Comparison of Environmental Lead Hazards and Risk Factors Among Dwellings Associated with Blood Lead Levels of 5 – 9 Ug/Dl Versus 10 Ug/Dl and Higher.

BACKGROUND:   In 2012, the U.S. CDC established a new reference level of 5 ug/dL for identifying a child with an elevated blood lead level (BLL). Currently, most states do not perform environmental lead inspections unless BLLs are above 10 ug/dL, and some states do not until BLLs exceed 15 or 20 ug/dl. There are limited published data on environmental lead hazards found when performing inspections associated with lower BLLs of < 10 ug/dL. Since September 2016, the State of Maine has been performing environmental lead inspections in all rental dwellings where a child with a confirmed BLL of 5 ug/dL or higher has been identified. This presentation compares identified lead hazards associated with lower versus higher BLLs.

METHODS:   Lead poisoning case data beginning mid-September 2016 were extracted from Maine’s case management data base. Cases were classified by BLL range as either 5-9 ug/dL or 10 ug/dL and higher. For each BLL range, environmental lead inspection reports were reviewed to compile information on ownership (private versus rental), age of building (pre-1950, post 1950), renovation activity, presence of identified environmental lead hazards.

RESULTS:   Initial results from the first three months of inspections down to the new blood lead reference level are reported. As of December 2016, 142 inspections were performed on confirmed cases of children with BLLs 5 ug/dL or higher; 77% were associated with BLLs of 5-9 ug/dL. Inspections performed in dwellings associated with a child’s BLL of 5 – 9 ug/dL versus 10 ug/dL or higher were just as likely to be associated with rental dwellings (74% vs 76%), to be associated with a building built before 1950 (89% vs 95%), and to have identifiable lead hazards during environmental inspections (88% vs 94%). The lower BLLs were less likely to be associated with recent renovation activity (22% vs 36%). These initial results will be updated as more units are inspected and will be supplemented with more specific data on nature of identified environmental lead hazards.

CONCLUSIONS:  Inspections of dwellings associated with BLLs in the 5-9 ug/dL range appear just as likely to find identifiable lead paint hazards as inspections of dwellings associated with BLLs 10 ug/dL and higher, and appear to have similar housing characteristics.