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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)
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.
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