The City of St Louis used to wait until a child tested positive for lead poisoning before inspecting their home and removing any lead hazards, however, now an initiative inspects and clears pregnant women’s housing prior to the child’s birth to prevent future harm. The American Journal of Obstetrics and Gynecology has published a study that demonstrates that childhood lead poisoning can be prevented by implementing this measure, whilst decreasing the overall burden of lead toxicity amongst children.

Lead researcher, Daniel R. Berg, M.D., M.P.H., of the Department of Internal Medicine, Family Care Health Centers, St. Louis, Missouri, explained:

“Our data provide evidence that a program of prenatal home screening and lead hazard remediation is effective. Children not only had a lower rate of poisoning, but also a lower average blood lead level. This is significant, since decreased intelligence in children is observed at blood lead levels below the government definition of lead poisoning, and no safe threshold of lead exposure in children has been found.”

The homes of pregnant women from a clinic mainly serving African-American women on Medicaid were targeted by The Heavy Metal Project in order to received prenatal home inspection by certified inspectors and be cleared of lead hazards.

When the inspectors found lead, remediation efforts included cleaning, paint stabilization, as well as replacing windows.

The researchers collected blood samples from 60 children in order to check their blood lead levels. Among participants, they found that the average blood lead level was 2.70 micrograms per deciliter (µg/dL) compared with 3.63 µg/dL for controls. In 13.3% of study participants and 22.5% of controls, the researchers found blood lead levels more than 5 µg/dL.

Similar results were not demonstrated in a recent study in Philadelphia that screened and remediated the homes of newborns’. In the St. Louis study, 62.5% of the homes underwent remediation, compared with only 28.2% of the homes in Philadelphia. According to the researchers St. Louis may have a riskier housing environment, and also the control population in St. Louis was older at the time of blood testing.

The researchers highlight that although it would be ideal for cities to correct lead hazards in all available housing, it is not financially possible.

Dr. Berg, explained:

“Long term solutions will only be possible with well-designed public policies which make use of both private and public monies for building repair, demolition, creation of new affordable housing developments, and targeted home screenings such as the one in our study.”

The researchers advise obstetricians to refer high-risk patients for prenatal home lead hazard screening and remediation.

Dr. Berg, said:

“Philosophically, this screening is similar to screening pregnancies for potential complications, and newborns for congenital metabolic diseases. Lead poisoning, however, is more prevalent than many disorders. Neonatal screening can detect a treatable disease in 1 of 800 newborns, but screening the homes of pregnant women for lead hazards can prevent lead poisoning in 1 of 27 children in the City of St. Louis.”

Written by Grace Rattue