title: The contribution of housing renovation to children's blood lead levels: a cohort study.
abstract: BACKGROUND
  Routine renovation of older housing is a risk factor for childhood lead poisoning, but the contribution to children's blood lead levels is poorly defined for children with lower exposure levels.
  
  
  METHODS
  We examined a prospective cohort of 276 children followed from 6 to 24 months of age. We conducted surveys of renovation activities and residential lead hazards and obtained blood lead level (B-Pb) every six months. We analyzed B-Pb in a repeated measures design using a mixed effects linear model.
  
  
  RESULTS
  Parent reported interior renovation ranged from 11 to 25% of housing units at the four, 6-month periods. In multivariable analysis, children whose housing underwent interior renovation had a 12% higher mean B-Pb by two years of age compared with children whose housing units were not renovated (p < 0.01). The time between renovation and the child blood lead sample was associated with higher B-Pb (p-value for trend <0.01); compared to children in non-renovated housing, children whose housing units underwent renovation in the prior month had a 17% higher mean B-Pb at two years of age, whereas children whose housing renovation occurred in the prior 2-6 months had an 8% higher mean B-Pb. We also found an association between higher paint lead loading, measured using an X-ray fluorescence (XRF) based paint lead index, and child B-Pb (p = 0.02); for every 10 mg/cm2 increase in paint lead loading index there was a 7.5% higher mean childhood B-Pb.
  
  
  CONCLUSIONS
  In an analysis of data collected before the recent changes to Environmental Protection Agency's Lead, Renovation, Repair and Painting Rule, routine interior housing renovation was associated with a modest increase in children's B-Pb. These results are important for the provision of clinical advice, for housing and public health professionals, and for policymakers.
authors: Department of Pediatrics, Penn State University Hershey Medical Center, HS83, 500 University Drive, P, O, Box 850, Hershey, PA 17033-0850, USA. aspanier@hmc.psu.edu.
authors: Adam J
authors: AJ
authors: Spanier
authors: Stephen
authors: S
authors: Wilson
authors: Mona
authors: M
authors: Ho
authors: Richard
authors: R
authors: Hornung
authors: Bruce P
authors: BP
authors: Lanphear
mesh_terms: D015331:Cohort Studies; D004781:Environmental Exposure; D004784:Environmental Monitoring; D006798:Housing; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000453:epidemiology* / Q000209:etiology; D009518:New York / Q000453:epidemiology; D010150:Paint / Q000032:analysis*; D011446:Prospective Studies; D013052:Spectrometry, X-Ray Emission; D013054:Spectrophotometry, Atomic
chemical_list: D007854:Lead
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