The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Public Health Rep. 2011 May-Jun;126 Suppl 1(Suppl 1):76-88. doi: 10.1177/00333549111260S111.
Lead exposure in children can lead to neuropsychological impairment. This study tested whether primary prevention interventions in the newborn period prevent elevated blood lead levels (BLLs).
The Philadelphia Lead Safe Homes (LSH) Study offered parental education, home evaluation, and lead remediation to the families of urban newborns. Households were randomized to a standard lead education group or maintenance education group. We conducted home visits at baseline, six months, and 12 months. To compare BLLs, we identified a matched comparison group.
We enrolled and randomized 314 newborns in the intervention component; 110 completed the study. There were few significant differences between the randomized groups. In the combined intervention groups, positive results on visual inspection declined from baseline to 12 months (97.0% to 90.6%, p = 0.007). At baseline, 36.9% of homes were above the U.S. Environmental Protection Agency's lead dust standard, compared with 26.9% at 12 months (p = 0.032), mainly due to a drop in windowsill dust levels. Both groups showed a significant increase in parental scores on a lead education test. Children in the intervention and matched control groups had similar geometric mean initial BLLs (2.6 vs. 2.7, p = 0.477), but a significantly higher percentage of children in the intervention group had an initial blood lead screening compared with those in the matched group (88.9% vs. 84.4%, p = 0.032).
A study of primary prevention of lead exposure showed a higher blood lead screening rate for the combined intervention groups and mean BLLs at one year of age not statistically different from the comparison group. Most homes had lead hazards. Lead education significantly increased knowledge.
儿童铅暴露可导致神经心理损伤。本研究旨在测试新生儿期的一级预防干预措施是否能预防血铅水平升高（BLL）。
费城铅安全家园（LSH）研究为城市新生儿的家庭提供父母教育、家庭评估和铅修复。家庭被随机分为标准铅教育组或维持教育组。我们在基线、六个月和 12 个月进行家访。为了比较 BLL，我们确定了一个匹配的对照组。
我们共招募了 314 名新生儿参与干预部分，其中 110 名完成了研究。随机分组之间几乎没有显著差异。在联合干预组中，肉眼观察的阳性结果从基线到 12 个月呈下降趋势（97.0%降至 90.6%，p = 0.007）。基线时，36.9%的家庭超过了美国环境保护署的铅尘标准，而 12 个月时为 26.9%（p = 0.032），主要是由于窗台灰尘水平下降。两组父母在铅教育测试中的得分都显著提高。干预组和匹配对照组的儿童初始 BLL 几何均数相似（2.6 与 2.7，p = 0.477），但干预组儿童初始血铅筛查率显著高于匹配组（88.9%比 84.4%，p = 0.032）。
一项关于铅暴露一级预防的研究表明，联合干预组的血铅筛查率更高，且一年时的平均 BLL 与对照组无统计学差异。大多数家庭都存在铅危害。铅教育显著提高了知识水平。
