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Adrienne S. Ettinger,¹ Robert L. Bornschein,² Mark Farfel,^3,4 Carla Campbell,⁵ N. Beth Ragan,⁶ George G. Rhoads,⁷ Merrill Brophy,⁴ Sherry Wilkens,² and Douglas W. Dockery¹

¹Environmental Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA; ²Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio, USA; ³Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; ⁴Kennedy Krieger Institute, Baltimore, Maryland, USA; ⁵Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; ⁶National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA; ⁷Environmental and Occupational Health Sciences Institute, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey, USA

Abstract

In this article we describe the assessment and control of lead dust exposure in the Treatment of Lead-exposed Children (TLC) Trial, a clinical trial of the effects of oral chelation on developmental end points in urban children with moderately elevated blood lead levels. To reduce potential lead exposure from settled dust or deteriorated paint during the drug treatment phase of the trial, the homes of 765 (98%) of the randomized children (both active and placebo drug treatment groups) were professionally cleaned. Lead dust measurements were made in a sample of 213 homes before and after cleaning. Geometric mean dust lead loadings before cleaning were 43, 29, 308, and 707 µg/ft² in the kitchen floor, playroom floor, playroom windowsill, and playroom window well samples respectively. Following cleaning, floor dust lead loadings were reduced on average 32% for paired floor samples (p < 0.0001) , 66% for windowsills (p < 0.0001) , and 93% for window wells (p < 0.0001) . Cleaning was most effective for 146 homes with precleaning dust lead levels above the recommended clearance levels, with average reductions of 44%, 74%, and 93% for floors (p < 0.0001) , windowsills (p < 0.0001) , and window wells (p < 0.0001) , respectively. Despite these substantial reductions in dust lead loadings, a single professional cleaning did not reduce the lead loadings of all dust samples to levels below current federal standards for lead in residential dust. Attainment of dust levels below current standards will require more intensive cleaning and lead hazard reduction strategies. Key words: chelation, cleanup, dustwipe, environmental exposure, lead dust, lead poisoning, prevention and control. Environ Health Perspect 110:A773-A779 (2002) . [Online 12 November 2002]

http://ehpnet1.niehs.nih.gov/docs/2002/110pA773-A779ettinger/ abstract.html

Address correspondence to D.W. Dockery, Harvard School of Public Health, Environmental Epidemiology Program, 665 Huntington Avenue, Boston, MA 02115 USA. Express Mail or Courier address: Landmark Building, 401 Park Drive, Suite 415, Boston, MA 02215 USA. Telephone: (617) 384-8741. Fax: (617) 384-8745. E-mail: ddockery@hsph.harvard.edu

We thank the TLC study families, the environmental field staff, especially D. Rich, P. Luby, S. Harper, K. Watts, and the staff at the data coordinating center.

This study was supported by National Institute of Environmental Health Sciences Contracts and Intra-Agency Agreements with the National Institutes of Health Office of Research on Minority Health and the Centers for Disease Control and Prevention. A.S.E. was supported in part by NIEHS NRSA #2 T32 ES07069-21.

Received 21 December 2001 ; accepted 23 July 2002.