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

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.

Can fish consumption advisories do better? Providing benefit and risk information to increase knowledge.

Humans exposed to methylmercury (MeHg) can suffer from adverse health impacts, e.g., serious neurological damage; however, fish is also a good source of omega-3 fish oils which promotes infants' neurological development. Because eating fish is the primary mechanism of MeHg exposure, federal and state agencies issue fish consumption advisories to inform the public about the risks of eating contaminated fish. An advisory's purpose is to provide information to consumers to increase their knowledge of specific product attributes; however, the difficulty in communicating both the risks and benefits of eating fish leads readers of fish advisories to over-restrict their fish consumption. Because the effectiveness of fish consumption advisories are not often evaluated by states, we help fill this gap by evaluating the effectiveness of Maine's fish consumption advisory in terms of improving knowledge. The results suggest the advisory successfully increased women's knowledge of both the benefits and risks of consuming fish while pregnant. The advisory also increased their ability to differentiate fish by their MeHg content, knowledge of both low and high-MeHg fish and knowledge of detailed attributes of seemingly substitutable goods, such as white tuna, light tuna and pre-packaged salmon. People who did not read the advisory lack the knowledge of how to identify fish that provide: health benefits like Omega-3 fatty acids, or health risks like MeHg; reading the advisory reduces this lack of knowledge. Readers increased ability to make specific substitutions to minimize risk while maintaining the benefits of fish eating suggests the advisory has the potential of reducing MeHg-related health risks while avoiding the drop in fish consumption show in other studies.