Effects of HUD-supported lead hazard control interventions in housing on children's blood lead.

The Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the effectiveness of the housing intervention performed in reducing the blood lead of children at four post-intervention times (6-months, 1-year, 2-years, and 3-years). A repeat measures analysis showed that blood lead levels declined up to three-years post-intervention. The results at each successive collection time were significantly lower than at the previous post-intervention time except for the difference between the levels at two and three years.

Improving cost-effectiveness of epidemiological studies via designed missingness strategies.

Modern epidemiological studies face opportunities and challenges posed by an ever-expanding capacity to measure a wide range of environmental exposures, along with sophisticated biomarkers of exposure and response at the individual level. The challenge of deciding what to measure is further complicated for longitudinal studies, where logistical and cost constraints preclude the collection of all possible measurements on all participants at every follow-up time. This is true for the National Children's Study (NCS), a large-scale longitudinal study that will enroll women both prior to conception and during pregnancy and collect information on their environment, their pregnancies, and their children's development through early adulthood-with a goal of assessing key exposure/outcome relationships among a cohort of approximately 100 000 children.

Selecting a lead hazard control strategy based on dust lead loading and housing condition: II. Application of Housing Assessment Tool (HAT) modeling results.

In Part I in this issue, modeling was used to identify a Housing Assessment Tool (HAT) that can be used to predict relative intervention effectiveness for a range of intervention intensities and baseline dust lead loadings in occupied dwellings. The HAT predicts one year post-intervention floor and windowsill loadings and the probability that these loadings will exceed current federal lead hazard standards. This article illustrates the field application of the HAT, helping practitioners determine the minimum intervention intensity needed to reach "acceptable" one year post-intervention levels, with acceptability defined based on specific project needs, local needs, regulations, and resource constraints.

Selecting a lead hazard control strategy based on dust lead loading and housing condition: I. Methods and results.

A methodology was developed to classify housing conditions and interior dust lead loadings, using them to predict the relative effectiveness of different lead-based paint hazard control interventions. A companion article in this issue describes how the methodology can be applied. Data from the National Evaluation of the HUD Lead Hazard Control Grant Program, which covered more than 2800 homes in 11 U.

Friction and impact surfaces: are they lead-based paint hazards?

Professionals who identify residential lead-based paint hazards and develop lead hazard control plans are instructed to assess painted friction and impact surfaces in homes as potentially active sources of dust lead, a known exposure vector for young children. However, empirical tests of the importance of these surfaces had not been conducted. Using data collected as part of a 1998 three-community study of the Housing and Urban Development Lead Risk Assessment protocols, this article explores how much rubbing or binding on friction and impact surfaces on windows and doors influence dust lead levels on windowsills and floors, while taking into account paint condition on these surfaces and other sources of lead.

Immediate and one-year post-intervention effectiveness of Maryland's lead law treatments.

A 1994 Maryland law prescribes a lead-based paint risk reduction standard for pre-1950, privately owned rental housing. This standard, applied at each tenancy change, can be met by sampling to verify that dust lead loadings are within acceptable limits or by performing specific lead hazard reduction treatments, followed by an independent visual inspection without dust sampling. We evaluated the ability of visual inspection to predict treatment completion and dust lead loadings.

An investigation of dust lead sampling locations and children's blood lead levels.

The objective of this study is to provide guidance on where to collect dust lead wipe samples in homes to best characterize the risk of a resident child having a blood lead level at or above the CDC level of concern (10 microg/dl). In 1998, the Milwaukee Health Department enrolled 72 children living in pre-1950 buildings: 34 had elevated (i.e.

Evaluation of HUD-funded lead hazard control treatments at 6 years post-intervention.

The Evaluation of the HUD Lead-Based Paint Hazard Control Grant Program (Evaluation) was a HUD-funded study of the effectiveness of lead hazard control (LHC) treatments conducted by 14 grantees in communities across the country. A stratified random sampling scheme was used to select treated units at four grantee sites for continued environmental assessment at 6 years post-intervention. The study compared the relative effectiveness after 6 years of the different classes of interventions used by the grantees, after controlling for such factors as housing conditions and characteristics and resident and neighborhood characteristics.

The influence of common area lead hazards and lead hazard control on dust lead loadings in multiunit buildings.

Owners of multiunit buildings built before 1978 that have interior common areas, and who receive certain forms of federal assistance are generally required to address lead-based paint hazards in those common areas. This study examines the relationships between common area paint and dust lead levels and the floor dust lead loadings in associated dwelling units, as well as the effects of lead hazard control treatments in common areas. This article presents data from common areas in 145 low-income, mostly pre-1940, multiunit buildings with 342 associated dwellings in the U.

National evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program: study methods.

The US Department of Housing and Urban Development (HUD) undertook an evaluation of its Lead Hazard Control Grant Program between 1994 and 1999. The Evaluation is the largest study ever done on the effectiveness of lead hazard controls implemented in residential dwellings. The Evaluation had several major objectives: determining the effectiveness of various lead hazard controls in reducing residential dust lead levels and children's blood lead levels, establishing the costs of doing lead hazard control work and factors that influence those costs, determining the rate of clearance testing failures and their causes, and identifying possible negative effects of lead hazard control work on children's blood lead levels.

Effectiveness of lead-hazard control interventions on dust lead loadings: findings from the evaluation of the HUD Lead-Based Paint Hazard Control Grant Program.

From 1994 to 1999, the Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the intervention experiences of over 2800 homes in 11 states in the USA. Each interior intervention was categorized as (in order of increasing intensity) (a) cleaning/spot painting; (b) complete repainting; (c) complete repainting plus window treatments; (d) window abatement plus treatments to other components; (e) abatement of all lead-based paint hazards; or (f) abatement of all lead-based paint. Complete dust testing and environmental data were available for 1034 and 278 dwellings through 12 and 36 months postintervention, respectively.

Residential dust lead loading immediately after intervention in the HUD lead hazard control grant program.

At the conclusion of most lead hazard control interventions in federally assisted housing built before 1978, a certified clearance examiner must verify that the lead hazard control work was completed as specified and that the area is safe for residents, a process referred to as clearance. This study explores the experience of 14 grantees participating in the Evaluation of the HUD Lead-Based Paint Hazard Control Grant Program in passing clearance. The study also considers how preintervention lead levels (interior dust and paint), building condition/characteristics, and the scope of work influenced initial clearance dust lead loadings and clearance rates.

The relationship between housing and health: children at risk.

In November 2002, the National Center for Healthy Housing convened a 2-day workshop to review the state of knowledge in the field of healthy housing. The workshop, supported with funds from the U.S.

Occurrence and determinants of increases in blood lead levels in children shortly after lead hazard control activities.

This study is an examination of the effect of lead hazard control strategies on children's blood lead levels immediately after an intervention was conducted as part of the US Department of Housing and Urban Development's Lead-Based Paint Hazard Control Grant Program. Fourteen state and local government grantees participated in the evaluation. The findings indicated an overall average reduction in the blood lead levels of 869 children soon after the implementation of lead hazard controls.

The influence of exterior dust and soil lead on interior dust lead levels in housing that had undergone lead-based paint hazard control.

To aid in understanding the contribution of exterior dust/soil lead to postintervention interior dust lead, a subset of housing from the HUD Lead-Based Paint Hazard Control Grant Program Evaluation was selected for study. Housing from 12 state and local governments was included. Exterior entry and street dust samples were obtained by a vacuum method, and soil samples were building perimeter core composites.

Imputation of data values that are less than a detection limit.

Results of the analyses of occupational and environmental samples are frequently reported as "less than a specified value," a practice followed by many analytical laboratories. A left-censored distribution occurs when analytical laboratories do not report results that fall below their limits of detection or quantification. Approximately 37% of the household interior dust lead loadings collected in a large-scale, multisite, longitudinal study of lead-based paint hazard controls were reported to be below the "method detection limit.

An evaluation of one-time professional cleaning in homes with lead-based paint hazards.

A key challenge in reducing the burden of lead poisoning is to identify cost-effective interventions that minimize lead-based paint hazards. One-time professional cleaning of lead-contaminated dust and debris was conducted in 37 housing units with deteriorated lead-based paint and dust lead hazards. These study units are a subset of a larger cohort of the nearly 3500 housing units enrolled in the Evaluation of the HUD Lead-Based Paint Hazard Control Grant Program.

Prevalence and location of teeth marks observed on painted surfaces in an evaluation of the HUD lead hazard control grant program.

Data from an evaluation of the HUD Lead Hazard Control Grant Program were used to evaluate the prevalence and location of teeth marks on painted surfaces in residential housing. The results of these analyses will be useful in the development of more effective pediatric lead poisoning prevention programs. These programs have historically placed considerable emphasis on surfaces accessible to children for mouthing activities.