Lead-Based Paint Awareness, Work Practices, and Compliance during Residential Construction and Renovation
Blando, James D., Antoine, Nickita, Lefkowitz, Daniel, Journal of Environmental Health
Exposure to lead is associated with adverse health effects among adults and children. Lead-based paint utilized on homes built prior to 1978 is currently the most common source of exposure among the general public in the U.S. According to a survey published by the Department of Housing and Urban Development in 2001, 24% of housing built between 1960 and 1977 contains lead-based paint, 69% of housing built between 1940 and 1959 contains lead-based paint, and 87% of housing built before 1940 contains lead-based paint (Clickner, Marker, Viet, Rogers, & Broene, 2001). They also found that housing in the Northeast and the Midwest had about twice the prevalence of lead-paint hazards compared with housing in the South and West (Clickner et al., 2001).
The abundance of paint with elevated levels of lead pigment makes contractors remodeling these homes as well as the residents at risk of exposure to lead-based paint. Construction activity can result in the disturbance of lead-based paint creating a significant amount of dust and debris that contributes to both contractor and resident exposure. Many researchers have shown that lead can be released during residential remodeling work, and it can result in exposures among the workers and dissemination of lead-containing dusts throughout the house (Kiefer & Morley, 1996; Sussell, Elliott, Wild, & Freund, 1992; Sussell & Piacitelli, 2001, 2005; Sussell, Piacitelli, Chaudhre, & Ashley, 2002). In addition, it has also been documented that exposures can occur beyond the workers and residents of homes being renovated. For example, the children of construction workers can be exposed through "take-home" exposures (Clickner et al., 2001; Ewers, Piacitelli, & Whelan, 1995; Scholz, Materna, Harrington, & Uratsu, 2002; Sussell, Gittleman, & Singal, 1997; Whelan et al., 1997).
The National Institute for Occupational Safety and Health (NIOSH) Adult Blood Lead Epidemiologic Surveillance (ABLES) program has ranked construction work as the third most common job classification with workers having elevated blood lead levels (Alarcon, Graydon, & Calvert, 2011). NIOSH-funded state ABLES surveillance programs have found construction workers to be at particular risk of having elevated blood lead levels as a result of exposure to lead-based paint. For example, in New Jersey the construction and renovation business represents a significant number of adult blood lead cases reported to the New Jersey adult lead registry, with a total of 975 persons and 2,455 blood tests recorded from 2001 through 2006 alone (Blando & Lefkowitz, 2010). The New Jersey registry data show that the relative proportion of cases in the lead registry from the construction and renovation trades with significant blood lead levels (>25 [micro]g/dL) appears to be increasing over time in New Jersey, with a 12% increase since 2001 (Blando & Lefkowitz, 2010). This is most likely the result of the recent decrease in manufacturing and the increasing need to renovate older homes with lead paint and the subsequent exposure among this cohort of workers.
As a result of the risk from exposure to lead due to construction activity, the U.S. Environmental Protection Agency (U.S. EPA) recently promulgated the Renovation, Repair and Painting (RRP) rule that applies to all residential structures built before 1978 with few exceptions (Renovation, Repair and Painting Rule, 2011). This rule includes provisions for education and training, work practices, workplace controls, and awareness as an intervention strategy to reduce the hazard posed by lead-based paint in the residential setting. Materna and co-authors (2002) showed that the educational intervention painters received to reduce lead exposure was moderately effective even one year after follow-up. Harrington and co-authors (2004) found some concerns about sustaining interest and compliance over the long term if incentives were not adequate to sustain compliance. …