摘要：Objectives. We determined the length of time needed to make homes lead-safe in a population of children aged 0 to 6 years with blood lead levels (BLLs) of 20 micrograms per deciliter (μg/dL) or greater. Reducing this time would reduce children’s exposure to lead. Methods. Data came from the Wisconsin Childhood Lead Poisoning Prevention Program’s comprehensive blood lead surveillance system. Analysis was restricted to children whose first BLL test value during 1996–1999 was between 20 and 40 μg/dL and for whom housing intervention data were available (n=382). Results. The median length of time required to make a home lead-safe was 465 days. Only 18% of children lived in homes that were made lead-safe within 6 months; 45% lived in homes requiring more than 18 months to be lead-safe. Conclusions. Efforts are needed to reduce the time it takes to make a home lead-safe. Although abatement orders always include time limits, improved compliance with the orders must be enforced. Greater emphasis should be placed on securing lead-safe or lead-free housing for families, thus reducing lead exposure. Homes are major contributors to elevated blood lead levels (BLLs) in young children, and thus reducing lead levels in homes should reduce BLLs in children. Although elevated BLLs in children have decreased throughout the United States, 1 , 2 there are still communities in which more than 20% of the children exhibit BLLs of 10 micrograms per deciliter (μg/dL) or greater. 2 – 4 According to data from the Third National Health and Nutrition Examination Survey, Wisconsin had the third highest prevalence of elevated BLLs in children among the 19 states studied. Statewide, 13% of children tested had BLLs of 10 μg/dL or greater; however, the prevalence in individual counties throughout the state ranged from 3% to 24%. 2 The most important factor in controlling lead poisoning is reducing the child’s exposure to lead. Although the number of housing units with lead paint hazards has decreased dramatically since 1990, an estimated 24 million housing units still contain this poisonous material. 5 The US Environmental Protection Agency reported in 1995 that 86% of all public housing and 83% of private homes had some lead-based paint. 6 Homes built before 1950 create the greatest risk for exposure to lead. In the United States, 27% of homes were built before 1950; however, in the state of Wisconsin, 37% of homes were built before that year. 7 It is estimated that 700 000 housing units in Wisconsin contain some lead-based paint hazards, 120000 of which are occupied by children aged younger than 6 years. 8 Studies have shown that timely remediation of lead hazards in homes of children with elevated BLLs has a protective effect on increasing lead levels in the blood. 9 – 11 In fact, low-cost procedures such as enclosing window wells with aluminum and wet-scraping, as well as repainting walls with latex paint, have decreased BLLs as much as 22%. 11 Most local health departments are responsible for testing homes when a child has a high BLL. However, each health department follows different rules when dealing with lead-poisoned children and lead hazards. In Wisconsin, once a lead-poisoned child is identified, the local health department has the authority to inspect the dwelling. Abatement orders cannot be written until the inspection is completed, specific hazards are identified, and the needed remediation is identified. Such abatement orders always include time limits. 12 The Centers for Disease Control and Prevention recommends that public health officials begin environmental intervention within 10 days of detection of a BLL of 20 μg/dL or greater. Beyond this guideline, little is known about the length of time needed to make homes lead-safe for children with elevated BLLs. Because young children spend much of their time indoors, the home is a significant target for intervention.
