title: Evaluating the effectiveness of state specific lead-based paint hazard risk reduction laws in preventing recurring incidences of lead poisoning in children.
abstract: BACKGROUND
  Despite significant progress made in recent decades in preventing childhood lead poisoning in the United States through the control or elimination of lead sources in the environment, it continues to be an issue in many communities, primarily in low-income communities with a large percentage of deteriorating housing built before the elimination of lead in residential paint. The purpose of this study is to determine whether state laws aimed at preventing childhood lead poisoning are also effective in preventing recurring lead poisoning among children previously poisoned.
  
  
  METHODS
  An evaluation was conducted to determine whether laws in two representative states, Massachusetts and Ohio, have been effective in preventing recurrent lead poisoning among children less than 72 months of age previously poisoned, compared to a representative state (Mississippi) which at the time of the study had yet to develop legislation to prevent childhood lead poisoning.
  
  
  RESULTS
  Compared to no legislation, unadjusted estimates showed children less than 72 months old, living in Massachusetts, previously identified as being lead poisoned, were 73% less likely to develop recurrent lead poisoning. However, this statistically significant association did not remain after controlling for other confounding variables. We did not find such a significant association when analyzing data from Ohio.
  
  
  CONCLUSIONS
  While findings from unadjusted estimates indicated that state lead laws such as those in Massachusetts may be effective at preventing recurrent lead poisoning among young children, small numbers may have attenuated the power to obtain statistical significance during multivariate analysis. Our findings did not provide evidence that state lead laws, such as those in Ohio, were effective in preventing recurrent lead poisoning among young children. Further studies may be needed to confirm these findings.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA. Electronic address: gjn5@cdc.gov.
authors.forename: Chinaro
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: Battelle Memorial Institute, Columbus, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lordo
authors.affiliation: Centers for Disease Control and Prevention, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA.
authors.forename: Marissa Scalia
authors.initials: MS
authors.lastname: Sucosky
authors.affiliation: Battelle Memorial Institute, Columbus, OH, USA.
authors.forename: Rona
authors.initials: R
authors.lastname: Boehm
authors.affiliation: Centers for Disease Control and Prevention, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA.
authors.forename: Mary Jean
authors.initials: MJ
authors.lastname: Brown
mesh_terms: D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects / Q000331:legislation & jurisprudence*; D005260:Female; D033161:Government Regulation; D015386:Hazardous Substances; D006798:Housing; D006801:Humans; D015994:Incidence; D007223:Infant; D007854:Lead / Q000009:adverse effects*; D007855:Lead Poisoning / Q000517:prevention & control*; D008297:Male; D008404:Massachusetts; D009820:Ohio; D010150:Paint; D012008:Recurrence; D040242:Risk Reduction Behavior; D013219:State Government
chemical_list: D015386:Hazardous Substances; D007854:Lead
keywords: Blood lead levels; Childhood lead poisoning; Lead; Lead law