title: Primary prevention of lead exposure: the Philadelphia lead safe homes study.
abstract: OBJECTIVE
  Lead exposure in children can lead to neuropsychological impairment. This study tested whether primary prevention interventions in the newborn period prevent elevated blood lead levels (BLLs).
  
  
  METHODS
  The Philadelphia Lead Safe Homes (LSH) Study offered parental education, home evaluation, and lead remediation to the families of urban newborns. Households were randomized to a standard lead education group or maintenance education group. We conducted home visits at baseline, six months, and 12 months. To compare BLLs, we identified a matched comparison group.
  
  
  RESULTS
  We enrolled and randomized 314 newborns in the intervention component; 110 completed the study. There were few significant differences between the randomized groups. In the combined intervention groups, positive results on visual inspection declined from baseline to 12 months (97.0% to 90.6%, p = 0.007). At baseline, 36.9% of homes were above the U.S. Environmental Protection Agency's lead dust standard, compared with 26.9% at 12 months (p = 0.032), mainly due to a drop in windowsill dust levels. Both groups showed a significant increase in parental scores on a lead education test. Children in the intervention and matched control groups had similar geometric mean initial BLLs (2.6 vs. 2.7, p = 0.477), but a significantly higher percentage of children in the intervention group had an initial blood lead screening compared with those in the matched group (88.9% vs. 84.4%, p = 0.032).
  
  
  CONCLUSIONS
  A study of primary prevention of lead exposure showed a higher blood lead screening rate for the combined intervention groups and mean BLLs at one year of age not statistically different from the comparison group. Most homes had lead hazards. Lead education significantly increased knowledge.
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, PA, USA. ccc57@drexel.edu
authors.forename: Carla
authors.initials: C
authors.lastname: Campbell
authors.forename: Mary
authors.initials: M
authors.lastname: Tran
authors.forename: Edward
authors.initials: E
authors.lastname: Gracely
authors.forename: Naomi
authors.initials: N
authors.lastname: Starkey
authors.forename: Hans
authors.initials: H
authors.lastname: Kersten
authors.forename: Peter
authors.initials: P
authors.lastname: Palermo
authors.forename: Nancy
authors.initials: N
authors.lastname: Rothman
authors.forename: Laura
authors.initials: L
authors.lastname: Line
authors.forename: Tine
authors.initials: T
authors.lastname: Hansen-Turton
mesh_terms: D002675:Child, Preschool; D004781:Environmental Exposure / Q000517:prevention & control*; D005260:Female; D006796:Household Work / Q000379:methods / Q000592:standards; D006798:Housing / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000517:prevention & control*; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education; D015143:Philadelphia; D011204:Poverty Areas; D011322:Primary Prevention / Q000379:methods*; D014504:Urban Health
chemical_list: D007854:Lead