The effect of interior lead hazard controls on children's blood lead concentrations: A systematic evaluation

Dust control is often recommended to prevent children's exposure to residential lead hazards, but the effect of these controls on children's blood lead concentrations is uncertain. We conducted a systematic review of randomized, controlled trials of low-cost, lead hazard control interventions to determine the effect of lead hazard control on children's blood lead concentration. Four trials met the inclusion criteria. We examined mean blood lead concentration and elevated blood lead concentrations (greater than or equal to 10 mug/dL, greater than or equal to 15 mug/dL, and greater than or equal to 20 mug/dL) and found no significant differences in mean change in blood lead concentration for children by random group assignment (children assigned to the intervention group compared with those assigned to the control group). We found no significant difference between the intervention and control groups in the percentage of children with blood lead greater than or equal to 10 mug/dL, 29% versus 32% [odds ratio (OR), 0.85; 95 % confidence interval (CI), 0.56-1.3], but there was a significant difference in the percentage of children with blood lead greater than or equal to 15 mug/dL between the intervention and control groups, 6% versus 14% (OR, 0.40; 95% CI, 0.21-0.80) and in the percentage of children with blood lead greater than or equal to 20 mug/dL between the intervention and control groups, 2% versus 6% (OR, 0.29; 95 % CI, 0.10-0.85). We conclude that although low-cost, interior lead hazard control was associated with 50 % or greater reduction in the proportion of children who had blood lead concentrations exceeding 15 mug/dL and greater than or equal to 20 mug/dL, there was no substantial effect on mean blood lead concentration.