Pathways and sources of lead exposure: Michigan Children's Lead Determination (the MI CHILD study).

There has been little research on childhood lead exposure pathways since the 1990s. New data from Michigan in 2017-2021 for 429 children in 345 homes included lead in blood, paint, dust, soil, water, and other housing, demographic, and behavioral metrics. Fifty-three percent of these children had blood lead (BPb) ≥5 μg/dL.

Aging Gracefully in Place: An Evaluation of the Capability of the CAPABLE Approach.

As American adults live longer, society must prioritize effective strategies promoting safe aging-in-place and decreasing institutional health care costs. Social determinants of health, especially housing, critically influence older adult health, particularly for disadvantaged, low-income older adults. Johns Hopkins University developed Community Aging in Place-Advancing Better Living for Elders (CAPABLE), a client-centered, home-based program to improve older adults' function and capacity to age in place.

CAPABLE program improves disability in multiple randomized trials.

Background: Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings.

Radon and moisture impacts from interventions integrated with housing energy retrofits.

Energy retrofits can reduce air exchange, raising the concern of whether indoor radon and moisture levels could increase. This pre/post-intervention study explored whether simple radon interventions implemented in conjunction with energy retrofits can prevent increases in radon and moisture levels. Treatment homes (n = 98) were matched with control (no energy retrofits or radon intervention) homes (n = 12).

Replacing Windows Reduces Childhood Lead Exposure: Results From a State-Funded Program.

Context: Despite considerable evidence that window replacement reduces childhood lead exposure and improves energy conservation and market value, federal policies in childhood lead poisoning, home improvement, and weatherization programs all tend to discourage it.

Objective And Intervention: To evaluate a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones.

Design And Setting: Pre-/post evaluation in 1 urban and 1 rural jurisdiction.

Self-reported health outcomes associated with green-renovated public housing among primarily elderly residents.

Objectives: Assess the benefits of green renovation on self-reported health of primarily elderly residents of a low-income public housing apartment building.

Design And Setting: Using questions from the Medicare Health Outcomes Survey, we interviewed residents at baseline and 1 year after green renovation of their 101-unit building in Mankato, Minnesota, comparing self-reported mental and physical health outcomes of 2 sets of residents (all-ages: median, 66 years, n = 40; elder: median, 72 years, n = 22) with outcomes for 2 same-aged low-income Minnesota comparison groups taken from Medicare Health Outcomes Survey participants (n = 40 and 572, respectively).

Study Group: Mankato apartment building residents.

An investigation into porch dust lead levels.

Lead in porch dust can expose children through direct contact or track-in to the home, but has not been adequately evaluated. At homes undergoing lead hazard control in Rochester, NY, we sampled settled dust lead on exterior porch floors at baseline, immediately post-lead hazard control and one-year post-work (n=79 homes with complete data) via wipe sampling and collected housing, neighborhood and soil data. Baseline GM porch floor dust lead loading (PbPD) was 68 µg/ft(2), almost four times more than baseline GM interior floor dust lead (18 µg/ft(2)).

Health and housing outcomes from green renovation of low-income housing in Washington, DC.

Green building systems have proliferated recently, but studies are limited of associated health and housing outcomes. The authors measured self-reported resident physical and mental health, allergens, and building conditions at baseline and one-year follow-up in a low-income housing development being renovated in accordance with green healthy housing improvements (Enterprise Green Communities standards and Leadership in Energy & Environmental Design [LEED] gold certification). Self-reported general health in adults significantly improved from 59% to 67% (p = .

Moving into green healthy housing.

Background: Green building systems have proliferated but health outcomes and associated costs and benefits remain poorly understood.

Objective: To compare health before and after families moved into new green healthy housing with a control group in traditionally repaired housing.

Design And Setting: Mixed methods study in 3 Chicago housing developments.

Effect of weatherization combined with community health worker in-home education on asthma control.

Objectives: We assessed the benefits of adding weatherization-plus-health interventions to an in-home, community health worker (CHW) education program on asthma control.

Methods: We used a quasi-experimental design to compare study group homes (n = 34) receiving CHW education and weatherization-plus-health structural interventions with historical comparison group homes (n = 68) receiving only education. Data were collected in King County, Washington, from October 2009 to September 2010.

Nurse case management and housing interventions reduce allergen exposures: the Milwaukee randomized controlled trial.

Objective: We examined the impact of a combination of home environmental interventions and nurse case management services on total settled dust loadings and on allergen concentrations in the homes of asthmatic children. METHODS Using a randomized longitudinal controlled trial study design, we randomly assigned homes of asthmatic children in Milwaukee to either a control (n = 64) or an intervention (n = 57) group. Control group homes received a visual assessment, education, bed/pillow dust mite encasings, and treatment of lead-based paint hazards.

Health outcomes and green renovation of affordable housing.

Objective: This study sought to determine whether renovating low-income housing using "green" and healthy principles improved resident health and building performance.

Methods: We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon.

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.

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.

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.