Department of Population Health & Disease Prevention, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA 92697, USA.
Department of Chicano/Latino Studies, School of Social Sciences, University of California, Irvine, CA 92697, USA.
Int J Environ Res Public Health. 2019 Mar 24;16(6):1064. doi: 10.3390/ijerph16061064.
Although lead has been removed from paint and gasoline sold in the U.S., lead exposures persist, with communities of color and residents in urban and low-income areas at greatest risk for exposure. The persistence of and inequities in lead exposures raise questions about the scope and implementation of policies that address lead as a public health concern. To understand the multi-level nature of lead policies, this paper and case study reviews lead policies at the national level, for the state of California, and for Santa Ana, CA, a dense urban city in Southern California. Through a community-academic partnership process, this analysis examines lead exposure pathways represented, the level of intervention (e.g., prevention, remediation), and whether policies address health inequities. Results indicate that most national and state policies focus on establishing hazardous lead exposure levels in settings and consumer products, disclosing lead hazards, and remediating lead paint. Several policies focus on mitigating exposures rather than primary prevention. The persistence of lead exposures indicates the need to identify sustainable solutions to prevent lead exposures in the first place. We close with recommendations to reduce lead exposures across the life course, consider multiple lead exposure pathways, and reduce and eliminate health inequities related to lead.
尽管美国已禁止销售含铅涂料和含铅汽油，但铅暴露仍在持续，有色人种社区和城市及低收入地区的居民面临着最大的铅暴露风险。铅暴露的持续存在和不平等现象引发了人们对解决铅这一公共卫生问题的政策范围和实施情况的质疑。为了了解铅政策的多层次性质，本文通过社区-学术合作的过程，对国家层面、加利福尼亚州以及加利福尼亚州圣安娜市（南加州一个人口密集的城市）的铅政策进行了案例研究和回顾。该分析考察了政策所涉及的铅暴露途径、干预程度（例如预防、补救），以及政策是否解决了健康不平等问题。结果表明，大多数国家和州的政策都侧重于在环境和消费产品中设定危险的铅暴露水平、披露铅危害以及修复含铅油漆。一些政策侧重于减轻暴露，而不是初级预防。铅暴露的持续存在表明，需要首先确定可持续的解决方案，以防止铅暴露。最后，我们提出了减少整个生命周期内铅暴露、考虑多种铅暴露途径以及减少和消除与铅有关的健康不平等的建议。
