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Evidence summaries

Household Interventions for Prevention of Domestic Lead Exposure in Children

Educational and dust control interventions may not be effective in reducing blood lead levels of young children. For soil abatement or combination interventions the evidence is insufficient. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 14 studies with a total of 2 643 children (under 6 years of age). Studies were subgrouped according to their intervention type. Educational interventions were not effective in reducing blood lead levels (MD 0.02, 95% CI -0.09 to 0.12, 5 studies, n=815; dichotomous ≥ 10 µg/dL (≥ 0.48 µmol/l) RR 1.02, 95% CI 0.79 to 1.30, 4 studies, n=520; dichotomous ≥ 15 µg/dL (≥0.72 µmol/l) RR 0.60, 95% CI 0.33 to 1.09, 4 studies, n=520). Meta-analysis of the dust control subgroup found no evidence of effectiveness (MD -0.15, 95% CI -0.42 to 0.11, statistical heterogeneity I2 =90%, 3 studies, n=298; dichotomous ≥ 10 µg/dL (≥ 0.48 µmol/L) RR 0.93, 95% CI 0.73 to 1.18, 2 studies, n=210; dichotomous ≥ 15 µg/dL (≥ 0.72 µmol/L) RR 0.86, 95% CI 0.35 to 2.07, statistical heterogeneitty I2 =56%, 2 studies, n=210). The studies using soil abatement (removal and replacement) and combination intervention groups were not able to be meta-analysed due to substantial differences between studies.

Comment: The quality of evidence is downgraded by inconsistency (variability in results) and by imprecise results (wide confidence intervals).

    References

    • Nussbaumer-Streit B, Yeoh B, Griebler U et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database Syst Rev 2016;(10):CD006047[PubMed].

Primary/Secondary Keywords