The association between state housing policy and lead poisoning in children

Objectives. This study examined the effect of an active program of househol d lead paint hazard abatement, applied over 22 years, on childhood lead poi soning in Massachusetts. Methods. A small areas analysis was used to compare screening blood lead le vels of children in Worcester County, Mass (n = 27590), with those in Provi dence County, RT (n = 19071). Data were collapsed according to census tract . Results. The percentage of children with lead poisoning (blood lead level g reater than or equal to 20 mu g/dL [Pe20]) was, on average, 3 times higher in Providence County census tracts (3.2% vs 0.9% in Worcester County census tracts, P < .0001), despite similar percentages of pre-1950s housing in bo th counties. The ratio of Pe20 in Providence vs Worcester County census tra cts was 2.2 (95% confidence interval = 1.8. 2.7), after adjustment for diff erences in housing, sociodemographic, and screening characteristics. This e stimate was robust to alternative regression methods and sensitivity analys es. Conclusions. Massachusetts policy, which requires lead paint abatement of c hildren's homes and places liability for lead paint poisoning on property o wners, may have substantially reduced childhood lead poisoning in that stat e.