Home Education Visits Reduce Childhood Lead Levels

Extracts of an article by Brad Schultz, David Pawel, and Amy Murphy: "A Retrospective Examination of In-Home Educational Visits to Reduce Childhood Lead Poisoning" in Environmental Research Section A 80 364-8 (1999) Abstract: http://www.ncbi.nlm.nih.gov/pubmed/10330310

A number of human health effects from lead are well known. However, the means for reducing lead exposure in children has been a subject of uncertainty. This paper presents results of a retrospective study of educational lead reduction interventions in Milwaukee, Wisconsin for children who had elevated blood lead [PbB] levels between 20 and 24  µg/dL.

The study examined Milwaukee Health Department (MHD) records of baseline and follow-up PbB measurements. A study group of children received an in-home education visit by an MHD paraprofessional. The education-al visits last about an hour and the importance of reducing lead exposure, nutritional suggestions, and dust clean-up practices and behavioral changes that can reduce lead exposure are discussed. After the intervention, the average observed PbB level (n = 187) declined by 4.2 µg/dL or about 21%.

A decline of 1.2 µg/dL (6%) [was] also observed in a reference group of 226 children who did not receive an MHD in-home visit. The decline in the reference group may be partially due to education at the clinics taking the blood samples. The study group had a decline in PbB levels 3.1 µg/dL (15%) greater than the reference group, with the difference between groups being statistically significant with a P value of less than 0.001. Although significant exposure remained in most of the children studied, important lead reductions were observed with this relatively inexpensive and simple intervention. Education in the homes of families at risk for lead poisoning may be an effective component of programs to reduce blood levels.

RESULTS

The analysis suggested that 4 months after the first measurement, average declines in PbB levels would be about 1 µg/dL for the reference group and 3.6 µg/dL for the study group. After 12 months, the average declines would be about 3 µg/dL for the reference group and 5.6 µg/dL for the study group.

The effect of the educational interventions did not depend significantly (at a = 0.05) on sex. For males, average declines in PbB levels were about 3.7 µg/dL in the study group and –0.4 µg/dL in the reference group. For females, these declines were 5.0 and 2.8 µg/dL, respectively. The difference in declines in PbB levels was 4.1 m /dL for male and 2.2 µg/dL for females.

DISCUSSION

This is the first study of educational interventions that has a reference group of children without the educational intervention.

From this study we saw that PbB levels decline significantly after the in-home educational intervention. The decline appeared to be fairly rapid, with declines appearing to occur within a few months after the relatively simple intervention. The data were sufficient to compare the reductions in PbB levels up to about 1 year after the intervention.

CONCLUSIONS

Costs of the Milwaukee educational visits were estimated to be in the range of $100 per visit including all program costs. Educational intervention appears to be a useful and inexpensive component of lead exposure reduction programs.