Interventions Reduced Childhood Lead Levels, But Did Not Improve Neurobehavioral Outcomes

MedicalResearch.com Interview with:

Joseph M. Braun, MSPH, PhD  Associate Professor of Epidemiology Epidemiology Master's Program Director  Brown University School of Public Health

Dr. Braun

Joseph M. Braun, MSPH, PhD
Associate Professor of Epidemiology
Epidemiology Master’s Program Director
Brown University School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented.

MedicalResearch.com: What are the main findings? 

Three main findings emerged from this study:

  1. This comprehensive residential intervention targeted lead exposures from paint, drinking water, and soil. We were able to substantially reduce dust lead loadings on floors, windowsills, and window troughs below the current federal clearance levels.
  2. Among Black children, who had higher blood lead concentrations than White children, the intervention reduced blood lead concentrations.
  3. Overall, the intervention did not improve neurobehavioral outcomes, but there was a trend suggesting some cognitive and behavioral benefits to children who received the intervention.

MedicalResearch.com: What should readers take away from your report?

Response: It is possible to reduce residential lead exposures and prevent lead exposures, particularly among children at higher risk of lead poisoning.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future work could determine whether children with higher lead exposure would benefit from such an intervention and if lead poisoning could be prevented in them. .

MedicalResearch.com: Is there anything else you would like to add?

Response: These results are particularly relevant and timely to a recent court case that demands the US Environmental Protection Agency to promulgate a new residential dust lead clearance standard. Our results suggest that it is possible to achieve lower residential dust lead levels than previously thoughout possible.

Disclosures: I was financially compensated for serving as an expert witness for plaintiffs in litigation related to tobacco smoke exposures.

Citation:

Braun JM, Hornung R, Chen A, et al. Effect of Residential Lead-Hazard Interventions on Childhood Blood Lead Concentrations and Neurobehavioral OutcomesA Randomized Clinical TrialJAMA Pediatr. Published online August 27, 2018. doi:10.1001/jamapediatrics.2018.2382

Aug 29, 2018 @ 8:03 pm 

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