Project Partner: Rhode Island Department of Health; Care New England Health System
Project Funder: U.S. Centers for Disease Control and Prevention (CDC)
Project Contact: Jonathan Wilson, jwilson@nchh.org, 443.539.4162
Project Description: NCHH and its partners undertook this study to measure the effectiveness of intensive case management on children’s blood lead levels (BLLs) in children. We conducted a community-based, randomized trial of comprehensive education and home visiting for 175 families of children in Rhode Island with BLLs 15 to 19 µg/dL. The study compared the BLLs of children whose families received individualized education during 5 visits over 1 year, with BLLs of children whose families received customary care, usually 1 or 2 educational visits. Environmental samples were collected at baseline and after 1 year of follow-up for intervention group children and compared with those of comparison group children, collected only at the end of study.
Parents in the case-management group successfully decreased dust lead levels and significantly improved parent-child interaction and family housekeeping practices compared with comparison group children. Overall geometric mean BLLs declined by 47%, but the difference in BLL by group was not significant (9 vs 8.3 µg/dL for intervention versus comparison group children, respectively.) After 1 year, nearly half of enrolled children had BLLs less than 10 µg/dL. The evaluators concluded that educating families with personalized information regarding lead contamination may have a role in lead exposure prevention, but such case management has little benefit once BLLs are elevated.