The effects of home lead abatements on childhood blood lead levels: A retrospective follow-up study

Home abatement is the environmental intervention most commonly mandated by law for children with lead poisoning. Previous studies of abatement efficac y, however, have yielded inconsistent results and have left doubt about the long-term effectiveness of this intervention in reducing children's blood lead levels. For this study, the authors analyzed 488 children six years ol d or less who had been reported to the New Jersey Department of Health and Senior Services from 1993 to 1997 with blood lead levels of 30 to 44 microg rams per deciliter (mug/dL); each of the children analyzed also had a follo w-up blood lead test at least two months after abatement if an abatement wa s completed, or two months after baseline if an abatement was not completed . Although home abatements were recommended for all children, they were not completed in 118 cases. A significant difference (p < .01) was seen in the mean declines of blood lead levels between children in abated homes (-10.1 mug/dL, or -28.5 percent) and those in unabated homes (-7.3 mug/dL, or -20 .8 percent). This difference was partially due to longer follow up in the g roup that received abatement. When this difference was adjusted in a multip le regression for age, time to follow up, baseline blood lead level, socioe conomic factors, and season-with time to follow-up restricted to 70-400 day s-the overall difference in decline of blood lead levels decreased from 7.7 percent to two percent, When the same restriction was applied,vith adjustm ent for the same confounders in a logistic regression and the probability o f a decline of >4 mug/dL was modeled, abatement had minimal effect (odds ra tio = 1.4; 95 percent confidence interval = 0.7, 2.5), Thus, lead paint aba tements, as required in New Jersey from 1993 to 1997, are of only modest ef ficacy in reducing children's blood lead levels. Stronger regulations, bett er enforcement, and more attention to lead-contaminated dust should be eval uated as ways of better protecting lead-exposed children.