The association between state housing policy and lead poisoning in children

Abstract

Objectives. This study examined the effect of an active program of household lead paint hazard abatement, applied over 22 years, on childhood lead poisoning in Massachusetts. Methods. A small areas analysis was used to compare screening blood lead levels of children in Worcester County, Mass (n = 27 590), with those in Providence County, RI (n = 19 071). Data were collapsed according to census tract. Results. The percentage of children with lead poisoning (blood lead level ≥ 20 μg/dL [Pe20]) was, on average, 3 times higher in Providence County census tracts (3.2% vs 0.9% in Worcester County census tracts, P < .0001), despite similar percentages of pre 1950s housing in both counties. The ratio of Pe20 in Providence vs Worcester County census tracts was 2.2 (95% confidence interval = 1.8, 2.7), after adjustment for differences in housing, sociodemographic, and screening characteristics. This estimate was robust to alternative regression methods and sensitivity analyses. Conclusions. Massachusetts policy, which requires lead paint abatement of children's homes and places liability for lead paint poisoning on property owners, may have substantially reduced childhood lead poisoning in that state.