Effect of Exterior Home Renovation on Community Lead Hazards: A Pilot Study in South Bend, Indiana

Communities across the US face challenges from legacy lead contamination. In South Bend, Indiana, over 68,000 homes were built before 1978, and most contain leaded paint. When these homes are repainted, repaired, or renovated, failure to use lead-safe practices can contaminate the surrounding soil with lead paint flakes and dust. In this study, we used X-ray fluorescence (XRF) to measure soil lead levels surrounding a home with exterior leaded paint (about 10% Pb w/w) after it was repainted in fall of 2019. The painted wooden exterior was prepared for painting by dry scraping without the use of tarps or plastic barriers. A total of 220 soil samples were collected from the home and its immediate neighbors, and an additional 102 samples were collected from 34 homes in the same neighborhood. The median lead level in dripline soil samples across the neighborhood was 434 ppm, but in the recently repainted house, the median soil lead was 1808.9 ppm, and it was 1,346.4 ppm in the four neighboring homes. The repainted house and its four neighbors were mulched by covering all bare soil to a 4-6 inch depth with chipped wood mulch. Two months later, another 100 soil samples were collected and analyzed. The surface lead level around the target house dropped to 13.8 ppm, showing that mulching is an effective strategy for interim control of high soil lead levels.

Is Time Spent Outside the Family Home a Risk Factor for Lead Exposure in Pre-School Children Living in Broken Hill?

Broken Hill is amongst a group of communities internationally that are at greater risk from lead due to active or historical lead industries. Current evidence suggests there is no safe level of lead for young children. This paper describes places outside the family home where young Broken Hill children spend time and considers the potential for this to contribute to lead risk. We interviewed 65 families of children 3 years old or younger and detailed the top five places children spent time at outside the family home. Exposure to private residences outside the family home was recorded for most (88%) young children. Nearly two thirds stayed there five or more hours per week. Most children went there on a weekly basis over many months (median, 12 months), increasing the likelihood of exposure to lead hazards. Further investigation of the lead hazard and risk behaviour of children at these residences would assist in developing guidelines for remediation of the lead hazard for all private residences in Broken Hill. This approach to elucidating the potential sources and pathways of lead and other heavy metal exposures for young children may have merit in other settings where comprehensive zonal remediation is not feasible or may not be warranted.

Neighborhood-Level Lead Paint Hazard for Children under 6: A Tool for Proactive and Equitable Intervention

Lead is well known for its adverse health effects on children, particularly when exposure occurs at earlier ages. The primary source of lead hazards among young children is paint used in buildings built before 1978. Despite being 100% preventable, some children remain exposed and state and local policies often remain reactive. This study presents a methodology for planners and public health practitioners to proactively address lead risks among young children. Using geospatial analyses, this study examines neighborhood level measurement of lead paint hazard in homes and childcare facilities and the concentration of children aged 0–5. Results highlight areas of potential lead paint hazard hotspots within a county in the Midwestern state studied, which coincides with higher concentration of non-white children. This places lead paint hazard in the context of social determinants of health, where existing disparity in distribution of social and economic resources reinforces health inequity. In addition to being proactive, lead poisoning intervention efforts need to be multi-dimensional and coordinated among multiple parties involved. Identifying children in higher lead paint hazard areas, screening and treating them, and repairing their homes and childcare facilities will require close collaboration of healthcare professionals, local housing and planning authorities, and community members.

Challenges and Opportunities for Communicating Lead Exposure Risks in Idaho’s Silver Valley

Lead-contaminated soil and dust remain a primary hazard for mining-impacted regions around the world. Exposure to lead is linked to a range of negative health consequences like developmental delays in children. Residents and visitors in mining-impacted regions can practice health protective behaviors such as handwashing and avoidance of possibly contaminated areas to limit exposure. Health districts face the challenge of informing people about these recommended protective behaviors. The objective of this case is to describe the risk communication strategies employed by a health district and to evaluate residents’ perceptions of the risk of lead exposure in a mining-impacted region of northern Idaho. The case examination draws from risk communication literature, the experiences of the health district, and a community survey. The survey results suggest that appropriately tailoring health risk messages based on elevating recipients’ risk perceptions and efficacy levels may help to encourage protective behaviors. Because lead hazards pose dynamic risks in mining-impacted communities, it is also important to periodically update health risk messages through two-way information exchanges between experts and nonexperts. Lessons learned from this case can be applied to improve health through risk communication in other communities where lead hazards pose threats to human health.

Evidence-based lead mitigation strategies: Are the DIY lead mitigation recommendations by health departments supported by research?

Background: Legislation outlawing leaded paint in 1978 and tetraethyl lead from gasoline in 1992 effectively decreased blood lead levels (BLLs), but the effects of lead are still felt in the United States to this day. There is no safe level of lead in the body, and even low level lead exposure can lead to cognitive and developmental delays such as learning delay and disabilities; low IQ; and attention-deficit/hyperactivity disorder. The CDC has determined that a BLL of 5 μg/dL or higher is cause for environmental and educational intervention. Today, the EPA estimates that there are approximately 24 million housing units containing significant lead hazards, with 4 million being home to children. Many of the families that are faced with lead hazards in their homes are minorities and low socioeconomic status. To assist families with possible lead hazards in the home, interim controls of lead hazards may be paramount to reducing lead levels in the household in a simple, cost effective manner. Methods: To that end, our research had two aims (a) conduct a systematic literature review to learn about do-it-yourself (DIY) interim controls that are evidence-based and effective in reducing lead hazards in the home and (b) conduct interviews with key personnel at each state health department to learn more about their lead prevention programs and the DIY mitigation strategies recommended to families. Results: Our provisional findings suggest there is an inconsistent, wide range of mitigation strategies recommended by the state health departments that often lack empirical evidence. . While our literature review identified effective interim controls, the literature is outdated. Conclusion and Potential Impact: We recommend more studies are needed to identify cost effective interim controls and the standardization of health department DIY interim controls across the nation.

Understanding evidence-based lead mitigation: Is the lead mitigation advice and strategies being communicated to citizens evidence-based?

Background and Hypothesis: The CDC has declared that there is no safe blood lead level for a child, but still approximately 37 million homes are lead-contaminated of which 4 million are home to small children. Lead abatement is an expensive strategy to remove all lead hazards rendering a home lead-free. Many of these lead-contaminated homes are in lower socioeconomic areas which makes lead abatement nearly impossible. Given the expense of lead abatement, low-cost interim controls are needed to reduce lead exposure thus creating a lead-safe home. We hypothesize that updated lead mitigation strategies need pursued, and there is a large disparity of lead information disseminated between health departments. Project Methods: Using JSTOR and Boolean criteria, we conducted a systematic literature review on evidence-based, do-it-yourself (DIY) lead mitigation strategies for sources of lead contamination. Once the literature review was completed, QualtricsR was used to quantitatively and qualitatively evaluate the 50 state health department’s websites for lead policy, user friendliness, and recommended lead interim controls as compared to the literature review. Results: Results from the literature indicate that there is a lack of current information regarding new strategies for lead mitigation. Research prior to the year 2000 shows that cleaning flat surfaces by wet mopping, washing hands frequently, mulching, removing shoes before entering the home, and painting over deteriorating paint significantly reduces lead accumulation in the home. Preliminary results from the website review found that there is no baseline of uniform information being distributed, and evidence-based practices are not included for each state health department. Potential Impact: The lack of continuity nationwide for lead mitigation showcases that families are not receiving all of the information that research has to offer to help keep their homes safe. This research indicates that there is a need for national lead policies and recommendations, so each family in the U.S. is equally informed.

Perceived Risk and Intentions to Practice Health Protective Behaviors in a Mining-Impacted Region

Effective risk communication strategies are critical to reducing lead exposure in mining-impacted communities. Understanding the strength of the associations between perceived risk and individuals’ behavioral intentions to protect their health is important for developing these strategies. We conducted a survey within three communities of northern Idaho, USA (n = 306) in or near a Superfund Megasite with legacy mining contamination. Survey data were used to test a theoretical model based on the Health Belief Model. Respondents had higher intentions to practice health protective behaviors when they perceived the risk of lead contamination as severe and recognized the benefits of practicing health protective behaviors. Women reported higher behavioral intentions than men, but age and mining affiliation were not significantly associated with behavioral intentions. Although managing lead hazards in communities impacted by mining is challenging due to widely distributed contamination, effective health risk messages, paired with remediation, are powerful tools to protect the health and safety of residents.