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Health and environmental outcomes of traditional and modified practices for abatement of residential lead-based paint.

M R Farfel and J J Chisolm, Jr

Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.

We evaluated traditional and modified practices for abating lead-based paint in homes of children with blood-lead concentrations (PbB) greater than 1.4 mumol/L (greater than 29 micrograms/dl). Traditional abatement resulted in acute increases in: 1) lead contaminated house dust (generally 3 to 6-fold over pre-abatement levels, but at abated sites typically 10 to 100-fold); and 2) the PbBs of nearly half of the occupant children. Modified practices represented modest short-term improvement compared to traditional practices but were also inadequate. By six months, it was clear that neither form of abatement resulted in long-term reductions of PbB or house dust lead levels, leaving children at continued risk of excessive exposure to lead and permanent adverse neurobehavioral effects. Windows were found to be high sources of lead contaminated house dust. Recommendations are made for improved abatement practices including more complete abatement of window units and more effective clean-up to remove lead-bearing dust. Thirteen million US children live in lead-painted dwellings. Research is needed to identify abatement strategies that will be practical and well suited to the current understanding of low-level lead toxicity.

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