Evaluation of HUD-funded lead hazard control treatments at 6 years post-intervention.

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.

Evaluation of lead hazard control treatments in four Massachusetts communities through analysis of blood-lead surveillance data.

This study utilized existing blood-lead surveillance data and records of housing properties treated for lead hazard control (LHC) in order to investigate the effectiveness of LHC treatments performed in four Massachusetts communities (Boston, Cambridge, Malden, and Springfield). This research is part of the US Department of Housing and Urban Development's (HUD) overall program evaluation strategy for assessing the effectiveness of their LHC Grant Program. Childhood blood-lead levels (BLLs) in housing units that were treated through HUD's LHC Grant Program were compared to BLLs in untreated matched control housing units. Data from multiple sources-local housing departments, local tax assessor departments, and the Massachusetts Department of Public Health-were linked to identify similar sets of treated and untreated dwellings. Geometric mean BLLs from before and after treatment were compared for the two sets of housing. Ten years of blood-lead surveillance data for children living in the selected dwellings were analyzed using log-linear mixed models and logistic regression models. Results indicate a 50% decline in BLLs in treated homes, a significantly larger decline than in untreated homes after adjusting for the general downward trend in BLLs observed in the general population for the last several years. Data show that homes that received HUD LHC treatments had children with blood-lead levels that declined twice as fast as in similar untreated homes. These findings show that LHC efforts are successful in reducing children's blood-lead levels.

Deaths from residential injuries in US children and adolescents, 1985-1997.

OBJECTIVE: The majority of deaths from unintentional injuries in children occur in the home environment, but there has not been a comprehensive analysis of residential deaths in the United States since 1985. The objective of this study was to determine the incidence and trends of deaths from injuries that occurred in the residential setting. METHODS: Injury-related death rates of all deaths among US children and adolescents who were younger than 20 years from 1985 to 1997 were calculated using National Vital Statistics System Mortality Data from 1985 to 1997 by age group, gender, region, and race. Poisson regression or negative binomial regression was used to test for trends over time in mortality rates. RESULTS: From 1985 to 1997, an average of 2822 (55%) of 5103 annual unintentional deaths in US children with a known location of injury took place in the home environment. The annual number and incidence of fatal residential injuries decreased by >22%, from 2973 (4.2 per 100000) in 1985 to 2310 (3.0 per 100000) in 1997. The death rate as a result of residential injury was highest in children who were younger than 1 year (12.6 per 100000) and 1 to 4 years (7.9 per 100000) compared with older children, boys compared with girls (4.9 vs 2.8 per 100000), and black children compared with white children (7.0 vs 3.3 per 100000). The highest death rates were attributable to fires (1.5 per 100000), submersion or suffocation (1.3 per 100000), poisoning (0.2 per 100000), and falls (0.1 per 100000). CONCLUSIONS: Despite a 22% decline since 1985, residential injuries remain a leading cause of death in US children and adolescents. Black children were 2 times more likely to die from residential injuries than white children.