Rochester's Lead Law: Evaluation of a Local Environmental Health Policy Innovation

Article excerpt

BACKGROUND: Significant progress has been made in reducing the incidence of childhood lead poisoning in the United States in the past three decades. However, the prevalence of elevated blood lead in children ([greater than or equal to] 10 [micro]g/dl) remains high in some communities, particularly those with high proportions of pre-1978 housing in poor condition. Increasingly, municipalities a using local policy tools to reduce lead poisoning in high-risk areas, but little is known about the effectiveness of such policies.

OBJECTIVES: In this article, we evaluated the effectiveness of a comprehensive rental housing-based lead law adopted in Rochester, New York, in 2005.

METHODS: This policy evaluation integrates analyses of city inspections data, a survey of landlords, landlord focus groups, and health department data on children's blood lead levels from the first 4 years of implementation of the 2005 law.

RESULTS: Implementation has proceeded consistent with projected numbers of inspections with nearly all target units inspected in the first 4 years. Higher than expected inspection passage rates suggest that landlords have reduced lead hazards in rental housing affected by the law. Implementation of the lead law does not appear to have had a significant impact on the housing market.

CONCLUSIONS: Although many uncertainties remain, our analysis suggests that the lead law has had a positive impact on children's health. Strong enforcement, support for community-based lead programs, and ongoing intergovernmental coordination will be necessary to maintain lead-safe housing in Rochester. Lessons learned from the Rochester experience may inform future local lead poisoning prevention policies in other communities.

KEY WORDS: childhood lead poisoning prevention, environmental health policy, healthy housing, local government. Environ Health Perspect 120:309-315 (2012). http://dx.doi.org/10.1289/ehp.1103606 [Online 14 October 2011]

Federal policies to reduce childhood lead poisoning, particularly bans on lead in paint and gasoline in the 1970s, resulted in drastic declines in the proportion of children with elevated blood lead (EBL; [greater than or equal to]10 [micro]g/dL) from nearly 20% in 1990 to 1.6% in 2000 (Levin et al. 2008). Despite this progress, lead remains a critical environmental health hazard for many low-income children who live in housing built before 1978, when lead paint was banned for residential use in the United States. To address these remaining problems, some states have adopted additional policies to reduce lead poisoning. Most state policies focus on screening and management of children with EBL, but scveral promote housing-based primary prevention (Breysse et al. 2007; Brown et al. 2001). In addition to these state laws, a small number of cities have longstanding local lead laws aimed at housing-based primary prevention; in fact, several local laws preceded federal lead legislation (Freudenberg and Golub 1987).

Recognition that some communities continue to suffer disproportionately from lead and increased appreciation for the negative health effects of low-level lead poisoning sparked renewed interest in local lead policies in recent years. Rochester, New York, is one such community. In 2000, the proportion of children with EBL was substantially higher among screened children in high-risk neighborhoods in Rochester than in the state of New York or the United States as a whole; in 12 extreme-risk census tracts, > 35% of screened children were identified as having EBL (Boyce and Hood 2002).

Rochester is typical of cities in which the proportion of screened children with EBL far exceeds the national average. The vast majority of Rochester's housing stock was built before 1978, with 87% constructed before 1950, when the highest amounts of lead in paint were used (Boyce and Hood 2002). Because of economic conditions in the city, many of these properties are now low-income rental units. …