CHILDHOOD LEAD POISONING: EVALUATING NEW CONTROL EFFORT

铅中毒是最严重、最普遍和最持久的 这个国家的童年问题。最新的联邦卫生与公众服务部 营养检查调查显示，每25名美国儿童中就有1名 近五分之一的5岁以下城市贫困黑人儿童受到影响。这 研究建议对两种新策略进行随机对照试验 在高风险的城市环境中减少儿童铅中毒(CLP)。 小孩子很容易吸收城市中普遍存在的铅 环境。越来越多的证据表明，铅 在儿童中积累，与显著的神经学和 行为缺陷。这些影响的严重性质与 高流行率构成了一个主要的公共卫生问题，但几乎没有 了解适当的公共政策以最大限度地减少铅暴露。 除了减少汽油中的铅的优点外，几乎没有 关于减少儿童接触的方法的有效性的信息 其他重要的铅来源，如家庭灰尘和油漆。 对研究评估的需求和日益增长的国家兴趣 新的和现有的预防和预防方法的有效性 中电的管理。拟议研究的目的是评估 减少儿童接触家庭污染源的替代战略 牵头并提出建议。该项目将启动一项 来自社区的工作人员演示替代战略作为 测试减少中电的效果的车辆。测试将由以下人员完成 将有受影响儿童的家庭随机安排到住房康复中心 干预，含铅的室内粉尘管理干预或控制 由管理家庭铅的现行做法组成的干预措施 曝光。评估将包括对可行性的分析 以及在现实情况下这些有希望的方法的成本效益 并将它们与当前的技术进行比较。这个项目 涉及社区组织和私营部门的合作。它 期望本研究成果具有一定的实用价值 对巴尔的摩卫生当局和社区团体的适用性 和其他受影响的地区在规划更有效的计划方面。这个 演示将作为在以下情况下可以实现的目标的典范 社区团体和私营部门以新的方式结合资源，以 解决复杂的公共卫生问题。

Lead poisoning is one of the most significant, pervasive, and persistent childhood problems in this country. The latest federal Health and Nutrition Examination Survey indicated that 1 in 25 American children and nearly 1 in 5 poor black urban children under age 5 is affected. This study proposes to conduct a ramdomized control trial of two new strategies to reduce childhood lead poisoning (CLP) in a high risk urban setting. Young children readily absorb lead which is ubiquitous in the urban environment. There is a growing body of evidence that lead, which accumulates in children, is associated with significant neurological and behavioral deficits. The serious nature of these effects combined with the high prevalence constitute a major public health concern, yet little is known about appropriate public policies for minimizing lead exposure. Apart from the merits of reducing lead in gasoline, there is scant information on the effectiveness of methods for reducing childhood exposure to other important sources of lead, such as household dust and paint. There is a need for and a growing national interest in research appraising the effectiveness of new and current approaches to the prevention and management of CLP. The purpose of the proposed research is to evaluate alternative strategies to reduce childhood exposure to household sources of lead and to formulate recommendations. This project will initiate a demonstration of alternative strategies by workers from the community as a vehicle for testing efficacy for reducing CLP. Testing will be done by randomizing households with an affected child to a housing rehabilitation intervention, a leaded housedust management intervention or to a control intervention consisting of current practices for managing household lead exposure. The evaluation will consist of an analysis of the feasibility and cost-effectiveness of these promising approaches under realistic conditions and will compare them to current techniques. This project involves both community organizations and private sector collaboration. It is expected that the results of this research will have practical applicability for both health authorities and community groups in Baltimore and other affected areas in planning for more effective programs. The demonstration will serve as a model for what can be accomplished when community groups and the private sector combine resources in new ways to attack a complex public health problem.