TY - JOUR T1 - CDC's Lead Poisoning Prevention Program: A Long-standing Responsibility and Commitment to Protect Children From Lead Exposure JF - Public Health Management and Practice Y1 - 2019 A1 - Adrienne S. Ettinger A1 - Monica L. Leonard A1 - Jacquelyn Mason KW - blood lead level KW - Children KW - lead poisoning KW - prevention KW - public health AB - The Centers for Disease Control and Prevention's (CDC's) Childhood Lead Poisoning Prevention Program (CLPPP) serves as the nation's public health leader and resource on strategies, policies, and practices aimed at preventing lead exposure in young children. CDC supports and advises state and local public health agencies and works with other federal agencies and partners to achieve the Healthy People 2020 objective of eliminating childhood lead exposure as a public health concern. Primary prevention-the removal of lead hazards from the environment before a child is exposed-is the most effective way to ensure that children do not experience the harmful effects of lead exposure. Blood lead screening tests and secondary prevention remain an essential safety net for children who may be exposed to lead. CDC's key programmatic strategy is to strengthen blood lead surveillance by supporting state and local programs to improve blood lead screening test rates, identify high-risk populations, and ensure effective follow-up for children with elevated blood lead levels. Surveillance plays a central role in helping measure the collective progress of federal, state, and local public health agencies in protecting children from lead, as well as enhancing our ability to target population-based interventions for primary prevention to those areas at highest risk. The CDC CLPPP has been at the front line of efforts to protect children from lead exposure and the resulting adverse health effects over the last 3 decades. As we chart our path for the future, we will continue to learn from past successes and challenges, incorporate new evidence and lessons learned, and work closely with federal, state, local, and nonprofit partners, experts in academia, and the community to advance the overarching goal of eliminating lead exposure in children. PB - CDC Lead Poisoning Prevention Program VL - 25 UR - https://journals.lww.com/jphmp/Fulltext/2019/01001/CDC_s_Lead_Poisoning_Prevention_Program__A.3.aspx IS - 1 ER - TY - JOUR T1 - Window replacement and residential lead paint hazard control 12 years later JF - Environmental Research Y1 - 2012 A1 - Sherry L. Dixon A1 - David E. Jacobs A1 - Jonathan Wilson A1 - Judith Y. Akoto A1 - Rick Nevin A1 - Scott Clark KW - Housing KW - Intervention KW - Lead paint KW - lead poisoning KW - Renovation KW - Windows AB - Window replacement is a key method of reducing childhood lead exposure, but the long-termeffectiveness has not been previously evaluated. Windows have the highest levels of interior leadpaint and dust compared to other building components. Our objective was to conduct a follow-up studyof residential window replacement and lead hazard control 12 years after homes were enrolled in anevaluation of the HUD Lead Hazard Control Grant Program, sampling settled lead dust in housing infour cities (n¼189 homes). Previous work evaluated lead hazard controls up to 6 years afterintervention using dust lead measurements and two years after intervention using both dust andblood lead data. But the earlier work could not examine the effect of window replacement over thelonger time period examined here: 12 years. The individual homes were assigned to one of threecategories, based on how many windows had been replaced: all replacement, some replacement, ornon-replacement. Windows that were not replaced were repaired. We controlled for covariates such assite, housing condition, presence of lead paint, and season using longitudinal regression modeling.Adjusted floor and sill dust lead geometric mean dust lead loadings declined at least 85% from pre-intervention to 12 years after the intervention for homes with all replacement windows, some windowsreplaced and no windows replaced. Twelve years after intervention, homes with all replacementwindows had 41% lower interior floor dust lead, compared to non-replacement homes (1.4 versus2.4mg/ft2,po0.001), and window sill dust lead was 51% lower (25 versus 52mg/ft2,p¼0.006) whilecontrolling for covariates. Homes with some windows replaced had interior floor and window sill dustlead loadings that were 28% (1.7 versus 2.4mg/ft2,p¼0.19) and 37% (33 versus 52mg/ft2,p¼0.07)lower, respectively, compared to non-replacement homes. The net economic benefit of windowreplacement compared to window repair (non-replacement) is $1700–$2000 per housing unit. Homesin which all windows were replaced had significantly lower lead dust. New windows are also likely toreduce energy use and improve home value. Lead-safe window replacement is an important element oflead hazard control, weatherization, renovation and housing investment strategies and should beimplemented broadly to protect children. PB - Elsevier Inc. VL - 113 UR - https://www.sciencedirect.com/science/article/pii/S0013935112000618 ER - TY - JOUR T1 - Childhood Lead Poisoning: Conservative Estimates of the Social and Economic Benefits of Lead Hazard Control JF - Environmental Health Perspectives Y1 - 2009 A1 - Elise Gould KW - cost–benefit KW - economics KW - Housing KW - lead poisoning AB - Background This study is a cost–benefit analysis that quantifies the social and economic benefits to household lead paint hazard control compared with the investments needed to minimize exposure to these hazards. Objectives This research updates estimates of elevated blood lead levels among a cohort of children ≤ 6 years of age and compiles recent research to determine a range of the costs of lead paint hazard control ($1–$11 billion) and the benefits of reduction attributed to each cohort for health care ($11–$53 billion), lifetime earnings ($165–$233 billion), tax revenue ($25–$35 billion), special education ($30–$146 million), attention deficit–hyperactivity disorder ($267 million), and the direct costs of crime ($1.7 billion). Results Each dollar invested in lead paint hazard control results in a return of $17–$221 or a net savings of $181–269 billion. Conclusions There are substantial returns to investing in lead hazard control, particularly targeted at early intervention in communities most likely at risk. Given the high societal costs of inaction, lead hazard control appears to be well worth the price. PB - Economic Policy Institute VL - 117 UR - https://ehp.niehs.nih.gov/doi/full/10.1289/ehp.0800408 IS - 7 ER - TY - JOUR T1 - Monetary benefits of preventing childhood lead poisoning with lead-safewindow replacement JF - Environmental Research Y1 - 2007 A1 - Rick Nevin A1 - David E. Jacobs A1 - Michael Berg A1 - Jonathan Cohen KW - Climate change KW - Cost benefit analysis KW - Energy efficiency KW - Housing KW - lead poisoning AB - Previous estimates of childhood lead poisoning prevention benefits have quantified the present value of some health benefits, but not the costs of lead paint hazard control or the benefits associated with housing and energy markets. Because older housing with lead paint constitutes the main exposure source today in the US, we quantify health benefits, costs, market value benefits, energy savings, and net economic benefits of lead-safe window replacement (which includes paint stabilization and other measures). The benefit per resident child from improved lifetime earnings alone is $21,195 in pre-1940 housing and $8685 in 1940–59 housing (in 2005 dollars). Annual energy savings are $130–486 per housing unit, with or without young resident children, with an associated increase in housing market value of$5900–14,300 per housing unit, depending on home size and number of windows replaced. Net benefits are $4490–5,629 for each housing unit built before 1940, and $491–1629 for each unit built from 1940–1959, depending on home size and number of windows replaced.Lead-safe window replacement in all pre-1960 US housing would yield net benefits of at least $67 billion, which does not include many other benefits. These other benefits, which are shown in this paper, include avoided Attention Deficit Hyperactivity Disorder, other medical costs of childhood lead exposure, avoided special education, and reduced crime and juvenile delinquency in later life. In addition,such a window replacement effort would reduce peak demand for electricity, carbon emissions from power plants, and associated long-term costs of climate change. PB - Elsevier VL - 106 UR - https://www.sciencedirect.com/science/article/pii/S0013935107001909 IS - 3 ER - TY - JOUR T1 - Evaluation of HUD-funded lead hazard control treatments at 6 years post-intervention JF - Environmental Research Y1 - 2006 A1 - Jonathan Wilson A1 - Tim Pivetz A1 - Peter Ashley A1 - David E. Jacobs A1 - Warren Strauss A1 - John Menkedick A1 - Sherry L. Dixon A1 - Hsing-Chuan Tsai A1 - Vincent Brown A1 - Warren Friedman A1 - Warren A. Galke A1 - Scott Clark KW - HUD lead hazard control grant program KW - Interior dust lead levels KW - Lead based paint KW - lead poisoning AB - The Evaluation of the HUD Lead-Based Paint Hazard Control Grant Program (Evaluation) was a HUD-funded study of the effectiveness of lead hazard control (LHC) treatments conducted by 14 grantees in communities across the country. A stratified random sampling scheme was used to select treated units at four grantee sites for continued environmental assessment at 6 years post-intervention. The study compared the relative effectiveness after 6 years of the different classes of interventions used by the grantees, after controlling for such factors as housing conditions and characteristics and resident and neighborhood characteristics. Geometric mean dust-lead levels on floors and window sills were 11% and 23% lower, respectively, at 6 years post-intervention than at any preceding point following the intervention. Although geometric mean window trough dust-lead levels were slightly higher at 6 years post-intervention than at other post-intervention time periods, they were still over 75% lower than before intervention. Treatment at more-intensive levels was associated with lower window sill and window trough dust-lead levels; however, statistical modeling found no significant difference in floor dust-lead loadings over time between the levels of treatment; however, significant differences in window sill and window trough dust-lead levels between treatment levels were evident. Findings from the 6-Year Extension study indicate that across all grantees and treatment strategies the treatments applied were effective at significantly reducing environmental lead levels on floors, window sills, and window troughs at least 6 years following the intervention. PB - Elsevier Inc. VL - 102 UR - https://www.sciencedirect.com/science/article/pii/S0013935106000818?via%3Dihub#aep-section-id28 IS - 2 ER - TY - JOUR T1 - Effectiveness of lead-hazard control interventions on dust lead loadings: Findings from the evaluation of the HUD Lead-Based Paint Hazard Control Grant Program JF - Environmental Research Y1 - 2005 A1 - Sherry L. Dixon A1 - Jonathan Wilson A1 - Scott Clark A1 - Warren A. Galke A1 - Paul A. Succop A1 - Mei Chen KW - Dust wipe sampling KW - Lead abatement KW - Lead based paint KW - Lead dust KW - Lead hazard control KW - lead poisoning AB - From 1994 to 1999, the Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the intervention experiences of over 2800 homes in 11 states in the USA. Each interior intervention was categorized as (in order of increasing intensity) (a) cleaning/spot painting; (b) complete repainting; (c) complete repainting plus window treatments; (d) window abatement plus treatments to other components; (e) abatement of all lead-based paint hazards; or (f) abatement of all lead-based paint. Complete dust testing and environmental data were available for 1034 and 278 dwellings through 12 and 36 months postintervention, respectively. Strategies ranging from complete repainting to window abatement plus other treatments reduced geometric mean preintervention windowsill and floor dust lead loadings up to 36 months postintervention (reductions for complete repainting, from 16 to 5 μg/ft2 on floors and 182 to 88 μg/ft2 on sills; for window abatement plus other treatments, 27–8 μg/ft2 on floors and 570–124 μg/ft2 on sills). Full abatement reduced windowsill and floor loadings from baseline to 12 months postintervention [95–6 μg/ft2 on floors and 518–30 μg/ft2 on sills (data were not available for this strategy at 36 months)]. Window lead-hazard abatement was the most effective measure to reduce dust lead loadings on windows, but this treatment would need to be performed in conjunction with treatments to floors as well as exterior and soil treatments for the most effective control of dust lead on floors. PB - Elsevier VL - 98 UR - https://www.sciencedirect.com/science/article/pii/S0013935105000216?via%3Dihub IS - 3 ER - TY - JOUR T1 - Costs and Benefits of Enforcing Housing Policies to Prevent Childhood Lead Poisoning JF - Medical Decision Making Y1 - 2002 A1 - Mary Jean Brown KW - cost benefit KW - housing code enforcement KW - lead poisoning AB - Background. Lead poisoning remains an important, yet entirely preventable disease among young children. This article compares the costs and benefits of strict versus limited enforcement of lead poisoning prevention housing policies in preventing additional cases of childhood blood lead elevation.Methods. The author conducted decision analysis using population-based data that compared recurrence of childhood lead exposure in 2 urban areas with different enforcement capacity, and cost data from a federal project and from medical and public health literature.Results. Strict enforcement prevented additional cases, resulting in $45,360 savings from decreased medical and education costs and increased productivity for protected children. The model was robust to changing estimates of followup, housing repairs, relocation, and increases in lead levels over baseline. No cost savings were realized by strict enforcement if the probability of recurrence in limited units was 44% lower than estimated, or if fewer children were identified in limited versus strict enforcement units. If the discount rate for future productivity losses was ≥7.5%, strict enforcement did not lower costs.Conclusion. This analysis suggests that strict enforcement of housing policies to prevent childhood blood lead elevation results in decreased societal costs due to the avoidance of future medical and special education and to increased productivity of resident children. VL - 22 UR - https://journals.sagepub.com/doi/pdf/10.1177/0272989X02238298 IS - 6 ER - TY - JOUR T1 - Childhood Lead Poisoning: Solving a Health and Housing Problem JF - Cityscape Y1 - 1996 A1 - Nick Farr A1 - Cushing N. Dolbeare KW - Blood KW - Chemical hazards KW - Children Insurance industry KW - Housing Lead poisoning KW - Lead hazards KW - lead poisoning KW - Liability insurance KW - Property ownership AB - Lead poisoning is the Nation's number one children's environmental health problem. Children are poisoned primarily by ingesting lead from household dust in older, low-rent housing. The best way to prevent this situation is to make housing in which young children live or likely to live lead safe. The Lead-Based Paint Hazard Reduction and Financing Task Force recommended a set of lead-safe standards that would protect children and would be feasible for property owners. It also proposed that, if a resident child were found to have an elevated blood lead level, owners who could document compliance with the standards be afforded some liability relief. Complying owners would then become eligible for liability insurance and financing. HUD is working with State and local governments and the real estate, lending, and insurance industries to develop programs to implement the Task Force's recommendations. PB - US Department of Housing and Urban Development VL - 2 IS - 3 ER -