Primary prevention of lead exposure interventions for low-income urban newborns and their families

Objective: To determine whether home-based parental education and home evaluation initiated in the newborn period prevent elevated blood lead levels later in childhood.

Methods: The Philadelphia Lead Safe Homes Study offers environmental education, home evaluation (visual evaluation and dust lead levels) for lead hazards, and lead remediation (as needed), to the families and homes of urban, high-risk newborn children for primary prevention of lead exposure. Households are randomized to receive the standard lead education at baseline, 6, and 12 months (standard education group, SEG) or maintenance education (the standard intervention plus home maintenance education, or MEG). Home evaluation and lead remediation are done at baseline and at 12 months. Parental knowledge regarding lead exposure prevention and cleaning practices are assessed periodically. Blood lead results will be collected through 2 years of age.

Results: 310 newborns and their families have been enrolled. Preliminary outcomes to be analyzed and presented include: general descriptors of the sample such as demographic and socioeconomic characteristics of the 2 groups, the degree of compliance with and cost of the lead remediation work, the extent that need for repair work is detected by MEG families, and the cleaning habits of the subject families. The extent of baseline parental lead knowledge and degree of change from baseline to 6 months, home evaluation results, indications for lead remediation, and blood lead levels from age 9-12 months of age will be compared between the two groups.

Conclusions: Some preliminary conclusions will be drawn and discussed.