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Lead paint abatement programs

Health Factors: Housing & Transit
Decision Makers: Community Development Professionals Employers & Businesses Local Government State Government Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 50-99% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

Lead paint abatement programs completely eliminate lead-based paint and contaminated dust via encapsulating or permanently containing lead paint and lead painted fixtures and surfaces (US HUD-Lead 2012). Permanent abatement strategies differ from interim control measures such as specialized cleaning, repairs, painting, or temporary containment (Cochrane-Nussbaumer-Streit 2016). As of 2012, scientists indicate no safe blood lead level (BLL); children whose lead tests show a reference level of 5 micrograms per deciliter (µg/dL) require treatment for lead poisoning (White 2015, NCHH-Lead 2014, CDC-Lead facts). 

Expected Beneficial Outcomes

Reduced lead exposure
Improved health outcomes

Evidence of Effectiveness

There is some evidence that lead paint abatement programs reduce lead dust exposure (NCHH-Jacobs 2009, Levin 2008, Dixon 2005, Wilson 2006). Additional evidence is needed to confirm effects on blood lead levels (Armstrong 2014).

Lead abatement can improve health outcomes for children and adults by reducing neurotoxicity rates, developmental disorders, attention deficit hyperactivity disorder-related behaviors (ADHD), anemia, hypertension, and kidney and brain damage (Armstrong 2014, Berg 2012, NCHH-Jacobs 2009). Newborn infants are especially vulnerable to effects of lead exposure (Vigeh 2014); a St. Louis-based study suggests prenatal screening and proactive lead hazard remediation can prevent exposure among newborns (Berg 2012). 

Childhood lead exposure is associated with an increased likelihood that children and teenagers engage in adverse behaviors such as aggression, crime, and risky sexual activity. Reduced lead exposure may be linked to reductions in violent crime levels roughly twenty years after exposure would have occurred (Wolpaw Reyes 2015, NBER-Wolpaw Reyes 2007, Feigenbaum 2015). 

Public-private sector partnerships can increase efficiency in remediation, prevention, and support of early interventions for children exposed to lead (NCHH-Lead 2014). Abatement and childhood lead screening programs that focus on communities with homes built before 1978, when lead paint was commonly used, may most effectively identify and reduce lead poisoning (White 2015). Local housing laws can support rehabilitation of older homes contaminated with lead (Korfmacher 2014). A Philadelphia court that enforces lead hazard laws appears to increase property remediation rates (Campbell 2013).

Childhood lead poisoning occurs at higher rates among families with lower incomes, those living in older homes, and those residing in urban areas than their counterparts (White 2015, Korfmacher 2014, Reed 2011a, NCHH-Lead 2014). On average, black children from low income families have higher blood lead levels than white or Hispanic children from low income families (White 2015). 

Cost benefit analysis finds positive net benefits and a high rate of return for lead abatement programs overall (Cochrane-Nussbaumer-Streit 2016, Gould 2009). Economic modeling suggests that future earnings and decreased medical costs for children who benefit from these programs range from 2-20 times the estimated costs of lead abatement (Jones 2012). 

Implementation

United States

As of 2016, 44 states have adopted laws to address lead hazards, primarily lead paint and lead dust (NCSL-Lead hazards 2016). In Maryland, Massachusetts, Rhode Island, and Washington DC, laws focus on identifying and fixing lead paint hazards before children are exposed (Korfmacher 2014). Some cities also have lead hazard laws. Rochester, NY, for example adopted a Lead-Based Paint Poisoning Prevention Ordinance in 2006 that requires lead paint inspections for rental units within the city limits (Rochester-Lead paint).

Many states also support lead abatement efforts. The New York State Department of Health, for example, supports regional lead resource centers in New York City, Syracuse, and Buffalo that work to improve lead testing, education, and prevention activities through partnerships with local medical providers and departments of health (NYS DOH-RLRCs). 

The Centers for Disease Control and Prevention (CDC) Childhood lead poisoning prevention program provides funding for population-based lead poisoning prevention interventions around the country, supporting interventions in 29 states, Washington DC and 5 other cities for 3 years as of 2014 (CDC-PPHF lead). The 10 regional offices of the US Environmental Protection Agency (EPA) each have a designated Regional Lead Coordinator who oversees lead-poisoning prevention efforts in the region (US EPA-Lead contacts).

Wisconsin

Several Wisconsin statutes and rules regulate abatement activities for lead-based paint hazards (WI DHS-WI lead statutes). DHS maintains a searchable database of properties where an inspection did not find any lead-based paint hazards--the Wisconsin Asbestos and Lead Database Online (WI DHS-WALDO). The Wisconsin Childhood Lead Poisoning Prevention Program (WCLPP) reports lead paint hazard abatement activities, tracks state trends in childhood lead poisoning, and provides abatement information and resources (WCLPP-Report 2014).

Implementation Resources

CDC-Lead facts - Centers for Disease Control and Prevention (CDC). Lead: Facts, tips, tools, training, and resources for childhood lead poisoning prevention. Accessed on October 25, 2016
EPHDT-WI Lead - Environmental Public Health Data Tracker (EPHDT): Wisconsin Environmental Public Health Tracking Program. Childhood lead poisoning: filterable map of lead poisoning in Wisconsin. Accessed on October 26, 2016
ME DEH-Lead - Maine Center for Disease Control and Prevention Division of Environmental Health (ME DEH). Childhood lead poisoning: Prevention resources and information. Accessed on October 26, 2016
NCHH-Lead 2014 - National Center for Healthy Housing (NCHH). Preventing lead exposure in US children: A blueprint for action. 2014. Accessed on October 26, 2016
NYS DOH-Lead paint 2013 - New York State Department of Health (NYS DOH). What home owners need to know about removing lead-based paint. 2013. Accessed on February 1, 2017
US EPA-LAF - US Environmental Protection Agency (US EPA). Locate certified inspection, risk assessment, and lead abatement firms (LAF) for assistance with lead removal. Accessed on March 16, 2017
US EPA-Lead hotline - US Environmental Protection Agency (US EPA). Lead hotline: The national lead information center. Accessed on February 28, 2017
US EPA-Protect your family - US Environmental Protection Agency (US EPA), US Consumer Product Safety Commission, US Department of Housing and Urban Development (US HUD). Protect your family from lead in your home. Washington, DC: US Environmental Protection Agency (EPA); 2012. Accessed on February 28, 2017
US HUD-Lead 2012 - US Department of Housing and Urban Development (US HUD), Office of Healthy Homes and Lead Hazard Control. Guidelines for the evaluation and control of lead based paint. 2012. Accessed on February 23, 2017

Citations - Description

CDC-Lead facts - Centers for Disease Control and Prevention (CDC). Lead: Facts, tips, tools, training, and resources for childhood lead poisoning prevention. Accessed on October 25, 2016
Cochrane-Nussbaumer-Streit 2016* - Nussbaumer-Streit B, Yeoh B, Griebler U, et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database of Systematic Reviews. 2016;(12):CD006047. Accessed on November 1, 2016
NCHH-Lead 2014 - National Center for Healthy Housing (NCHH). Preventing lead exposure in US children: A blueprint for action. 2014. Accessed on October 26, 2016
US HUD-Lead 2012 - US Department of Housing and Urban Development (US HUD), Office of Healthy Homes and Lead Hazard Control. Guidelines for the evaluation and control of lead based paint. 2012. Accessed on February 23, 2017
White 2015 - White BM, Bonilha HS, Ellis C. Racial/ethnic differences in childhood blood lead levels among children <72 months of age in the United States: A systematic review of the literature. Journal of Racial and Ethnic Health Disparities. 2015:1-9. Accessed on October 26, 2016

Citations - Evidence

Armstrong 2014 - Armstrong R, Anderson L, Synnot A, et al. Evaluation of evidence related to exposure to lead. Canberra: National Health and Medical Research Council; 2014. Accessed on October 25, 2016
Berg 2012* - Berg DR, Eckstein ET, Steiner MS, Gavard JA, Gross GA. Childhood lead poisoning prevention through prenatal housing inspection and remediation in St. Louis, MO. American Journal of Obstetrics and Gynecology. 2012;206(3):199.e1-199.e4. Accessed on October 25, 2016
Campbell 2013* - Campbell EC, Ross M, Webb KL. Improving the nutritional quality of emergency food: A study of food bank organizational culture, capacity, and practices. Journal of Hunger & Environmental Nutrition. 2013;8(3):261-280. Accessed on October 25, 2016
Cochrane-Nussbaumer-Streit 2016* - Nussbaumer-Streit B, Yeoh B, Griebler U, et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database of Systematic Reviews. 2016;(12):CD006047. Accessed on November 1, 2016
Dixon 2005* - Dixon SL, Wilson JW, Clark CS, et al. Effectiveness of lead-hazard control interventions on dust lead loadings: Findings from the evaluation of the HUD Lead-Based Paint Hazard Control Grant Program. Environmental Research. 2005;98(3):303–14. Accessed on October 25, 2016
Feigenbaum 2015 - Feigenbaum JJ, Muller C. Lead exposure and violent crime in the early twentieth city. Cambridge: Harvard University; 2015. Accessed on October 26, 2016
Gould 2009 - Gould E. Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives. 2009;117(7):1162-7. Accessed on October 26, 2016
Jones 2012* - Jones DJ. Primary prevention and health outcomes: Treatment of residential lead-based paint hazards and the prevalence of childhood lead poisoning. Journal of Urban Economics. 2012;71(1):151-164. Accessed on October 26, 2016
Korfmacher 2014 - Korfmacher KS, Malone J, Jacobs D. Local housing policy approaches to preventing childhood lead poisoning. Public Health Law Research: Making the Case for Laws that Improve Health. 2014. Accessed on October 26, 2016
Levin 2008 - Levin R, Brown MJ, Kashtock ME, et al. Lead exposures in U.S. children, 2008: Implications for prevention. Environmental Health Perspectives. 2008;116(10):1285-93. Accessed on October 26, 2016
NBER-Wolpaw Reyes 2007 - Wolpaw Reyes J. Environmental policy as social policy? The impact of childhood lead exposure on crime. National Bureau of Economic Research (NBER). 2007. Working Paper 13097. Accessed on October 26, 2016
NCHH-Jacobs 2009 - Jacobs DE, Baeder A. Housing interventions and health: A review of the evidence. Columbia: National Center for Healthy Housing (NCHH); 2009. Accessed on October 26, 2016
NCHH-Lead 2014 - National Center for Healthy Housing (NCHH). Preventing lead exposure in US children: A blueprint for action. 2014. Accessed on October 26, 2016
Reed 2011a* - Reed W. Preventing childhood lead poisoning. In: Lemelle AJ, Reed W, Taylor S, eds. Handbook of African American Health: Social and Behavioral Interventions. New York: Springer; 2011:103-11. Accessed on October 26, 2016
Vigeh 2014* - Vigeh M, Yokoyama K, Matsukawa T, Shinohara A, Ohtani K. Low level prenatal blood lead adversely affects early childhood mental development. Journal of Child Neurology. 2014;29(10):1305-1311. Accessed on October 26, 2016
White 2015 - White BM, Bonilha HS, Ellis C. Racial/ethnic differences in childhood blood lead levels among children <72 months of age in the United States: A systematic review of the literature. Journal of Racial and Ethnic Health Disparities. 2015:1-9. Accessed on October 26, 2016
Wilson 2006* - Wilson J, Pivetz T, Ashley P et al. Evaluation of HUD-funded lead hazard control treatments at 6 years post-intervention. Environmental Research. 2006;102(2):237-48. Accessed on October 26, 2016
Wolpaw Reyes 2015* - Wolpaw Reyes J. Lead exposure and behavior: Effects on antisocial and risky behavior among children and adolescents. Economic Inquiry. 2015;53(3):1580-1605. Accessed on October 26, 2016

Citations - Implementation

CDC-PPHF lead - Centers for Disease Control and Prevention (CDC). Prevention and Public Health Funds (PPHF) 2014: Lead poisoning prevention- Childhood lead poisoning prevention. Accessed on October 25, 2016
Korfmacher 2014 - Korfmacher KS, Malone J, Jacobs D. Local housing policy approaches to preventing childhood lead poisoning. Public Health Law Research: Making the Case for Laws that Improve Health. 2014. Accessed on October 26, 2016
NCSL-Lead hazards 2016 - National Conference of State Legislatures (NCSL). Lead hazards project: State efforts to address lead in housing. 2016. Accessed on January 5, 2017
NYS DOH-RLRCs - New York State Department of Health (NYS DOH). Regional Lead Resource Centers (RLRCs) work to improve lead testing, education, and prevention activities through partnerships with local medical providers and departments of health. Accessed on February 8, 2017
Rochester-Lead paint - City of Rochester, NY. The Rochester lead law: A lead-based paint poisoning prevention ordinance. Accessed on January 5, 2017
US EPA-Lead contacts - US Environmental Protection Agency (US EPA). Lead: EPA regional lead contacts. Accessed on March 16, 2017
WCLPP-Report 2014 - Wisconsin Childhood Lead Poisoning Prevention Program (WCLPP), Wisconsin Department of Health Services (WI DHS). 2014 Report on childhood lead poisoning in Wisconsin. 2016. Accessed on January 5, 2017
WI DHS-WALDO - Wisconsin Department of Health Services (DHS). Wisconsin asbestos and lead database online (WALDO). Accessed on October 26, 2016
WI DHS-WI lead statutes - Wisconsin Department of Health Services (DHS). Lead-safe Wisconsin: Wisconsin statutes and administrative rules. Accessed on October 26, 2016

Page Last Updated

January 5, 2017

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