Hazard 7: Lead. Housing Health and Safety Rating System

Transcription

1 Hazard 7: Lead Housing Health and Safety Rating System

2 Potential for Harm The most vulnerable age group is children under six years old. This is because of potential effects on neurological development, and because young children s bodies more readily take up lead. Other risk groups include pregnant women and fetuses

3 Relevant Matters Affecting Likelihood and Harm Outcome 1. Date of construction Dwellings constructed before 1978 may contain lead based paint (LBP). 24% of houses built from contain LBP. 69% of houses built from contain LBP 87% of houses built before 1940 contain LBP. 2. Disrepair to Lead Based Paint Damage and/or flaking of old paintwork leads to possible ingestion of lead dust and leadcontaining paint chips. Lack of heat can cause increased deterioration Lack of water can cause inability to wet clean lead contaminated dust Roof and pipe leaks can cause increased deterioration. Evidence of remodeling may indicate more dust and debris Lead pipework The presence of lead pipework for domestic water increases likelihood of lead exposure and more severe harm outcomes., 4. Plumbo-solvent water Plumbo-solvent water, or water of high acidity likely to dissolve lead in pipes, affects likelihood of exposure

4 Potential for Harm (UK Standards) N/A for any U.S. urban or rural setting. Lead Average likelihood and health outcomes for all persons aged under 3 years, Dwelling type and age Average likelihood (1 in...) Spread of health outcomes Class I Class II Class III Class IV Non HMOs Pre , (J) , (J) , (J) Post , (J) HMOs Pre , (J) , (J) , (J) Post , (J) All Dwellings 58, (J) Average HHSRS scores 1 Table from HUD Guidance Manual on HHSRS. Data should be generalizable to the United States, as mainly US studies or high exposure area studies were used to generalize current background rates of lead exposure for children in the UK (p. 78)

5 Adjusting averages to fit local circumstances Detroit Data: In 2011, there were 64,302 children under the age of 6 in Detroit; 28,674 (44.6%) were tested for lead. 2,317 (8.08%) had blood lead levels from 5 to 9 µg/dl. 310 (1.08%) had a confirmed EBLL between µg/dl. 105 (0.37%) had a confirmed EBLL between µg/dl. 120 (0.42%) had a confirmed EBLL between µg/dl. 10 (0.0003%) had a confirmed EBLL 45 µg/dl. There were another 66 children with elevated capillary tests (50 between µg/dl, 7 between µg/dl, & 9 between µg/dl) that were not confirmed by a venous test. 9.95% of Detroit children have a level over 5 µg/dl, Based on this data, we have adjusted our Average Detroit Likelihood to 1 in 10

6 Adjusting averages to fit local circumstances The highlighted portion represents the average house in Detroit. Rating guide based on data and informed professional judgment. 7. Lead Likelihood Outcome Class I Outcome Class II Outcome Class III Notes Detroit Local Outcomes Average A. With lead grant 1 in 180 or 320 B. New windows but no lead grant 1 in 32 C. Old win., little chipping paint 1 in 10 or 1 in 18 D. bad front porch, some chipping paint. 1 in 6 E. poor condition ext. paint 1 in 6 increase moderate chipping paint and all old window1 in 3 increase How do we determine outcomes: Class I: Death- very unlikely (statistically zero) Class II: Hospitalization because of chelation Class III: Repeated poisonings; lead level does not go down; higher blood lead level

7 What would influence likelihood and outcome? Windows and window components Severe cases- Increase both likelihood and outcome

8 Doors, door components, and interior trim

9 Exterior surfaces, porches, and components

10 Metal Objects

11 What may not be a lead hazard? Ceilings and walls Look for alligatoring

12 As we all know, the best way to measure is through a Lead Inspection/ Risk Assessment. But without this, assume lead based paint (based on age of house and components) and use your informed professional judgment

13 Determining Your Likelihoods and Outcomes: Hazard Prevalence in HHRS Study Sites Poor housing quality is a major risk factor elevated blood lead levels. Older housing (pre-1978) is more likely to have lead products, such as paint or piping. In Detroit, 62.2% of housing was built before 1950, a substantially higher percentage than any other county in Michigan. In Alameda County, CA, 29.8% of housing was built before 1950, and another 48.7% was built between 1950 and Chipping, peeling paint can lead to higher lead levels in the home. According to the 2003 American Housing Survey, 72,100 (3.8%) of units in metro Detroit (Wayne, Macomb, Oakland, St. Clair, Monroe, Livingston, & Lapeer counties) had this problem. In the AHS s 1998 survey of metropolitan Oakland (Alameda & Contra Costa counties), 42,100 housing units (4.7%) had broken plaster or peeling paint in their interiors

14 Outcome Data: National Nationally, in 2010 there were 24,258,220 children under 6 years old 3,937,631 of those children were tested for an elevated blood lead level (EBLL). Of those children that were tested, 24,043 (0.61%) had an EBLL 10 µg/dl (the previous CDC action level). Another 238,260 children tested (6.05%) had a blood lead level between 5-9 µg/dl, above the new CDC action level of 5 µg/dl

15 Outcome Data: Oakland (CA) In 2009, 17,892 children ages 0-5 were tested for lead. 97 (0.5%) had an EBLL of 9.5+ µg/dl 524 (2.9%) had a blood lead level of 4.5 to < 9.5 µg/dl. Statewide, there were 2,426 cases of an EBLL 9.5+ µg/dl, meaning Alameda accounted for nearly 4% of all such cases in California

16 Healthy Home Rating System Project Leadership Lyke Thompson Director CUS/WSU (313) Allyson Lindsey Research Assistant CUS/WSU (313) Angie Sarb Research Assistant CUS/WSU (313) David Ormandy Professorial Fellow University of Warwick +44 (0)