Hazard 7: Lead Housing Health and Safety Rating System 2012 1 - PowerPoint PPT Presentation

Hazard 7: Lead Housing Health and Safety Rating System 2012 1

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. 2012 2

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 1960-1978 contain LBP. – 69% of houses built from 1940-1960 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 lead- containing 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 ---------------------------------------------------------------------------------------------------------------------------- 3. 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. 2012 3

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, 1997-1999 1 Dwelling type and age Average Spread of health outcomes Average likelihood HHSRS scores (1 in...) Class I Class II Class III Class IV Non HMOs Pre 1920 39,060 0.0 1.0 9.0 90.0 0 (J) 1920-45 40,710 0.0 1.0 9.0 90.0 0 (J) 1946-79 99,580 0.0 1.0 9.0 90.0 0 (J) Post 1979 179,600 0.0 1.0 9.0 90.0 0 (J) HMOs Pre 1920 38,680 0.0 1.0 9.0 90.0 0 (J) 1920-45 33,730 0.0 1.0 9.0 90.0 0 (J) 1946-79 63,930 0.0 1.0 9.0 90.0 0 (J) Post 1979 59,740 0.0 1.0 9.0 90.0 0 (J) All Dwellings 58,400 0.0 1.0 9.0 90.0 0 (J) 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). 2012 4

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 ,g/dL. 310 (1.08%) had a confirmed EBLL between 10114 ,g/dL. 105 (0.37%) had a confirmed EBLL between 15119 ,g/dL. 120 (0.42%) had a confirmed EBLL between 20144 ,g/dL. 10 (0.0003%) had a confirmed EBLL ≥ 45 ,g/dL. There were another 66 children with elevated capillary tests (50 between 101 14 ,g/dL, 7 between 15119 ,g/dL, & 9 between 20144 ,g/dL) that were not confirmed by a venous test. • 9.95% of Detroit children have a level over 5 ,g/dL, • Based on this data, we have adjusted our Average Detroit Likelihood to 1 in 10

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 0 0.5 10 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 windows 1 in 3 increase ���������������������������� : Class I: Death1 very unlikely (statistically zero) Class II: Hospitalization because of chelation Class III: Repeated poisonings; lead level does not go down; higher blood lead level

What would influence likelihood and outcome? Windows and window components… ������������� ������������������������������������

Doors, door components, and interior trim

Exterior surfaces, porches, and components

Metal Objects

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

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 2012 12

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 1979. • 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. 2012 13

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. 2012 14

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. 2012 15

��������������������������������������������� Lyke Thompson Allyson Lindsey Angie Sarb David Ormandy Director Research Assistant Research Assistant Professorial Fellow CUS/WSU CUS/WSU CUS/WSU University of Warwick (313) 577-5209 (313) 577-9382 (313) 577-8911 +44 (0) 76524 936 ad5122@wayne.edu ap2854@wayne.edu angie.sarb@wayne.edu david.ormandy@warwick.ac.uk 2012 16