The length of time it can take to rid homes of lead hazards is "unacceptable" according to researchers from Wake Forest University School of Medicine and colleagues in this month's American Journal of Public Health.

"This is the first study that looks at the time that it takes from a child's first blood lead level (BLL) test to the time when their home is made lead safe," said Kristina M. Zierold, Ph.D., lead author. "We knew there were a lot of kids with elevated BLLs, but nobody really knew how long it was taking to remove the exposure."

The study was conducted in Wisconsin while Zierold was an epidemic intelligence service officer with the Centers for Disease Control and Prevention (CDC).

"While our results apply only to Wisconsin, the fact that this was the first time anyone had studied this issue suggests that the problem may apply to other states," Zierold said.

An estimated 24 million housing units nationwide contain this poisonous material. The U.S. Environmental Protection Agency reported in 1995 that 86 percent of all public housing and 83 percent of private homes had some lead-based paint.

The research evaluated 382 Wisconsin children aged 6 months to 6 years during a four-year period (1996 - 1999), with BLLs of 20 micrograms per deciliter (µg/dL) or greater. In Wisconsin, these levels required a lead hazard investigation of children's residences. The median length of time it took to eliminate the lead exposure was 465 days. Overall, only 18 percent of homes were completed within six months, and 46 percent required more than 18 months to be considered lead safe.

The study did show some improvement. The median amount of time it took to remediate a lead problem in 1996 was 828 days, and 347 days in 1999.

Researchers also found that African-American children were almost twice as likely as other races to live in homes taking longer than six months to be made lead safe. Zierold said a possible reason for the difference is that many of the African-American children in the study lived in rental housing. "Rental housing is a big indicator of lead poisoning because it's up to the landlord to take care of the lead hazards in the house and not the resident. And many times, the money is not there to fix up the property," said Zierold.

Children living in pre-1978 housing are also at risk for lead poisoning. Zierold says that to prevent the damage from lead poisoning, the CDC recommends that all at-risk children be screened for lead poisoning at 6 months of age.

Zierold says the most common form of lead exposure in children is through hand and mouth contact. Lead-based paint flakes off walls, windows and doors, and then children pick up the flakes on their hands while crawling on the floor.

"Often you'll see kids chewing on lead paint because it's sweet," said Zierold.

Once ingested, lead can have detrimental effects on a child's IQ and cause cognitive impairments and hearing and behavioral problems. High levels of exposure for long periods of time can cause convulsions, and in extreme cases, lead poisoning can result in death.

Zierold says there are several steps landlords and homeowners can take to remediate a lead problem. Paint-removal professionals can either remove the paint altogether, encapsulate windows, or paint over lead-based paint with a latex paint. Tenants and homeowners can clean around window sills, floors and in cabinets.

"Good nutrition is also important," said Zierold. "If kids are anemic, lead is more likely to be absorbed into the body."

Zierold said she hopes that states will create programs that will improve the amount of time that it takes to clean up a lead problem.

For example, a Wisconsin program allows any landlord or rental agent who brings a unit up to standard to go on a lead-free/lead-safe housing registry. Zierold said this protects the landlord from being sued if a child does become poisoned, and it allows new residents to find a place they know is going to be safe.

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Co-researchers for the study were Jeff Havlena and Henry Anderson, both with the Wisconsin Division of Public Health.

Contact: Shannon Koontz
Wake Forest University Baptist Medical Center