Comparison of techniques to reduce residential lead dust on carpet and upholstery: the new jersey assessment of cleaning techniques trial

Remediating Thirdhand Smoke Pollution in Multiunit Housing: Temporary Reductions and the Challenges of Persistent Reservoirs

INTRODUCTION

Toxic tobacco smoke residue, also known as thirdhand smoke (THS), can persist in indoor environments long after tobacco has been smoked. This study examined the effects of different cleaning methods on nicotine in dust and on surfaces.

AIMS AND METHODS

Participants had strict indoor home smoking bans and were randomly assigned to: dry/damp cleaning followed by wet cleaning 1 month later (N = 10), wet cleaning followed by dry/damp cleaning (N = 10) 1 month later, and dry/damp and wet cleaning applied the same day (N = 28). Nicotine on surfaces and in dust served as markers of THS and were measured before, immediately after, and 3 months after the cleaning, using liquid chromatography with triple quadrupole mass spectrometry (LC-MS/MS).

RESULTS

Over a 4-month period prior to cleaning, surface nicotine levels remained unchanged (GeoMean change: -11% to +8%; repeated measures r = .94; p < .001). Used separately, dry/damp and wet cleaning methods showed limited benefits. When applied in combination, however, we observed significantly reduced nicotine on surfaces and in dust. Compared with baseline, GeoMean surface nicotine was 43% lower immediately after (z = -3.73, p < .001) and 53% lower 3 months later (z = -3.96, p < .001). GeoMean dust nicotine loading declined by 60% immediately after (z = -3.55, p < .001) and then increased 3 months later to precleaning levels (z = -1.18, p = .237).

CONCLUSIONS

Cleaning interventions reduced but did not permanently remove nicotine in dust and on surfaces. Cleaning efforts for THS need to address persistent pollutant reservoirs and replenishment of reservoirs from new tobacco smoke intrusion. THS contamination in low-income homes may contribute to health disparities, particularly in children.

IMPLICATIONS

Administered sequentially or simultaneously, the tested cleaning protocols reduced nicotine on surfaces by ~50% immediately after and 3 months after the cleaning. Nicotine dust loading was reduced by ~60% immediately after cleaning, but it then rebounded to precleaning levels 3 months later. Cleaning protocols were unable to completely remove THS, and pollutants in dust were replenished from remaining pollutant reservoirs or new secondhand smoke intrusion. To achieve better outcomes, cleaning protocols should be systematically repeated to remove newly accumulated pollutants. New secondhand smoke intrusions need to be prevented, and remaining THS reservoirs should be identified, cleaned, or removed to prevent pollutants from these reservoirs to accumulate in dust and on surfaces.

Relative contribution of potential modes of surface dust lead contamination in the homes of boatyard caulkers

OBJECTIVES

The aim of this study was to quantify the relative contributions to surface lead contamination of boat-caulkers' houses of three contamination modes, namely "take-home" lead from the caulker, "natural" spatial dispersal from boatyard to household and "redistribution" of accumulated lead-laden dust within the house.

METHODS

Boat-caulkers' houses situated in areas surrounding boat repair yards were recruited. Caulkers' houses that were located close together were divided into location-matched pairs, within which one was randomly assigned to be given a cleaning and designated a CL house, and the other was to be left uncleaned and designated a NCL house. Geographically isolated caulker's houses were randomly assigned to one of the two categories. The nearest non-boatyard worker's house (NB) was additionally recruited for each set. The surface lead loading rate (SLLR), defined as the mass of lead deposited in dust per unit area of surface per unit time, was measured over a period of 3 mo in all houses, and the data were modeled using linear mixed effects regression.

RESULTS

Adjusted values of SLLR differed only slightly between CL and NCL houses (0.96 to 1.02 times) but were between 1.65 and 2.03 times higher in CL and NCL houses than in NB houses depending on proximity to the boatyard and between 2.12 and 2.61 times higher in houses within one km of a boatyard than in more distant houses depending on category of house.

CONCLUSIONS

Newly deposited dust lead likely resulted from the take-home and spatial dispersion modes. The contribution of redistribution is very small.

Cadmium exposure in the population: from health risks to strategies of prevention

We focus on the recent evidence that elucidates our understanding about the effects of cadmium (Cd) on human health and their prevention. Recently, there has been substantial progress in the exploration of the shape of the Cd concentration-response function on osteoporosis and mortality. Environmental exposure to Cd increases total mortality in a continuous fashion without evidence of a threshold, independently of kidney function and other classical factors associated with mortality including age, gender, smoking and social economic status. Pooled hazard rates of two recent environmental population based cohort studies revealed that for each doubling of urinary Cd concentration, the relative risk for mortality increases with 17% (95% CI 4.2-33.1%; P < 0.0001). Tubular kidney damage starts at urinary Cd concentrations ranging between 0.5 and 2 μg urinary Cd/g creatinine, and recent studies focusing on bone effects show increased risk of osteoporosis even at urinary Cd below 1 μg Cd/g creatinine. The non-smoking adult population has urinary Cd concentrations close to or higher than 0.5 μg Cd/g creatinine. To diminish the transfer of Cd from soil to plants for human consumption, the bioavailability of soil Cd for the plants should be reduced (external bioavailability) by maintaining agricultural and garden soils pH close to neutral (pH-H(2)O of 7.5; pH-KCL of 6.5). Reducing the systemic bioavailability of intestinal Cd can be best achieved by preserving a balanced iron status. The latter might especially be relevant in groups with a lower intake of iron, such as vegetarians, and women in reproductive phase of life. In exposed populations, house dust loaded with Cd is an additional relevant exposure route. In view of the insidious etiology of health effects associated with low dose exposure to Cd and the current European Cd intake which is close to the tolerable weekly intake, one should not underestimate the importance of the recent epidemiological evidence on Cd toxicity as to its medical and public health implications.

Risk remaining from fine particle contaminants after vacuum cleaning of hard floor surfaces

In the indoor environment, settled surface dust often functions as a reservoir of hazardous particulate contaminants. In many circumstances, a major contributing source to the dust pool is exterior soil. Young children are particularly susceptible to exposure to both outdoor derived soil and indoor derived dust present in the indoor dust pool. This is because early in life the exploratory activities of the infant are dominated by touching and mouthing behavior. Inadvertent exposure to dust through mouth contact and hand-to-mouth activity is an inevitable consequence of infant development. Clean-up of indoor dust is, in many circumstances, critically important in efforts to minimize pediatric exposure. In this study, we examine the efficiency of vacuum cleaner removal of footwear-deposited soil on vinyl floor tiles. The study utilized a 5 x 10 foot (c. 152.5 x 305 cm) test surface composed of 1-foot-square (c. 30.5 x 30.5 cm) vinyl floor tiles. A composite test soil with moderately elevated levels of certain elements (e.g., Pb) was repeatedly introduced onto the floor surface by footwear track-on. The deposited soil was subsequently periodically removed from randomly selected tiles using a domestic vacuum cleaner. The mass and loading of soil elements on the tiles following vacuuming were determined both by wet wipe collection and by subsequent chemical analysis. It was found that vacuum cleaner removal eliminated much of the soil mass from the floor tiles. However, a small percentage of the mass was not removed and a portion of this residual mass could be picked up by moistened hand-lifts. Furthermore, although the post-vacuuming tile soil mass was sizably reduced, for some elements (notably Pb) the concentration in the residual soil was increased. We interpret this increased metal concentration to be a particle size effect with smaller particles (with a proportionately higher metal content) remaining in situ after vacuuming.

Cleaning efficacy of high-efficiency particulate air-filtered vacuuming and "dry steam" cleaning on carpet

Previous studies for lead exposure reduction have indicated the difficulty in reducing surface contamination of carpets with the use of regular vacuum cleaners. To find a solution, a household vacuum cleaner equipped with a high-efficiency particulate air (HEPA) filter and a dust finder indicator, and a "dry steam" cleaner previously reported effective in reducing dust mite allergens in carpets and mattresses were tested for effectiveness in reducing lead dust in carpets. Fifty homes of lead-exposed children were tested in New Jersey. A selected carpet in the living area of each home was tested with two interventions: half was cleaned by HEPA vacuuming twice (VAC-VAC) and the other half by dry steaming between the two HEPA vacuumings (VAC-DSC-VAC). Wipe and vacuum samples, representing surface dust and total dust collections, respectively, were taken before and after cleaning. The wipe and vacuum sample data indicated that both cleaning methods substantially reduced dust lead levels (p < 0.001). The mean percent reductions in lead loading were approximately 29% and 40% for the VAC-VAC and VAC-DSC-VAC interventions, respectively. The difference between the two postcleaning levels was statistically significant by wipe sampling (p = 0.038) but was marginally insignificant by vacuum sampling (p = 0.072). A subset of sample data collected before repeat vacuuming (VAC-DSC) suggested that repeat vacuuming after dry steam cleaning is unnecessary. In summary, slow and steady HEPA vacuuming with the help of a dust finder indicator reduces surface and overall lead dust in carpets, and dry steam cleaning further reduces surface lead contamination as compared with HEPA vacuuming alone.

Interpreting and managing blood lead levels of less than 10 microg/dL in children and reducing childhood exposure to lead: recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention

Lead is a common environmental contaminant. Lead exposure is a preventable risk that exists in all areas of the United States. In children, lead is associated with impaired cognitive, motor, behavioral, and physical abilities. In 1991, the Centers for Disease Control and Prevention defined the blood lead level that should prompt public health actions as 10 microg/dL. Concurrently, the Centers for Disease Control and Prevention also recognized that a blood lead level of 10 microg/dL did not define a threshold for the harmful effects of lead. Research conducted since 1991 has strengthened the evidence that children's physical and mental development can be affected at blood lead levels of < 10 microg/dL. In this report we provide information to help clinicians understand blood lead levels < 10 microg/dL, identify gaps in knowledge concerning lead levels in this range, and outline strategies to reduce childhood exposures to lead. We also summarize scientific data relevant to counseling, blood lead screening, and lead-exposure risk assessment. To aid in the interpretation of blood lead levels, clinicians should understand the laboratory error range for blood lead values and, if possible, select a laboratory that achieves routine performance within +/-2 microg/dL. Clinicians should obtain an environmental history on all children they examine, provide families with lead-prevention counseling, and follow blood lead screening recommendations established for their areas. As circumstances permit, clinicians should consider referral to developmental programs for children at high risk for exposure to lead and more frequent rescreening of children with blood lead levels approaching 10 microg/dL. In addition, clinicians should direct parents to agencies and sources of information that will help them establish a lead-safe environment for their children. For these preventive strategies to succeed, partnerships between health care providers, families, and local public health and housing programs should be strengthened.

Mass transfer of soil indoors by track-in on footwear

Inadvertent soil ingestion, especially by young children, can be an important route of exposure for many environmental contaminants. The introduction of exterior soil into the interior environment is a significant element of the exposure pathway. The unintentional collection of outside soil on footwear followed by subsequent deposition indoors is a principal route of soil ingress. Here we have investigated likely rates of dry and wet soil deposition on indoor hard surface flooring as a result of mass transfer from soiled footwear. In this pilot study, testing involved both single track-in events (with deposition resulting from a single progression of transfer steps) and multiple tracking actions (with deposition and dispersion resulting from repeated transfer steps). Based on soil mass recovery from the floor surface it was found that any contamination introduced by one-time track-in events was of limited spatial extent. In contrast, under repeated tracking conditions, with multiple soil incursions, widespread floor surface contamination was possible. Soil mass recovery was accomplished by brushing, by vacuum cleaner removal and by wet wiping. All the clean-up methods operated imperfectly and failed to remove all initially deposited soil. The level of floor surface soiling that resulted from the track-in tests, and the incomplete clean-up strongly suggest that under unrestricted transfer conditions rapid accumulation and dispersal of soil on indoor flooring is likely.

Effectiveness of lead-hazard control interventions on dust lead loadings: findings from the evaluation of the HUD Lead-Based Paint Hazard Control Grant Program

From 1994 to 1999, the Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the intervention experiences of over 2800 homes in 11 states in the USA. Each interior intervention was categorized as (in order of increasing intensity) (a) cleaning/spot painting; (b) complete repainting; (c) complete repainting plus window treatments; (d) window abatement plus treatments to other components; (e) abatement of all lead-based paint hazards; or (f) abatement of all lead-based paint. Complete dust testing and environmental data were available for 1034 and 278 dwellings through 12 and 36 months postintervention, respectively. Strategies ranging from complete repainting to window abatement plus other treatments reduced geometric mean preintervention windowsill and floor dust lead loadings up to 36 months postintervention (reductions for complete repainting, from 16 to 5 microg/ft2 on floors and 182 to 88 microg/ft2 on sills; for window abatement plus other treatments, 27-8 microg/ft2 on floors and 570-124 microg/ft2 on sills). Full abatement reduced windowsill and floor loadings from baseline to 12 months postintervention [95-6 microg/ft2 on floors and 518-30 microg/ft2 on sills (data were not available for this strategy at 36 months)]. Window lead-hazard abatement was the most effective measure to reduce dust lead loadings on windows, but this treatment would need to be performed in conjunction with treatments to floors as well as exterior and soil treatments for the most effective control of dust lead on floors.

A federal agency's role in fulfilling the public health core functions: the childhood lead poisoning prevention program model

The Institute of Medicine identified 3 core functions of public health: assessment, policy development, and assurance. Federal, state, and local public health agencies all have an obligation to provide these vital functions to ensure conditions in which people can be healthy. However, the few publications that provide core function applications only focus on applications at the local or state levels. The Centers for Disease Control and Prevention's Childhood Lead Poisoning Prevention Program uses a comprehensive public health approach. This article describes the Centers for Disease Control and Prevention's leading role in applying the core public health functions to prevent childhood lead poisoning.

Impact of home carpets on childhood lead intervention study

Blood lead data for a childhood lead exposure study have been reanalyzed to examine the impact of carpets on the effectiveness of a cleaning intervention in 39 New Jersey urban houses. All eligible houses in the study were classified as carpeted and uncarpeted depending on the number of rooms that were carpeted. The cleaning protocol was associated with a significant reduction in the blood lead concentrations for the uncarpeted homes (P = 0.004), whereas no significant change was found for the carpeted homes (P = 0.566). We also completed correlation analyses between the number of cleaning visits and the percentage reduction in blood lead for the carpeted/uncarpeted houses. There was a significant correlation (r = 0.67) between the number of cleanings and blood lead reduction for the uncarpeted homes, but no correlation (r = 0.04) for the carpeted homes. In a multiple regression model that took confounding variables into account, the carpet status (carpeted or uncarpeted) remained a factor of the effect of cleaning on blood lead (P = 0.05). We conclude that the presence of contaminated carpets inhibits the effectiveness of home cleaning despite a high-efficiency particulate air filtered vacuum protocol that removes a substantial amount of lead dust.