Findings of a Statewide Environmental Lead Inspection Program Targeting Homes of Children With Blood Lead Levels as Low as 5 µg/dL.

Document Type


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Journal Title

Journal of Public Health Management & Practice

MeSH Headings

Program Implementation; Inspection (Clinical) Maine; Lead Blood; Home Environment; Environmental Exposure Risk Factors; Lead Poisoning Risk Factors; Human; Child; Reports; Maine; Fisher's Exact Test; Wilcoxon Rank Sum Test; Family Attitudes; Residence Characteristics; Spearman's Rank Correlation Coefficient; Dust; Child: 6-12 years


Context: There are limited data on the nature of environmental lead hazards identified during residential inspections for child blood lead levels (BLLs) of less than 10 µg/dL. We compare inspection findings for child BLLs of 5 to 9 µg/dL versus 10 µg/dL or more. Design: We reviewed inspection reports in Maine from September 2016 to March 2018. We used continuity-adjusted or Fisher's exact test for categorical variables and Wilcoxon rank-sum tests for continuous variables to compare differences in child, family, household, and lead hazard characteristics between BLL categories (5-9 µg/dL vs ≥ 10 µg/dL). We used Spearman correlation coefficients to assess relationships between home surface lead dust measurements and BLLs. Results: Of 351 residential inspections, 272 (77%) were for children with BLLs of 5 to 9 µg/dL. Children with BLLs of 5 to 9 µg/dL as compared with children with BLLs of 10 µg/dL or more were less likely to chew window sills and door frames (8% vs 21 %; P = .01), but otherwise were similar with respect to other established risk factors for lead poisoning. Children with BLLs of 5 to 9 µg/dL tended to have fewer paint hazards inside their homes (64% vs 78%; P = .03), and they were more likely to have dust-only hazards (8% vs 3%) or no identified lead paint hazards (23% vs 15%), though these differences were not statistically significant. For children with BLLs of 5 to 9 µg/dL, BLL was weakly correlated with average window sill dust level (Spearman r = 0.16; P = .01) and average floor dust level (r = 0.13; P = .03), but these correlations were not observed for children with BLLs of 10 µg/dL and higher. Conclusions: We have found that inspections of homes of children with BLLs of 5 to 9 µg/dL are nearly as likely to identify lead hazards that require abatement as inspections of homes of children with BLLs of 10 µg/dL.

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