STATED briefly Evaluation of the Invest in Children Primary Lead Prevention Project

Despite extensive interventions to reduce lead exposures over the past several decades, lead poisoning remains a major environmental health threat to children in the United States. In Cleveland and Cuyahoga County, the prevalence of elevated blood lead levels far exceeds that of the United States; among children 0 to 72 months of age who were screened in 2009, 21% and 16 % respectively, had blood lead levels ≥5 µg/dL1. Older housing stock is a significant risk factor for lead poisoning among children as the use of lead-based paint in houses was not banned in the United States until 1978. Children living in older homes within low-income neighborhoods are affected disproportionately as their residences are more likely to contain chipping, peeling, or water damaged paint that has not been properly addressed. These conditions combined with the normal hand-to-mouth behaviors of small children can result in ingestion and inhalation of lead dust, flakes, and contaminated soil. Despite being an established and well-studied public health problem, the majority of lead poisoning intervention occurs at the level of secondary, rather than primary prevention; that is, efforts are aimed at screening children for lead poisoning between 1 and 6 years of age. We therefore designed a primary lead prevention study to evaluate the effectiveness of low cost, minor lead repairs and caregiver education in homes of newborn infants to prevent lead poisoning in these children. The lead repairs performed as part of this study were not meant to remove lead completely from the home, nor were the repairs meant to be permanent; however, they were meant to reduce the risk of elevated blood lead levels among young children when they are at the greatest risk. If low cost repairs are effective in preventing elevated blood lead levels in young children, more homes can be addressed in the near-term thereby decreasing the incidence of lead poisoning in children