Preventing lead poisoning in New York City: priorities for lead abatement in housing.

The major challenge for lead poisoning prevention programs is to increase the availability of lead-safe housing as quickly as possible. The approach proposed by the City of New York maximizes the impact of the limited resources available to address this problem. The approach, however, is based on an assumption that in the short-term, modest lead hazard reduction measures such as restoring surfaces to an intact condition is adequate for most units and that more extensive abatement should be reserved for the relatively fewer units in which there is a high risk of exposure of lead-poisoned children reside. Ideally, this plan would be implemented with voluntary efforts to abate lead hazards when other renovation or remodeling occurs or when dwellings are vacant and more extensive abatement work can be performed at lower cost and without the attendant difficulty of abating occupied units. Approaches ranking hazards and implementing varying levels of hazard reduction must be fully evaluated and modified as new information becomes available. The specific criteria used to rank hazards should be evaluated to determine what measures best differentiate risk. Given the magnitude of the problem and the numerous obstacle--lack of funding, limited trained workers, and limited technical knowledge--it will probably take years, if not decades, to abate lead hazards in all the dwellings in which they exist. We must not be deterred, however, from beginning this effort in the communities and dwellings that need intervention the most: deteriorated, older housing units in which young children reside. In major urban centers such as New York City the greatest lead hazards will generally be found in areas where poverty is greatest. Thus, every effort must be made to ensure that adequate resources are available to improve housing in the communities in greatest need.

Radiation decontamination unit for the community hospital.

"Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit.