abatement |
28.8 µg/dL |
Adjusted for season and age of child:
T: 28.8 / 22.8 / -6.0 (p=0.05)
C: 31.1 / 29.5 / -1.6 (p=ns) |
+ |
540 Gaither Road Rockville, MD 20850