-------
r
Hi
u
<
li-
a.
u.
O
V
uj
a o
> z
_
as uj
t/l O
_i
UJ I-
> z
UJ UJ
-J X
UJ
-I
trt
3
Q
Z
UJ
O UJ
x a.
x
Z UJ
UJ >
i s
u
a
o
z —
< a
UJ
u
04
UJ
Z
UJ
a
UJ
a:
a.
(C
UJ
IT
C3
O
O
o
¥ O
o
O
4-0
en
r*
09
3)
3
O
1/1
V.
o
o
L
U
o i
o **
l/l
o o
o
*t I-
UJ
ffi
O <
in i
— ui
a
a
\
O
a
x
X
o
•o
c
i
o
•o
c
— in
3 0)
II O
a
L t-
O 3
O **
— W
u. z
H
u. c
Q IA
Z 0)
UJ —
13 a)
uj u
-------
In dwelling 4, before abatement, all sampled sites (27 out of
27) had PbD levels outside the target range. After abatement,
repainting, and floor treatments, all sites remained outside the
PbD target range, despite substantial improvements in sill and
well levels overall. Again, the final cleanup was not effective
in reducing dust-lead levels, and some sites had increased levels.
In summary, prior to abatement nearly all household sites in our
four experimental abatement dwellings had dust-lead levels outside
the target range. During abatement, PbD levels tended to increase.
After abatement, floor treatments, and repainting, dust-lead levels
on floors, window sills, and window wells generally improved. Most
floors were within the target range. The results after final
cleanup, however, were inconsistent: sometimes PbD levels
decreased, and sometimes they increased. A single cleanup with a HEPA
vacuum and wet scrubbing was not sufficient for window sills and
window wells.
Dust Levels at One and Three Months After Abatement Were Generally
Lower Than Pre-Abatement Levels but Not Necessarily in the Target Range
Compared to post-cleanup levels, mean PbD levels on floors
decreased or remained the same one and three months post-
occupancy. Post-occupancy, treated floors (tiled or coated) in
abatement homes 1 through 3 had mean PbD levels within or close to
the target range. In abatement home 4, mean one- and three - month
levels on treated floors were over 300 mcg/sq ft. However, we found
that lead in dust tended to reaccumulate on window wells over time.
On window sills, we found increasing, decreasing, and unchanging
mean PbD levels over time after abatement and across the four
abatement homes.
Dust-Lead Levels in Previously Renovated Comparison.Group Dwellings
Were Generally within the Target Range
Tables 8 through 11 display PbD levels over time in comparison
group dwellings (see Appendix B for raw data). Comparison
dwellings 1 and 2 were renovated before this study. Both were
occupied dwellings with new walls, vinyl replacement windows, and
vinyl tile or linoleum floor coverings. We selected these houses to
compare PbD levels in our demonstration houses with PbD levels in
houses without lead-based paint that were in the same older housing
neighborhood. Comparison dwellings 3 and 4 were occupied and
fairly well maintained, but not previously renovated, older
dwellings with original walls and windows and, for the most part,
original wood flooring.
Unlike pre-abatement PbD levels in our substandard demonstration
dwellings, mean PbD levels on floors and window sills in our two
previously renovated comparison houses were within the target range
(less than 150 mcg/sg ft) at the beginning of the study period.
And although mean PbD levels on window wells were outside the
traget range, they were an order of nagnitude-less than the mean
pre-abatement PbD levels on window wells in our demonstration
-31-
-------
TABLE 8:
HOUSEHOLD DUST-LEAD LEVELS OVER TIME
COMPARISON DWELLING 1
Completely Renovated Row Home
- New walls, floor coverings, windows
ARITHMETIC MEAN
(micrograms/sg ft)
SITE (N)*
WINTER
Time 1
SPRING
Time 2
SUMMER
Time 3
FALL
Time 4
12/15/86 4/22/87 7/2/87 10/5/87
FLOORS (2)
(tile)
13
13
WINDOW SILLS (4) 15
16
29
27 (3)*
WINDOW WELLS (4)
vinyl
replacement
1,058
927
614
517 (3)*
*(N) = (number of samples)
-32-
-------
TABLE 9: HOUSEHOLD DUST-LEAD LEVELS OVER TIME
COMPARISON DWELLING 2
i •
Previously Rehabilitated Row Home
- (renovated after house fire)
ARITHMETIC MEAN
(micrograms/sg ft)
SITE
(N)*
FLOORS (3)
WINTER
Time 1
12/5/86
17
SPRING
Time 2
4/20/87
60
SUMMER**
Time 3
_
FALL
Time 4
10/5/87
6
(linolium &
painted wood)
WINDOW SILLS (5)
(new wood)
128
161
49
WINDOW WELLS (4) 290
(vinyl replacement)
869
315 (n=3)
*(N) = (number of samples)
**We were unable to arrange home visit to collect dust.
-33-
-------
TABLE 10:
HOUSEHOLD DUST-LEAD LEVELS OVER TIME
COMPARISON DWELLING 3
Fairly well maintained older row home -
original walls, nearly all windows and
floors original wood
ARITHMETIC MEAN
(micrograms/sq ft)
SITE (N)*
FLOORS (6)
(wood & linol)
WINDOW
SILLS (4)
(original and
recently painted)
WINDOW WELLS
vinyl (1)
original (2)
WINTER
Time 1
11/19/86
126
346
745
34,427
SPRING
Time 2
4/20/87
103
655
528
9,692
SUMMER** FALL
Time 3 Time 4
9/24/87
92
1,670
345
12,470
*(N) = number of samples
**We were unable to arrange home visit to collect dust.
-34-
-------
TABLE 11:
HOUSEHOLD DUST-LEAD LEVELS OVER TIME
COMPARISON DWELLING 4
Older row home
- original walls, nearly all windows and
floors original wood
ARITHMETIC MEAN
(micrograms/sq ft)
SITE (N)*
WINTER
Time 1
SPRING
Time 2
SUMMER
Time 3
FALL
Time 4
12/2/86
4/22/87 7/2/87 9/26/87
FLOORS
linol, polyur
or painted (5)
original wood
(2)
WINDOW SILLS
new wood (2)
original
wood (5)
WINDOW WELLS
vinyl (1)
new wood (2)
original
wood ( 3 )
193
2,543
466
6,273
1,146
131
90,925
68
927
20
4,851
1,422
282
57,850
119
630
192
8,179
1,015
51
94,137
28
153
118
7,355
615
147
58,529
*(N) = (number of samples)
-35-
-------
dwellings. Furthermore, we found that mean PbD levels in these
renovated houses remained constant at low levels, over a 10-month
period. Mean floor, sill, and window well PbD levels in these homes
had the following ranges: floors—6 to 60 mcg/sg ft; sills—15 to
161 mcg/sq ft; and wells—290 to 1,058 mcg/sq ft.
Comparison dwelling 3 is a fairly well-maintained older home
with original walls, windows, and floors. Mean floor levels were in
the target range across time. Mean sill PbD levels (range: #346 to
1670 mcg/sg ft) were lower than mean pre-abatement levels on sills
in our demonstration dwellings (range: 2,560 to 10,793 mcg/sg ft).
The original window wells had PbD levels similar to levels found in
the demonstration dwellings.
We selected comparison dwelling 4 because it allowed for a
comparison of PbD levels on new and original surfaces within the
same dwelling. We found striking differences (typically 10- to 20-
fold) in PbD values between replacement windows and original
units and between original wood floors and floors that had been
covered or coated. Mean PbD levels on original floor, sill, and
window well surfaces over time were similar to pre-abatement PbD
levels in our demonstration dwellings (i.e., similar to levels in
homes of lead-poisoned children). However, mean PbD levels from
covered or coated floors and replacement windows (sills and wells)
were similar to levels found on corresponding surfaces in
our previously renovated comparison homes.
We also have data suggesting that the construction of the
window unit may influence PbD levels on window wells, we measured a
100-fold increase in PbD in going from the sills to window wells of
vinyl replacement windows in renovated comparison dwellings 1 and
2. We did not find this difference with wooden replacement window
units in comparison home 4. This suggests that certain types of
vinyl replacement windows may trap exterior dust in the window
well.
Air-Lead Levels Often Exceed Safe Levels
The State of Maryland requires monitoring of workers' blood-
lead levels when their exposure to airborne lead exceeds 30
micrograms (meg) per cubic meter per hour on average over an eight-
hour day. Respirator protection is required at levels in excess of
an average of 50 meg per cubic meter per hour over an eight-hour
day (MOSH, 1984).
In this project, we conducted limited air-lead monitoring to
begin to establish a data base on worker exposure from various
methods of abatement. We monitored the air during the removal of
wood trim components for off-site dipping (see Appendix C). Some
of the tests revealed levels in excess of 50 meg per cubic meter
per hour. However, these test results were unreliable because of
dry sweeping that was done by one worker. (Dry sweeping should not
be done before, during, or after lead paint abatement because of
dry sweeping that was done by one worker. Dry sweeping should not
-36-
-------
be done before, during, or after lead paint abatement because it
can resuspend lead-bearing particulates in the air and expose
workers to them unnecessarily.)
In a previous study, airborne lead levels were monitored
during the application and removal of PEEL AWAY in one demonstration
dwelling abated as part of the Mayor's Task Force on Lead Paint
Poisoning (August 1986). The air-lead levels were found to be less
than 10 meg per cubic meter per hour. These findings suggest that
respirator protection may not be necessary when abatement is
performed using this caustic chemical system (see Appendix G) .
However, further air monitoring is warranted to confirm this finding.
t
We also performed air-lead monitoring during a demonstration
of a disk sander that attaches to a HEPA filtering vacuum cleaner
(see Appendix D). Again, some, but not all, of the tests indicated
that air-lead exposure exceeded 50 meg per cubic meter per hour.
Chemical Precipitation Greatly Reduces Lead in Waste Water
Waste water is generated during the PEEL AWAY process when
abated surfaces are rinsed with water to remove lead-laden residue.
We found that this waste water also had a high lead content
(greater than 660 ppm) well in excess of the extraction process
(EP) toxicity concentration .of 5 ppm. EP toxicity is one of the
criteria for determining whether a material must be handled as a
hazardous waste under federal law (Resource Conservation and
Recovery Act).
To reduce the lead concentrations below 5 ppm and pass the EP
toxicity test, we precipitated the lead from the waste water using
either sodium hydroxide or phosphoric acid (see Appendix E). After
this chemical precipitation, the waste water had lead concentrations
lower than 5 ppm and as low as less than 1 ppm. In order to prepare
the water and precipitate for disposal, we had to carefully
separate the water from the precipitate in a manner that prevents
mixing.
Blood-Lead Levels in a Small Sample of Workers Did Not Exceed State
Standards for Medical Removal from the Job
We obtained limited blood-lead (PbB) data from three workers
performing the four abatements. Before starting this project, we
tested the PbB levels of 13 Baltimore Jobs in Energy Project
(BJIEP) workers employed in various construction tasks. The PbB
distribution ranged from 14.5 mcg/dl to 38 mcg/dl.
BJIEP workers selected for abatement work had pre-project PbB
concentrations of 15.5 to 20 mcg/dl, which were above the average
U.S. adult level (less than 10 mcg/dl) [17]. None of the
documented PbBs of the workers exceeded 22 mcg/dl during the
project period (see Appendix F) , and no worker required medical
removal from the job, as specified in Maryland regulations (i.e.,
•37-
-------
PbB of at least 40 or 50 mcg/dl, depending on PbB history (MOSH,
1984)).
Each Experimental Abatement Produced Valuable Information About
Actual Abatement Practices
People abating the hazards of lead paint by propane torch or
sanding methods can readily get clinical lead poisoning and have
their blood-lead concentrations rise over 50 mcg/dl in a short
period of time (personal communication, Dr. James Keogh). Previous
experience with workers using electrical heat guns for abatement
suggests that lead absorption can increase (Farfel, 1987). Mean
blood-lead concentrations for 23 abatement workers and supervisors
rose from 12.2 mcg/dl before any abatement work was performed to
21.9 mcg/dl approximately eight months later when the abatement
project ended.
This section summarizes some of what we learned from each
experimental abatement dwelling. Appendix A contains detailed
descriptions of the processes and scope of work.
Experimental Abatement Dwelling 1
In this dwelling we tested a home-made caustic mix and high-
pressure water spray as an abatement method for removing lead .paint
from all interior wood trim surfaces in a vacant dwelling. The
method is routinely used to remove paint from exterior brick. In
summary, we learned the following:
1. The method is not effective in one or two applications as
a total abatement method for interior wood trim surfaces.
Removal of three to six layers of paint was incomplete
and spotty.
2. Caustic mix and two gallons of water from a medium-
pressure spray is a successful and needed method for
removing lead paint from radiators.
3. The basic principles of abatement (e.g., containment of
debris, worker protection, floor coverings, and thorough
cleanup) run counter to the training and work habits of
construction workers. The development of an abatement
team that puts the principles of abatement into practice
is a process that takes time.
4. When abatement work is being done at the same time as
renovation work, coordination with the other trades is
important in ensuring that other workers are not exposed
to lead and that abatement work can proceed unhampered.
5. On-site supervision is crucial to reinforcing the
principles of abatement.
-38-
-------
Experimental Abatement Dwelling 2
In this dwelling we tested a combination of off-site dipping
and PEEL AWAY as an abatement method for removing lead paint from
all interior and exterior wood trim surfaces in a vacant dwelling.
We learned the following:
1. Considerable on-the-job training is required for workers
and supervisors to learn to use the PEEL AWAY stripping
system as a one-step abatement procedure. The procedure
has multiple steps (application, removal and wash down,
and pH adjustment), each of which must be performed
correctly to achieve a successful abatement.
2. Off-site dipping, in addition to PEEL AWAY, was
successful in removing lead paint. However, we detected
residual lead-dust on the surface of dipped wood that
needs to be removed by wet scrubbing. We also detected
lead-laden residue surfaces abated by PEEL AWAY that need
to be removed as part of the abatement process.
3. None of the glass in doors and windows broke, and few of
the joints became unglued. Wood trim components can be
removed, sent off site for chemical stripping in enclosed
tanks, and returned with very little breakage.
Experimental Abatement Dwelling 3
In this dwelling we tried to remove lead paint more
efficiently by having all easily removable trim from doors,
baseboards, and windows dipped off site and by restricting PEEL
AWAY to door and window jambs. We learned the following:
1. Having had some experience, the workers performed
abatement more easily and with more attention to
containment and floor coverings. (Post-abatement dust-
lead levels were lowest among the four experimental dwellings.)
2. Cleanup was easier because plastic coverings were on the
floors throughout the abatement process.
3. A single application of PEEL AWAY was successful for door
and window jambs.
Experimental Abatement Dwelling 4
In this dwelling we removed lead paint from an occupied home
using a combination of off-site stripping, PEEL AWAY, and a HE PA
sander. The residents were temporarily relocated, and the
furnishings remained in the home. Again the strategy was to
maximize off-site dipping and restrict PEEL AWAY to sites where
trim could not be easily removed. We learned the following:
-39-
-------
3.
4.
Working in a furnished home hampers the abatement
activities and cleanup.
In occupied dwellings, security concerns dictate the
order in which the work is done. Window components
(including sashes) and doors can be removed, stripped off
site, and rehung in one day to avoid security problems in
a furnished home.
The HEPA sander did remove lead paint from flat surfaces
(e.g., door jambs). The unit requires an air compressor.
The ease of trim removal should be checked. Trim removal
was hampered by large cut nails every six inches.
Abatement Costs Decease With Experience
Table 12 summarizes the labor and material costs for abatement
by study dwelling. Costs in abatement dwelling 1 include the costs
of using what turned out to be an unsuccessful method for interior
wood trim (caustic mix and high-pressure spray) and then doing the
abatement by off-site dipping. During abatement in dwelling 2,
BJIEP workers learned how to use the PEEL AWAY system; labor costs
reflect considerable on-the-job training. Dwelling 3 was the first
to be abated with a crew that had at least some experience with the
methods. Dwelling 4 was occupied and had the largest scope of work
(see Appendix A).
Experimental abatements 1 through 3 were done in the context
of a general renovation and upgrading of the property. Abatement 4
was not. The crew was somewhat experienced with the abatement
techniques by the time they did abatement number 3. The cost of
abatement 3 probably best reflects the additional costs of work required
to completely remove the lead paint and dust, given all the other
renovation work that was done. The owner of the dwelling was
already planning to cover or coat all the floors, to replace some
of the original windows, and to paint all the household surfaces.
To conduct a complete abatement in the dwelling, we needed to
remove all the interior and exterior lead paint on trim components
and on windows that were not replaced. The total direct cost for
this additional abatement work in this two-story row house was
$2,759, exclusive of the cost to rehang, prime, and repaint the
trim that was abated off site. The total direct cost for abatement
4, including the costs of floor treatments, rehanging trim, and
priming and painting abated trim, was $5,810.
-40-
-------
TABLE 12:
ABATEMENT COST SUMMARY
EXPERIMENTAL ABATEMENT DWELLING
1* 2* 3* 4**
Labor (a)
$1,889 $4,360*** $1,117 $2,100
Supplies and
Protective Gear
Off -Site Dipping
Rental
PEEL AWAY
440
732
325(b)
-
1,217
268
-
440
659
788
-
195
1,100
1,800
210(c)
600
Total Direct Costs
$3386
$6285
$2759
$5810
* Totals do not include the costs of floor treatments, re-hanging
trim and painting. These activities were done by the owner of
the dwellings as part of a general upgrading of the dwellings.
** Totals include costs of floor treatments, re-hanging trim,
and painting.
*** Labor costs are high because the abatement workers were learning
how to use a new process - PEEL AWAY.
(a) labor costs averaged $9.00 per hour, including FICA and worker's
compensation.
(b) rental of high pressure sprayer.
(c) rental of air compressor.
-41-
-------
Many home renovation activities abate the hazards from lead
lead paint either by replacing or by encapsulating the lead-painted
areas (e.g., new replacement windows, floor coverings, and
drywall). Thus, an abatement that is done as part of a renovation
can be less costly than one that is not.
In Decontamination fBetter Cleanup) of Three Traditionally Abated
Houses. Target Levels Aren't Always Reached
Tables 13 through 15 display mean household dust-lead levels
for three traditionally abated houses before and after we
decontaminated them in Hay and June of 1987. The time period
between the abatements and our decontaminations was two to three
months. Figures 7 through 9 display plots of pre- to post-final
cleanup changes in dust-lead levels.
Mean dust-lead levels two to three months after abatement by
traditional methods and before our decontamination were similar to,
or higher than, (1) levels previously found in homes of lead-
poisoned children (Farfel, 1987) and (2) the mean pre-abatement
levels in our demonstration dwellings. Indeed, children with blood-
lead elevations and a history of chelation therapy lived in each of
the three decontamination dwellings. At pre-decontamination, mean
PbD levels had the following ranges: floors—380 to 4,024 mcg/sg
ft,* sills—4,869 to 34,138 mcg/sg ft; and window wells—6,091 to
156,065 mcg/sq ft.
Following the decontamination and painting and before the
final cleanup, mean PbD levels on floors, sills, and window wells
improved; however none of the mean values was in the target
range. Findings from decontamination dwelling 2 indicate that the
final cleanup was effective in reducing levels further; mean PbD
values were within or close to the target (less than 150 mcg/sq
ft). Findings from dwelling 3, however, indicate that the cleanup
was not effective, and that mean PbD levels on floors, sills, and wells
increased. In dwellings 1 and 3, mean post- cleanup levels were
higher than the target range. In all cases, mean PbD values on
treated floors were less than mean values on untreated floors. In
dwelling 3, one worker reported that the wash water was not
frequently changed and that wash water used on highly contaminated
window wells was also used on the floors. This may account for the
relatively high lead levels on floors after cleanup.
By one month after decontamination, mean PbD levels increased
by less than a factor of 2 in two dwellings and decreased by more
than half in the third dwelling. Mean PbD levels on window sills
and window wells tended to increase during this period because only
partial abatement (up to four feet from the floor) was performed in
these substandard homes, and the remaining paint continued to
deteriorate. Overall, however, PbD levels one month after our
decontaminations were lower than levels found before decontamination.
-42-
-------
TABLE 13: HOUSEHOLD DUST-LEAD LEVELS BEFORE AND AFTER
DECONTAMINATION BY HEPA VACUUM AND WET CLEANING
In Dwelling Abated of Lead Paint by Traditional
Methods
Decontamination Dwelling 1
ARITHMETIC MEAN
(micrograms/sq ft)
SITE (N)*
PRE
DECON-
TAMINATION
POST DECON-
TAMINATION
& PAINT***
POST
FINAL
CLEAN
ONE
MONTH
POST
7/27/87
7/30/87 8/26/87
FLOORS
TX** - coated (4) 380
no TX (4) 448
940
871
199
326
WINDOW
SILLS (7)
34,138
486
1,359
WINDOW
WELLS (2)
156,065
5,600 25,315
*(N) = (number of samples)
**TX = treatment
***We were unable to arrange home visit to collect dust.
-43-
-------
TABLE 14: HOUSEHOLD DUST-LEAD LEVELS BEFORE AND AFTER
DECONTAMINATION BY HEPA VACUUM AND WET CLEANING
In Dwelling Abated Of Lead Paint By Traditional
Methods
Decontamination Dwelling 2
SITE (N)*
ARITHMETIC MEAN
(micrograms/sq ft)
PRE
DECON-
TAMINATION
POST DECON-
TAMINATION
& PAINT
POST
FINAL
CLEAN
ONE
MONTH
POST
7/29/87
8/20/87
8/26/87
9/26/87
FLOORS
TX* - coated (5) 3,648
no TX (1) 1,620
254
510
136
210
162
330
WINDOW
SILLS (4)
4,869
332
44
641
WINDOW
WELLS (5)
6,091
690
2,507
(185)(a)
2,376
*(N) = (number of samples)
**TX = treatment
a. mean value excluding 1 outlier (11,798)
-44-
-------
TABLE 15: HOUSEDUST LEAD LEVELS BEFORE AND AFTER
DECONTAMINATION BY HEPA VACUUM AND WET CLEANING
In Dwelling Abated Of Lead Paint By Traditional
Methods
Decontamination Dwelling 3
ARITHMETIC MEAN
(micrograms/sq ft)
SITE (N)*
7/27/87
PRE
DECON-
TAMINATION
POST DECON-
TAMINATION
& PAINT
8/20/87
8/27/87
POST
FINAL
CLEAN
ONE
MONTH
POST
10/4/87
FLOORS (7)
4024
256**
513
822
WINDOW
SILLS (6) 30,972 185
WINDOW
WELLS (2) 72,338 4210
210 2850
(590)a
8079 25,032
*(N) (number of samples)
** all coated with polyurethane
a. mean value excluding 1 outlier (13,148)
-45-
-------
2
lit -*
Q
<
ul
Q <
Z
UJ MM
S
D <
O I-
I Z
O
Ul
O
Z >
«. O
r =
U I-
l/l
0.
3 I-
Z O
Q.
UJ
X
t-
z
O
(J
UJ
i/t
o
a
a:
a.
a:
O
in
01
o
t.
u
z
o
o
UJ
O
t
Ul
<£
a.
o
•o
c
c «
•^ a
3 O
II -J
IS,
I. L
O 3
o *-
— »
u. z
u
u. c
Q Ifl
Z 0)
UJ —
is a
UJ U
QSlrtt-
-------
HI
(J
< a
r- 3
a.
3 K
Z O
< -I
ID >-.
-i a
u
>d a
tu
O
<
z
UJ
Q
t/1
O
a.
UJ
cc.
a.
UJ
a
O *<
O «>
II)
E
L
O 0)
O O
O <-
n o
oo
0)
3
O
I/I
O
<
ut
I/)
z
o
f-t
O H
a <
t z
o u
in o
•- i
UJ
DC
a.
z
o
•o
II
X
I
o
n
C «l
i- O)
i o
II -I
O 3
O *•
—
-------
u.
cc
U
a
UJ
>
UJ
UJ
-I
CO H
3 «
o z
ul S
in <
3 t-
O Z
X O
u
Z UJ
•_• a
Ul
a
z
>
o
« D
X t-
u in
a t-
3 O
Z a
o4
O
a
UJ
UJ
o
O
CL
UJ
a
a
UJ
cc
CD
Ol
ui
- o
i
UJ
O ~ L
- « «
u. z in
ii £1
u. C O
a «
z « ••
UJ — 31
u a *•
UJ U O
_l in Z
_
-------
Children's Blood-Lead Levels Remained Stable Following Decontamination
for the Small NumberSampled
Blood-lead (PbB) concentration is an indicator of recent lead
absorption, and can rapidly reflect increased absorption. Previous
studies (Chisolm et al., 1985; Farfel, 1987) have
documented the problem of renewed excessive lead absorption (FbBs
greater than 49 mcg/dl) in approximately 40 percent of children
following chelation therapy and discharge to traditionally abated
older homes. Host readmissions for chelation therapy occurred
during the first month following discharge.
We have one-month post-discharge PbB values for children who
received chelation therapy and returned to their decontaminated
homes. Among one child in decontamination dwelling 1 and two
children in dwelling 2, we found no evidence of renewed and
excessive lead absorption at one month. Based on experience, and in
the absence of a decontamination, we would have expected at least
one of three children to have had renewed and excessive lead
absorption. We have no data on the children in dwelling 3 because
the family has repeatedly failed to keep clinic appointments.
Admittedly, our sample is so small as to be inconclusive.
Decontamination Costs Vary with Dwelling size and Vacuum Quality
Decontamination consisted of:
o vacuuming household surfaces with a HEPA vacuum and wet scrubbing,
o applying two coats of polyurethane or paint to all exposed
wood floors,
o priming and painting all abated and unpainted wood trim,
and
o revacuuming with a HEPA vacuum and wet scrubbing.
The costs for decontamination in study homes 1, 2, and 3 were
$1,300, $760, and $1,105, respectively. Decontamination dwellings 1
and 3 were four-room apartments. Dwelling 1, however, was larger
than dwelling 3. Dwelling 2 was a two-story, six-room row house.
HEPA vacuums cost $1,000 - $2,000. The cost varies with the
quality, capacity, and performance of the vacuum. Replacement HEPA
filters cost approximately $500; secondary filters, $15 each; and
bags, $2 each. The life of the HEPA filter is difficult to
predict; however, it is maximized when the bags and the secondary
filters are changed regularly.
-49-
-------
CONCLUSIONS
Our dust-lead findings suggest the following conclusions:
1. our experimental methods are more effective at reducing
exposure to lead-dust than traditional methods (e.g., propane
torch and/or sanding) and alternative methods used by
Baltimore City crews in 1984 (heat gun, repainting, and
cleanup by standard vacuums and wet scrubbing) (see Table 16).
2. Our experimental abatement methods may achieve household
dust-lead levels similar to levels found in renovated homes
and modern suburban homes. However, we did not consistently
achieve target dust-lead levels across study households. We
did measure at least one mean household dust-lead level in the
target zone after final cleanup on treated floors, window
sills and window well surfaces.
3. Even our experimental abatement techniques increase dust-lead
levels; they too produce residues laden with lead. Thus post-
abatement cleanup is a key part of the entire abatement. It
reduces (but does not eliminate) lead-bearing particulates and
residues.
4. High-efficiency particle accumulator (HEPA) vacuums are a
vital part of post-abatement cleanup procedures. Clark et al.
(1985) indicate that much of the lead in dust is in the
smallest particle size range (less than 175 microns). HEPA
vacuums can trap particles down to 0.3 microns. However, a
single cleanup by HEPA vacuuming and wet scrubbing is not
adequate to reduce household sites to the target range (less
than 150 mcg/sq ft), particularly window wells. Some sites
also had increased PbD levels after cleanup, which suggests
that lead may be spread from one site to another, if the
cleanup is not done carefully. Furthermore, the findings
suggest that cleanup may be more difficult and less effective
in an occupied dwelling than in a vacant dwelling.
5. Repainting and covering are particularly effective measures
for reducing dust-lead levels. Lead-bearing particulates are
sealed and made inaccessible. This finding is consistent with
findings from demonstration dwellings treated by the Mayor's
Task Force in 1986 and other monitored homes (Farfel, 1987).
6. Better abatement and cleanup do not simply require different
physical methods and equipment. Workers must be taught why
better abatement and cleanups are important for their safety
as well as for the safety of the future occupants of the
house. Supervisors must reinforce the principles that are the
basis for better abatement (e.g., minimize production of lead-
bearing particulates, contain debris, clean up thoroughly, and
use of personal protection gear).
-50-
-------
Table 16: Mean House Dust-Lead Levels After Abatement and Final
Cleanup bv Traditional Methods, bv Alternative Methods by
City Crews in 1984. and byOur Experimental Methods
(micrograms per square foot)
Surface
Traditional
Abatement*
Alternative
Abatement*
Our
Experimental
Abatements**
Floors
Window
Sills
4,750
11,410
895
730
37 - 558
107 - 3,649
Window
Wells
31,550
27,360
100 - 8,368
* Values are mean post-abatement and post-cleanup PbD
levels across 53 homes abated by traditional methods
(propane torch and/or sanding, minimal cleanup,
no repainting), and 18 homes abated by city crews in
1984 using alternative methods (heat gun, cleanup by
standard vacuums and wet scrubbing, and repainting).
** Values are the ranges of arithmetic mean PbD values
found in each of our 4 experimental abatement homes
after final cleanup.
-51-
-------
RECOMMENDATIONS
We Must Make Sure Abatements Are PerformedSafely and Consistently
Our pilot project suggests that better abatement techniques
and cleanups can lead to significant reductions in residual dust-
lead levels in comparison with both traditional and formerly
permitted city practices. This means reduced risk of exposure for
child and adult occupants of abated houses, as well as workers
performing the abatements.
On July 1, 1987, Baltimore city promulgated regulations
concerning the conditions for and conduct of required abatements of
lead paint. In general, the regulations require abatement and
cleanup practices analogous to those described in this report.
(See Section IV of the attached regulations.) A notable difference
is that the City regulations permit the use of heat guns. Nonetheless,
these regulations are a definite step in the right direction.
In our findings, we noted that better abatements and cleanups,
however, are not solely a function of chemicals and machines.
Equally important are an understanding of why the new practices are
necessary. In recognition of the importance of these factors, we
recommend the following specific actions:
1. Disseminate information about the new city regulations to
landlords, contractors, and workers via associations,
trade groups, and unions.
2. Establish efforts to inform contractors and workers about
the new abatement methods and the health and safety
issues that clarify for the need for the new regulations.
3. Encourage the development of a trades-based clearinghouse
of information on evolving abatement methods.
4. Vigorously enforce the new city regulations.
We Must Conduct Research in Several Areas
To confirm the findings of this pilot project, expand our data
base, and fill in gaps in abatement information, we recommend:
1. Additional surveys of lead-dust in "lead-free" houses in
order to establish more firmly the target range of
residual dust-lead levels that better abatements and
cleanups must obtain.
2. Additional surveys of lead-dust levels over time
following better abatement and cleanup to determine the
contribution of ambient exposure to residual levels.
-52-
-------
8.
9,
Development and evaluation of more effective methods for
reducing lead-bearing particulates in household dust,
specifically:
evaluation of the use of heat guns and the dust-lead
levels they generate;
post-abatement cleanup methods that will consistently
yield dust-lead levels in the target range; and
methods for removing lead-laden dust/residue that
remains on surfaces after using PEEL AWAY and
off-site dipping methods.
Development of field methods for:
mass-testing of the lead content of household dust
in order to more quickly judge the efficacy of
abatement and cleanup techniques and
easy measurement of the rate of reaccumulation once
levels have been reduced to target levels after
abatement and cleanup.
Extensive monitoring of blood-lead levels of workers to
obtain data on:
pre-project blood-lead levels and
increases in blood-lead levels under different
abatement practices. Concurrent monitoring of air-
lead levels should occur to determine if workers are
experiencing exposure via this pathway.
Extensive monitoring of the blood-lead levels of children
residing in houses abated, cleaned, and maintained using
better techniques to establish the effectiveness of
abatements in reducing blood-lead levels of children.
Development of field methods to:
test the EP toxicity of lead in various forms of
abatement waste in order to comply with disposal
requirements; and
- test and treat waste water on site.
Collection of better and more data on the labor,
material, and disposal costs of better abatements.
Development of preventive strategies (e.g., evaluation
of periodic professional decontamination to reduce
children's exposure to household lead-dust during their
High-risk years (ages 1-6) .
-53-
-------
6. REFERENCES
Annest, J. L., Pirkle, J. L., Makuc, D., Neese, J. W.,
Bayse, D. D., et al. 1983. Chronological trend in blood
lead levels between 1976 and 1980. N. Enal. J. Med.
308:1373-77
Bellinger, 0., Leviton, A., Waternoux, C., Needlemen, H.,
and Rabinowitz, M. 1987. Longitudinal analyses of prenatal
and postnata exposure and early cognitive development.
N. Enal. J. Med. 316:1037-43
Charney, E., Kessler, 8., Farfel, M., Jackson, D. 1983.
Childhood lead poisoning: a controlled trial of the
effect of dust control measures on blood lead levels.
N. Enal. J. Med. 309:1089-93
Chisolm, J. J. Jr., Mellits, E.D. Quaskey, S. A., 1985.
Relationship between level of lead absorption in children
and type, age, and condition of housing.
Environ. Research 38:31-45
Chisolm, J. J. Jr., 1986. Removal of lead paint from housing:
the need for a new approach. Amer. J. Public Health
76:236-37
Clark, S., Succop, P., Bornschein, R., Que Hee. S.,
Hammond, P., Peace, B. 1985. Condition and type of housing
as an indicator of potential environmental lead exposure
and pediatric blood lead levels. Environ. Research
38:46-53
Dietrich, K. N., Krafft, K. M., Bornschein, R. L.,
Hammond, P.B., Berger, 0. et al. Effects of low level
fetal exposure on neurobehavioral development in early
infancy. Pediatrics. in press.
Farfel, M., 1987. doctoral thesis. Evaluation of health and
environmental effects of two methods for residental lead
paint removal. Department of Health Policy and Management,
Johns Hopkins University School of Hygiene and Public Health
Maryland Occupational Safety and Health Administration
Standard for Occupational Exposure to Lead in Construction
Work. Effective Jan. 1984. Maryland Register 13:2197-2201
-54-
-------
Morrell, G., and Giridhar, 6. 1976. Rapid method for blood lead
analysis by anodic stripping voltammetry. J. Clin. Chem.
(Winston-Salem, NC) 22:221-23
Provenzano, G. 1980. in: Low LevelExposure! The Clinical
Implications of Current Research. Needleman, H. L. (ed.)
New York: Raven Press, pp 299-315
Que Hee, S. S., Peace, B., Clark, C. S., Boyle, J. R.,
Bornschein, R. L., and Hammond, P. B. 1985. Evolution
of efficient methods to sample lead sources such as
house dust and hand dust, in the homes of children.
Environ. Research 38:77-95
Sayre, J. W., charney, E., Vostal, J., Pless, I. B. 1974.
House and hand dust as a potential source of childhood
lead exposure. Amer. J. Pis. Child. 127:167-170
Sayre, J., and Katzel, M. 1979. Household surface lead dust:
its accumulation in vacant homes. Environ. Health
Perspect^ 29:179
U.S. Centers for Disease Control. 1985. Preventing
lead poisoning in vouna children. A statement by the
Centers for Disease Control - Jan. 1985 U.S. PHS Atlanta
U.S. Environmental Protection Agency. 1977. Air cruality
criteria for lead. Publication no. EPA-600/8-77-017,
Research Triangle Park, NC
U.S. Environmental Protection Agency. 1986. Air Quality
Criteria for Lead, Volumes I-IV, "Draft Final." Environmental
Criteria and Assessment Office, Research Triangle Park, NC
Vostal, J., Taves, E., Sayre, J. W., and Charney, E. 1974.
Lead analysis of housedust: a method for detection of
another source of lead exposure in inner city children.
Environ. Health Perspect 7:91
-55-
-------
APPENDIX A: DESCRIPTIONS OF ABATEMENT WORK
A-l
-------
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING #1
DfiTES OF wQRKs January 1987
OBJECTIVE!
To test A home-made caustic mix and hi gn-pressure soray as an
abatement method for removing lead-based paint from all interior
wood trim surfaces in a vacant dwelling. The caustic mix and trie
high-pressure soray method is routinely used to remove paint from
exterior brick.
METHOD! Caustic Mix
A. Caustic soda flakes were mixed in varying concentrations as
follows:
weakest: £ boxes of corn starch as thicKener and £ cups of
caustic flakes in 4 gallons of water
strongest: 1 box of corn starch and 4-5 cups of caustic
flakes in 4 gallons of water
B. fioplication and Removal
Caustic mix was brushes on wood trim surfaces including coor and
winaow trim, jambs, basecoards, and a stairway railing, posts.
soindles ana trim that were identified with lead paint in excess
of 0.1 mg Pb/sa cm using a portaole XRF analyzer. These surfaces
had aoprox iniately six coats of old oaint. The XRF analyzer coes
not soecify which layers of paint contained lead. The caustic
mix was left on overnignt anc sorayec witn hi an—pressure watsr
(aoorox. 4t3wtZi psi) to see if it would remove the paint in ons
aoplicat ion.
C. PnticiDated Problems ana Preventive Measures
1. Worker safety:
&JEP staff experienced in aoolication of caustic on exteriors of
buildings conducted a one cay training session for tne crew.
Goggles, face snields ana rubber suites ana gloves were proviaea
to eacn worker. Running water and vinegar wera available in cass
of accidential exposure. On-site suoervision was provided at all
times curing use of pressure soray. The dwelling was also ventillatec.
A-2
-------
Experimental Abatement Dwelling #1
£. Water damage due to excessive water:
Floors were prepared with 3-5 layers of paoer covered
with 4 ml plastic which was staoled in place. Plastic was used to
cover walls uo to level of window aorons. Saw dust was ussa for
water absorption and control on top of the plastic (especially
around radiators). Two—by—fours were used to create small aa.pns
and lakes to catch and collect the waste water so that it coulc
be removed immediately following soraying usinc wet vacuums.
3. Cold weather conditions and subfreezing temperatures:
We arranged for heat to be turned on and aid not score any
chemicals on site that might freeze
the second aooiication of caustic. The caustic mix froze and was
reactivated with water.
3. Some water, not caustic to the touch and minus tne settled
paint Chios ana solids, was allowed to co into the storm arain
(aoprox 500 gallons).
4. After clean—uo, the dwelling resembled a poorly abatad "-EEL
AwftY" dwelling. We decided to remove easily rernovaaie trim for
off-site chemical diooing ana to try a second acolicacion of the
causeic/pressure spray method on the stairwell components to sas
if it would work as a two—stao process. Remaining lead paint was
finally, abated by rnethyiene cnloriae. and scraping.
A-3
-------
Experimental Abatement Dwelling #1
RESULTS
WASTE COLLECTION AND DISPOSAL
The paoer, plastic and saw dust successfully controlled excess
water, and thereby prevented carnage to wood floors and other
surfaces. If a process such as this reouires large volumes of
water (hundreds of gallons), then one day of oresaration in
comoi nat ion with "dams11 and "lakes" can prevent water carnage.
Some water was absorbed into the pacer and the sawdust. Excess
water was collected in wet vacuums. All soli a cebris was
disoosed of at a sanitary landfill.
UNSUCCESSFUL APPLICATIONS
The caustic/high pressure soray method at any strength cic not
remove six layers of paint from wood trim in a single
aoplication. Removal was inconsistent, incomplete and sootty.
Intersoersed with flat and irregular areas where all layers of
paint had been removed and tne wood was exposed were other flat
and irregular areas that still had 2-3 layers of paint. Unlil/s
tne PEEL AWAY method, this method did not include working the
surfaces with brushes and plastic soatulas. The method was still
laborious. Similar results were obtained after the second
apoiication of the caustic mix/high pressure soray method on the
stairwell trim. Again, large Quantities of water were generated
that had to be collected ana vacuumed.
SUCCESSFUL APPLICATIONS
4-s cups o
gallons of
caustic to 1-2 boxes of corn
water makes a strong mix that.
starcn
if aooiiad
with 4
and
water
uncsr
Waste
Radi ators:
mixed with 4
to raciators and allowec to sit overnight can be wasned off
light brushing (hard bristles) and a oaint sorayer ( psi
gal Ions/mi n) using aoorox irnately two gallons of water. The
is easily controlled with paoer covered with clastic, both
the raciator and'over the wall surface benind tne radiator.
water can be col.iected using a cam made from £:<4' s around the
sides of the radiator. This water can then be vacuumed. The
radiators with £—4 coats of paint became comoletely clean in on*
analication without the use of a high—pressure sorayer. Two
gallons of water is no more than that procucsc by a leaky valve
tnat mignt stain the csiling below.
Off—Site Dipping: Since the home—rnaoe caustic mix and high
pressure soray methoa was not successful, all easily rsmovaole
wooa trim (baseboards, coors, window and door trim) was removed
and sent off-site for commercial striooing in enclosed cnemicai
tanks. Trim was removed and returnee with very little breakage.
Paint removal was close to 100 oercent after cioping.
Methyiene cnioride was usea sucsssfuliy as a toucr.-uo method.
A-4
-------
Experimental Abatement Dwelling II
DAMAGE to SURFACES
There was minimal damage to the wood by the caustic ana high
pressure soray. "Fussing " or raising of the grain of pine and
minor splintering of small areas of wood wa£ ooservec.
WORKER PERCEPTIONS. ATTITUDES. ACCEPTANCE
Although the workers were protected, tney
or interested in using ths methoa again.
were not at all haaay
The coic and mess of
workers did not perform as well
during the second apolication of the metnoc as during tne first.
Thev were sure tnat the second aooiication would not work.
the job made it unaooealing.
The
Mr. Dobie has explained to us tnat the basic principles of lead
aoatement
-------
Experimental Abatement Dwelling #1
Recommendations:
These findings do not preclude the testing cf home—mace caustic
mixes together with plastic coverings and nisei urn/low pressure snray«
sucn as paint sorayers and hand held sorayers and liant brushing
as a lower cost alternative to the commercial PEEL fiwftY product.
Examine further the radiator abatement method in other study homes.
Continue to have easily removable trim sent off-sits for chemical
stri poing.
Continue to use rnethylene en 1orida as touch—uo or finishing
methoa as long as precautions are followed.
Until sucn time as the abatement principles anc concepts become
automatic with the 'workers, the project should continue to rely
on tne on—site supervisor to direct t-e work and reinforce tne
conceots with the workers.
Cost-effectiveness:
The tneory tnat after capitalisation and training tne use of
caustic and pressure soray would be a very cost-effective total
house method for removing all lead paint from wood trim was
negated by the results of only partial paint removal. Materials.
(caustic, corn starch) were inexpensive, however, equipment
(rental of high—pressure sorayer) , labor (inducing clean-up) and
traininn costs accounted for most of tne abatement excenses.
A-6
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 12
DATES OF WORK: 2 February 1987 - 1 March 1987
OBJECTIVE:
To test a combination of off-site dipping and Peel Away as
an abatement method for removing lead-based paint from all
wood trim surfaces* in a vacant dwelling.
METHOD: Off-site Dipping
Wood trim, some doors, some window sashes, and the shutters}
which were identified with lead paint in excess of 0.1 mg.
Pb/sq. cm. using a portable XRF analyzer, were removed and
sent to Baltimore Stripping Company. These surfaces had ap-
proximately six coats of old paint. At the stripping compa-
ny, the wood pieces were dipped in caustic ingredients and
solvents (eg.; methylene.chloride).
RESULTS: Off-site Dipping
All of the wood pieces sent in were totally stripped to a
ready-for-repainting surface in one application. This method
is quick and provides no exposure to toxic chemicals. In
addition, two anticipated problems turned out to be unfound-
ed: none of the glass in the doors or windows broke and al-
most none .of the joints became unglued Cor even loosened)
during the process.
METHOD: Peel Away
PREPARATION: All of the floor and up the wall a foot was cov-
ered with 4 mm. plastic, stapled in place, to protect the
floor from water and tracking of lead-contaminated substances
APPLICATION: Peel Away (a caustic adhesive paste, 15.1 %
sodium hydroxide) was applied to jambs, columns, the mirror,
some window sashes, and one door with lead paint in excess
of 0.1 mg. Pb/sq. cm.. Application was done using one of
two methods. One method was to apply the Peel Away directly
to the wood surface with a wall scraper, trowel, or rubber
glove. Then the Peel Away was covered with strips of the
specially designed paper (which keeps the Peel Away moist so
that it can keep working and bonds to the Peel Away layer
for easy removal). The other was to apply the Peel Away to
strips of paper and then put the paper onto the wood surface.
On relatively large flat surfaces, there was no difference
sash
*-Total:7 doors/jambs + I jamb
5 double-hung windows/jambs + 1
3 columns, total surface area = 39 sq. ft.
2 shutters, " " = 30 sq. ft.
1 mirror, "
trim,
60 sq. ft.
= 712 sq. ft
A-7
-------
Experimental Abatement Dwelling #2
between Che two methods other than personal preference. But
on rounded or carved surfaces, the apply-to-strip method
seemed to work better.
REMOVAL AND WASHDOWN: Peel Away and paper was left on for one
or two days and removed using scrapers to loosen while pull-
ing on the paper. The used Peel Away and paper was deposited
into plastic trash bags and tied closed. Washdown consisted
of spraying, using 3 gal. capacity hand-held sprayers, with
varying concentrations of acetic acid in water:
weakest: 2 gal. 5 7, acetic acid : 10 gal. water
strongest: 1 gal. 99 \ acetic acid : 10 gal. water
Acetic acid was used to solubulize lead and to neutralise
the strong alkalinity of'the Peel Away (leaving the surfaces
safe and paint-ready). While spraying, the wood surfaces
were scraped with metal and plastic scrapers and brushed with
soft-bristled brushes. Waste water was vacuumed using a wet/
dry vacuum and deposited into a large plastic garbage can for
analysis.
CLEAN UP: All abated wood surface were washed down with a weak
solution of trisodium phoj^hate { in> 7. phosphate) (1 c. : 5 gal,
water) to try to precipitate more lead out. The plastic cov-
ering the floors was taken up. The floors were mopped with'
trisodium phosphate solution as well.
SAFETY MEASURES FOR WORKERS:
Rubber boots and gloves, poly vinyl chloride rain suits, mis't
goggles, and face shields were provided (with instruction
as to proper usage) to each worker. Water was available in
case of accidental exposure to caustic. Dwelling was also
ventilated.
PROBLEMS:
1) PREPARATION: Not all of the floors were covered as com-
pletely or as smoothly as desired. Consequently, 'daily
clean up and the big clean up at the end was not easy.
2) APPLICATION: Some surfaces had to be re-done for the
first application was too thin. Successful thicknesses were
1/8" - 1/4" of Peel Away. A few windows and one door be-
came softened by the Peel Away, so that even a plastic spat-
ula cut into the surface. A way to figure out which surfaces
will be damaged needs to be figured out before application.
3) REMOVAL AND WASHDOWN: Removal and washdown was the most
time intensive step. There was no running water nor electri-
city on site for most of the time. The acetic acid accident-
ly froze and so needed to be thawed out. Meanwhile, vinegar
hadtaie bought daily (since the amount needed was unknown).
Sometimes while the job coordinator was out trying to
take care of these problems, surfaces were left overnight
from which the Peel Away had been removed but which had not
been washed down, thus making them twice as hard to wash
down the next day.
A-8
-------
Experimental Abatement Dwelliing #2
RESULTS: Peel Away
Excepc as noted above, Peel Away was almost completely suc-
cessful in removing lead painc in one application, with no
toxic fumes and nothing flammable. What little paint that
was left could easily be removed 'by methylene chloride.
However, the removal/washdown step of abatement using Peel
Away was very time intensive.
WORKERS' PERCEPTIONS, ATTITUDES, ACCEPTANCE:
Workers' attitudes had improved over their attitudes toward
using the homemade caustic because all of the workers had
had previous experience with Peel Away and knew that it could
work and that it was not nearly as toxic as the homemade mix.
However, they are still developing as an abatement team.
While they are improving, they are still experiencing dif-
ficulty with automatically containing lead debris, wearing
their protective gear, covering the floors, and washing down
well.
SUMMARY AND RECOMMENDATIONS:
A combination of off-site dipping/Peel Away is effective in
one application as a total abatement method for lead-based
paint on all wood trim surfaces.
RECOMMENDATIONS: In order to effect a quick complete abate-
ment, a LI lead painted trim, doors, window sashes, and any-
thing else that can be easily removed, should be dipped off-
site. The remaining wood surfaces (usually jambs) should
be abated using the Peel Away method. Especially important
for quick removal is to have electricity and water hooked up,
to put Peel Away on thick (1/8" - 1/4") and to further de-
velop the workers as an abatement team (eg.; to cover floors
completely, washdown same day as removal, and wear protective
gear).
COST EFFECTIVENESS:
The combined off-site dipping and Peel Away method is very
effective in terms of removing lead-based paint safely. How-
ever, neither dipping nor Peel Away is inexpensive. Cost
may be reduced by using off-site dipping as much as possible,
thereby eliminating much of the time, labour, and materials
in using the Peel Away method. Only further testing of al-
ternative methods will locate a cheaper method (or combination
of methods) that is as effective and safe as the off-site
dipping/Peel Away method.
A-9
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING #3
DATES OF'WORK: 27 February 1987 - 13 March 1987
OBJECTIVE:
To test a combination of off-site dipping and Peel Away as an
expeditious abatement method for removing lead-based paint
from all wood trim surfaces"1" in a vacant dwelling. (To im-
prove on the abatement at
METHOD: Off-site Dipping
Same as at EA Dwelling #2* except that all wood trim, doors,
and window sashes, which'were identified with lead paint in
excess of 0.1 mg. Pb/sq. cm., were removed and sent out to
be dipped.
RESULTS: Off-site Diooing
Same as at EA Dwelling #2* Most importantly, since everything
that could be dipped was dipped, the bulk of the wood surfaces
to be abated were abated in a very quick, safe manner with
very little labour, time, and materials spent by BJEP.
METHOD: Peel Away
Same as at EA Owe Hi
PREPARATION; Special
the floor and up the
uously as possible.
APPLICATION: Special
Peel Away 1/8" - 1/4
REMOVAL AND WASHDOWN
the washdown. Very
hooked up before the
were washed down.
CLEAN UP: No change from the method used at 2629 Barclay.*
ng n* except/and:
attention was paid to covering all of
wall a foot, as smoothly and as contin-
attention was paid to putting on the
" thick.
Undiluted 5% acetic acid was used for
importantly, water and electricity were
Peel Away was removed and the surfaces
SAFETY MEASURES FOR WORKERS:
Same as at EA Dwelling #2 and canvas bags were provided for
each worker to keep their protective gear in.
RESULTS: Peel Away
Same as at EA Dwelling #2* except that Peel Away was even
more successful in removing lead paint in a timely manner.
Since the preparation was done so well, CLEAN UP was very
*-Total: 8 doors/jambs
6 double hung windows/jambs and 1 sash
1 column, total surface area = 13 sq. ft,
stairs. " " = 77 sq. ft,
2 bannister posts, " " = 3 sq. ft,
trim," " = 3000 sq. ft,
*-See write-up for EA Owl ling #2
A-10
-------
Expermienta! Abatement Dwelling #3
quick and easy because none of the debris ever Couched Che
floor. ExcepC for Che column (whose layer of Peel Away and
paper for some unfachomable reason kepc sliding down), no
Peel Away had Co be re-applied from having been puc on coo
thinly.
The REMOVAL AND WASHDOWN seep was much quicker EAD #3 chan
ac EAD 12 . One reason was chac chere were so fewer wood
surfaces Co wash Peel Away off of. Also, wacer and eleccric-
icy were hooked up before work commenced, eliminacing cime-
consuming Crips co gee gas for a generacor and water fot
washdown, clean up, and washing Cools and proceccive gear-
Removal and wash down was much more quickly done aC'27—
even including the exCra cime caken Co Cry Co gee Che pH of
the stripped wood surfaces down (from Peel Away's 14) Co
neucral (7). Ic is scill unknown as co how low in pri ic is
necessary Co gee Che surfaces Co be safe and painc-ready.
The canvas bag Chat each worker goC for her/his proceccive
gear saved Cime by promocing becter care of her/his protec-
tive gear and tools, thus eliminating Cime spenc in replacing
lose or mis-used gear/cools.
On Che non-improvemenC side, Chere was noc a full, productive
abacemenc Ceam available Co Che effort ac EA Dwelling #3 Two
of Che four workers were fired because of Cheir concinual
unproduccive and irresponsible work conduce. Thus, Che
rest of the time, the work was done by only two workers.
SUMMARY AND RECOMMENDATIONS:
A combination of off-site dipping/Peel Away is effective in
one applicacion as a quick Cotal abatement method for lead-
based painC on all wood Crim surfaces.
RECOMMENDATIONS: A quick, complece abacemenc can-.be efrecced
by using Che same proceedures used at EA Dwelling #3wiCh a full
abacemenc Ceam of four people.
A-11
-------
ADDENDUM: FINAL CLEAN UPS AT:
Experimental Abatement Dwelling #1
Dace of Work: April 3 1987
Method:
After all rehabilitation work was completed, all window wells,
radiators, stairs (including handrail and rail at bottom of
spindles), baseboards, and floors were KEPA vacuumed to re-
duce the amount of lead dust which had settled. These same
surfaces were sponged/mopped with ale. trisodium phosphate:
3 gal. water solution. The second floor was HEPA vacuumed
and sponged/mopped twice, while the first was done only once.
Experimental Abatement Dwelling #2
Date of Work: May 10 1987
Method:
After all rehabilitation work was done, all of surfaces (as
above) on the second floor and in the kitchen were sponged/
mopped with ale. trisodium phosphate:3 gal. water solution
and then KEPA vacuumed. The surfaces on the first floor were
only HEPA vacuumed.
A-12
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING #4
DATES OF WORK: 19 May 1987 - 12 June 1987
OBJECTIVE:
To see if/how a lead painc abatement could be done in an occupied house*
(residents temporarily moved outbut all furniture and dog still present)
using a combination of sanding/HEPA vacuum, off-site dipping, PeeL Away,
and touch-up with methylene chloride.
METHOD AND RESULTS: OFF-SITE DIPPING
Same as at IAD #3 (see report for EAD #3 )•
METHOD: SANDING
Sanding was done with a Nilfisk sanding unit (an orbital sander with a shroud
which connects it to a HEPA vacuum), a HEPA vacuum, and an air compressor.
We tried sanding window jambs and door jambs.
RESULTS: SANDING
The assemblage was very noisy, so that we had to wear ear plugs. The air
compressor also produced a lot of carbon monoxide, but the distance from which
it can be moved from the worker is limited by the length of the compressor
to sander hose. The sander worked the best on door jambs (taking approximately
one hour to do a door or window jamb). But at the corners and all along the
outside stop bead on the window jamb, Peel Away had to follow up on the sander.
METHOD: PEEL AWAY
Same as at EAD #3 except:
WASHDOWN became two steps (washdown and clean up). Washdown consisted of washing
down most'of the Peel Away with just water (using a bucket, brush, scraper,
and a sponge). Clean up consisted of a vinegar washdown (after allowing the
surface to dry slightly) to rid the surfaces of the white powdery residue
(using a spray/vacuum machine spraying a 1:5 vinegar:water solution). The
trim, doors, and windows which were dipped off-site were cleaned this time
(following a high lead dust level test report of dipped surfaces).
RESULTS: PEEL AWAY
Same as at EAD #3
WASHDOWN: washdown and clean up were effected more quickly as separate seeps.
Since washdown,'which is the most time intensive step, was done using only
hand tools, we were not limited to one machine (sprayer/vacuum) - we could all
washdown. And it was easier to do the bulk of washdown with our hand tool
ensemble because of the superiority of the stiffer hand-held brushes.
Finally, it was a gea$t save on vinegar to do the bulk of the washing with
water, then finish up^with vinegar. The surfaces were neutralised more quick-
ly as well.
SAFETY MEASURES FOR WORKERS:
**>
Same as EAD #3 and:
EPA monitoring showed that trim removal and/or dry sweeping produced levels of
air-prone lead dust at which respirators should be (and were) worn. Ear
plugs (which provided protection to 26 decibels) were worn by everyone during
the use of che sandins unit. An eye wash was purchased and used several times.
A-13
-------
Co i nOa Ccifleli v
PROBLEMS:
Some unforeseen problems which swallowed up time were:
* TOTAL ABATED LEAD PAINTED SURFACES:
j? Doors/jambs -10 + 1 jamb
0 Windows/jambs « 11
Trim - 1770 sq. ft.
Excerior back wall (brick) - 53 sq. ft.
Removing the TRIM was very (unexpectedly) difficult (because of large
cut nails every six-twelve inches).
The abatement of the BACK WALL was very difficult as well because it
was covered with many layers of paint, at least one of which containing some-
thing which Peel Away could not, even on three applications,get through —
probably cementatious paint.
Another problem had to do with trying Co BALANCE IDEAL WITH ACTUAL con-
ditions. Abatement is suppo d to occur from top to bottom, back to front.
So that is how we tried to apply the Feel Away. But in an actual occupied house,
SECURITY is very important. So we found ourselves removing from the outer
edge of the house (windo s and exterior doors) to the inside, first floor first
to secure the house. This meant that when we got to the second floor, a lot
of the surfaces* especially the exterior part of the window jambs, were dried,
thus possibly releasing lead dust into the air, but certainly difficult to re-
move and washdown.
Another IDEAL VR ACTUAL problem came up with the CARPENTRY step (replacing
trim, installing window sashes, stop and parting bead, and hanging doors).
The plan was to have carpenters go into a room, do everything in it and go onto
the next room then the clean up crew can come in (since they had to wash the
trim). But for a production carpenter it made more sense not to go room by
room but to do the whole floor step by step (eg.; install all the windows
first, then replace all the trim). Unfortunately, since this was not known *
before now, it was not set up to make that happen easily. Since the clean up
crew had to keep working and they were not skilled carpenters, they had to
clean up where the carpenters were going to come back. Thus, the two crews got
in each others way and even more importantly, lead dust was probably tracked from
dirty rooms to clean rooms.
SUMMARY AND RECOMMENDATIONS:
All in all the lead painted surfaces were abated efficiently using the above
methods. Recommendations would try to answer the problems encountered above.
A sampling should be made of each kind of TRIM (door, window, baseboard)
REMOVAL. Then we could see it they can be dipped (i.e.; if they can be removed
without destroying the surrounding surfaces) and if so, if they are difficult
to remove, we can plan to have the necessary amount of workers.there. And if
the trim can not be removed, we can plan to have the necessary amount of
Peel Away there,
BACK WALL: a test patch of all proposed Peel Away surfaces should be
made as well (to see if Peel Away is in face the method to use).
IDEAL VR ACTUAL: SECUIRTY AND CARPENTRY: the lead paint abatement should
be done a floor at a time instead of a room at a time. Remove all trio that
will be dipped; apply all the second floor; apply test pacches in Che first floor;
remove, washdown, clean up second floor, then have carpenters do their work on
the second floor; apply first floor (enough days before done with the second
floor so that - according to the test patches - first floor will be ready for
removal when done with second floor); remove, washdown, clean up first floor,
then have the carpenters do their work on the first floor. .Then final
clean up (water and trisodlum phosphate sponge/mop) the whole house second
floor to first, back to front.
A-14
-------
-------
APPENDIX B: RAW DUST-LEAD DATA
FOR EACH STUDY DUELLING
B-l
-------
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 1
DUST LEAD LEVELS OVER TIME (micraarams/square foot>
FLOORS
1st, Floor:
Vestibule
Hall -
Frt Rm at R sill
Frt RID at mantle
Mid Pn at entrance
Kid Rm at center
Kitchen -at center
Kitchen at bk dr
2nd Floor:
Frt RM -at L *ill
Frt RIB at Mid rat
Hall at rail
Mid Rm at sill
Mid Rm at center
Bk Rm at R eill
Bk Rm at center
Bat'nrw at center
PRE- POST-
ABATEMENT ABATE
10/31/86 1/21/87
*
P 3340
P-' 280O
576
P 3310
P* 368
P 367
42O
23OO
P- 491
P* IIS
P* 3O3
P* 32
P- 44
P 480
P 123
43O
• •
7620
3030
P* 1720
4620
305O
1970
P 433O
P* 8210
P 8580
P 1740
2427
583
P- 323
P* 118OO
1630
1830
PQST-Faint
& FLOOR Tx
3/30/87
»••
3O3O none
45 paint
22 paint
15 paint
6 paint
3 paint
540 tile
2640 tile
4O paint
20 paint
33 paint
12 paint
6 paint
14 paint
2 paint
480 tile
POST
CLEAN
4/7/86
• *»»
3030
120
171
60
84
90
20 1
330
ISO
252
57
27
213
324
177
243
1 MO POST
OCCUPANCY
5/22/87
176O
78
74
13
53
64
41
SO
342
156
43
72
45
138
52
42
3 MO "POST
OCCUPANCY
8/1/87
3OO
33
3O
42
57
IS
IS
42
7O
31
36
69
22
54
15
33
House in initial stages of demolition
Post-Abatement samples taken ax'ter unsuccessful treatment
with s home-made caustic mix and s contractor type clean
-up; trim was then taken out. for ox's-site dipping.
> Floors painted 2 days prior and no one entered until
samples were collected; trim was paintea 2 weeks prior.
>* 1st Floor: HEPA Vacuuraina followed by mopping with
trisoaium phosphate solution: 2nd Floor: ssme x2
B-2
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 1
DUST LEAD LEVELS OVER TIME
-------
PROJECT SXrSRIWEXTAL ABATEMENT DWELLING 2
DUST LEAD LEVELS OVER TIME Cwicro-rrams/s^uar* foot)
FLOORS
1st Floor:
Vestibule
Hall -
Frt Rm at sill
Frt Rm at center
Hid Rm at fr dr
Mid RM at center
Kitchen at L eol
Kitchen at bk dr
2nd Floor:
Top Stair tread
Frt Rn at L sill
Frt Rm at center
Hid Rm at sill
Hid Rm at center
Hall
Bathrm at center
Bk Rm at bk door
Bk Rm at center
PRE- POST-
ABATSMENT ABATE
1O/31/S6 2/26/87
354
167
P SOI
122
127
143
227
P 1S90
P 206
P* 1140
930
P 169
22O
173
2O9
1270
87
*
P 2230
P 1530
P 2140
P 1330
P 171O
P* 1770
P* 256O
P* 3600
P* 2760
P* 115OO
(on plastic)
1290
7SO
P 1510
P 7OOO
P 2370
P 3350
3670
POST-Paint POST 1 KO POST
& FLOOR Tx CLEAN OCCUPANCY
5/7/37 5/11/37 6/12/37
* *
114 paint
26 paint
5 paint
3 paint
3 paint
3 paint
223 tile
651 tile
14 paint
112 paint
12 paint
73 paint
21 paint
29 paint
396 tile
99 paint
3 paint
» • •
135
78
21
10
15
13
33
53
35
40
33
29
24
33
32
34
27
190
67
34
39
69
93
15
57
112
230
69
96
6O
72
27
NA
NA
3 MO POST
OCCUPANCY
8/14/87
96
39
96
P 51
42
P 87
15
39
IS
57
40
45
54
33
39
156
36
« Post-Abatement samples taken a*t«r abatement by PEEL AWAY. N*
Visible PEEL AWAY residue wss observed on these samples.
»» Floors painted 1 day prior and no on* entered until
samples" were collected; trim was paj.nt*d "1 week prior.
*•» 1st Floor: HEPA Vaccuming only; 2nd Floor: wet moopin-a
with triaodium phosphate solution followed by KE?A vacuum.
Note: Post values - PEEL AWAYED door iamb 4251 (li?ht residue)
PEEL AWAY column 427 ; Dipped door 833O: non-tx door 235.
Not Available
B-4
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 2
DUST LEAD LEVELS OVER TIME (microcrama/s-suar* foot)
WINDOW SILLS
1st Floor:
Frt Rm sill
Hall Mirror
Kitchen sill
2nd Floor:
Frt Rm left
Frt Rw riant
Hid Rm sill
Bath sill
Bk Rm right
Bk Rn left
WINDOW WELLS
1st Floor:
Frt Rm well
Kitchen well
Bathrm well
2nd Floor:
Frt Rm left
Frt Rm richt
8k Rn riant
Bk Rm left
Noca: P-. P, P- »
were observe
Note: C-. C, C- »
were observe
NA • Not Available
PRE- POST- POST-Paint
ABATEMENT ABATE S. FLOOR Tx
10/31/86 2/26/87 3/7/87
» •»
P 1636 P 16374 603 paint
P 673 P 1037 P 990 paint
237 P 2580 P- 923 paint
P 9956 P* 40335 P 74 paint
P 6210 P- 57143 138 paint
P 2291 P* 2373 p 150O paint
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 3
OUST LEAD LEVELS OVER TIME (mierograaa/aeuare foot)
PRE-
ABATEMENT
FLOORS 1O/31/86
lac Floor:
Veatibule
Hail -
Frt Rm at aill
Frt Rm at cancer
Mid Ra at entrance P
Hid Rm at center
Kitchen at center
Kitchen at aill P
2nd Floor:
Stair 2nd PC-
Frt Rm at L aill PC
Frt Rn at center P
Mid Rm at center
Mid Rm at entr fr
Bk Rn at center
8k Rn at sill P»C-
622
1030
253
462
462
278
1290
744
72O
167O
242
97
2O4
41
683
POST-
ABATE
5/19/87
*
1068
132O
P 1O4O
864
P 168O
699
1030
1410
P 1634
P 564
P- 337
P- 3O7
3O7
P- 439
P- 842
POST-Paint POST 1 MO POST
& FLOOR Tx CLEAN OCCUPANCY
6/19/87 6/27/87
* *
84 paint
10 paint
10 paint
15 paint
1O paint
10 paint
3OO new tile
91O new tile
18 paint
10 paint
15 paint
15 paint
13 paint
15 paint
15 paint
* »»
840
390
330
420
510
42O
27O
24O
179
S4O
72O
6OO
S7O
36O
27O
•>
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3 MO POST
OCCUPANCY
8/26/87
260
13O
P 33O
210
ISO
NA
63
9O
118
13O
120
193
175
200
16O
• Poat-Abatament aaaplea taken after abatement
by PEEL AWAY and Off-Site Dipping
*» After floors were coated, no one entered until samples
were collected: trim waa painted weeka prior to sampling.
••• HEPA Vaccuming followed by wet cleaning with triaodium
pnoaphata solution followed by HEPA vacuuming again.
* Not Available
B-6
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DWELLING 3
DUST LEAD LEVELS OVER TIME <«icroarai»8/*quare foot)
WINDOW SILLS
let Floor:
Frt Rm sill
Kitchen sill
2nd Floor:
Frt Rm left
Frt Rm ri«rht
Bath «ill
Bfc Rm sill
WINDOW WELLS
1st Floor:
Frt Rm well
Kitchen well
2nd Floor:
Frt Rm left
Frt Rm right
Bk Rm
Bath Rm
PRE- POST-
ABATEMENT ABATE
1O/31/36 S/19/87
CP
P
c
c
c-
c
CP
c
c
c
c
1794
178O
6303
11275
35O8
23OO
NA
1O2O3
7726
6199O
44O3
6438S
*
1770
5450
removed
removed
removed
3552
NA
P 6192
boarded
14337
P 534
P 1443
POST-Paint POST 1 «O POST
6. FLOOR Tx CLEAN OCCUPANCY
6/19/37 6/27/37
* «
540
274
333
334
1234
334
NA
3376
3314
16903
493
5327
# • e>
293
333
356
222
1333
353
NA
vinyl 2O63
1463
13272
vinyl 166
vinyl 164O
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3 MO POST
OCCUPANCY
3/26/37
335
P- 294
39
147
P 91
234
NA
P 2O63
1714
P- 13545
P 153
P- 3453
Nota: P-, P, P* « varin? quantities of visible dusc/particulate<
were observed in the aampl*a.
Note: C-, C. O * varina quantitie* of visible chip* of paint
were observed in the samples.
NA - Not Available
• • •• , snd ••* -
previous page.
B-7
-------
r
E?A PSOJSCT EXPERIMENTAL ABATEMENT DWELLING 4
DUST LEAD LEVELS OVER TIME aft door
BR#2 at sill
8k Rm at e«nt«r
PRE-
AaATEHEMT
S/15/S7
P 432O
S78
633
1870
447
2=S
313
534
PC 4O2
2320
POST-
ABATE
6/12/Q7
•*
607OO
7SO
4O3O
p 9000
P 4050
3930
2220
2280
249O
1&3O
POST-Paint POST
& FLOOR Tx GLEAM
6/16/87 7/6/37
• *
3457
NA paint
NA paint
360 paint
33O painc
420 tile
145O paint
42O paint
19O paint
68 paint
.„
P 1330O
P- 750
P- 62O
P 840
p- 540
300
P- 33O
350
480
P S1O
1 MO POST
OCCUPANCY
8/8/84
373O
36O
69O
54O
24O
ISO
.ISO
17O
3OO
P 26O
3 MO POST
OCCUPANCY
10/4/87
3650
330
420
6OO
13O
70
50
110
P 6OO
330
* Visible PEEL AWAY r««idu« was ob*«rv«d in th«a« samples.
** Single coat of polyurthan*-baa«d paint wa« applied to
the floors. Furni*hings w«r« in the horn* during «bar.«mant.
•«•••• HE?A vacuuming followed by w«t acrubbina with triaodium
phoaphat* aolution followed by HEPA vaeuuminc
NA * Not Available
B-8
-------
EPA PROJECT EXPERIMENTAL ABATEMENT DUELLING 4
DUST LEAD LEVELS OVER TIME
Bath w*ll
BK Rm riant
PRE-
ABATEHENT
5/15/87
P
P
P
P-
P-C
P-C*
P*
P-C
P-C.
P-C*
P-C
PC
5550
13502
4692
7317
1944O
2412
1714O
NA
63062
417OOO
5436
6O9OO
134134
30450
56O34
3966O
POST- POST-Paint POST j MO POST
ABATE & FLOOR Tx CLEAN OCCUPANCY
6/12/87 6/16/37 7/6/87 8/8/87
.
1105
8526
P 793O2
19230
6642
13439
375O
31*7
5351
432OO
P- 6250O
19791
P 13373
P 10615
13939
4O46
* *
NA
NA
1256
533
396
234
659
NA
NA
NA
25457
535
3O6
630
1494
NA
• »•
2O33
1145
14093
P- , 2346 p
80O
P- 3939
61-4
934
P- 1265 p-
1021 P-
P- 32012 p
C- 15672 p
1O21
P- 1719 p-
P- 24 3O
P- 2057 p
1439
1263
29116
49230
194O
1655
632
85O
3056
99OO
91763
12S06
2357
4673
5013
4114
3 HO POST
OCCUPANCY
10/4/87
P 17363
P- 2947
5721
4923
1343
4424
563
17OO
CP 62112
C-? S64OO
CP- 33537 not paint*
CP- 22473
P 1OO63
P- 232S3
NA
PC- 144O
Note: P-. P, P- • varing quanti-ies or visible ausw/parti
ware ooaarvec in wh« aamoi«3-
: C-, C, C- = w.srina cuancitiais of visible chipa of paint
wer* obaarv<9<3 in th«
NA > Nat Availaoi*
» , •» . and »»» -
pravioua
B-9
-------
EPA PROJECT DECONTAMINATION DWELLING 1
Apartment in Older Poorly Maintained Row Home
- original walls, floor coverings, windows
- previously and partially abated by traditional
methods ci.e. open-flame burning, not repainted>
DUST LEAD LEVELS OVER TIME (micrograms/square foot)
FLOORS
PRE POST POST 1 MONTH
DECONTAM DECGNTAW CLEANUP POST
7/27/87 7/30/67 3/26/87
Frt Rm at sill -wd
Frt Rm at entrance -wd
Entrance to apt -wd
Livina Rm at entr -lin
Living Rm at R sill -lin
Living Rm at center -iin
Kitchen at center -lin
Kitchen at bk door -1 P
WINDOW SILLS
54O
2OO
48O
300
66O
150
170
81O
NA
NA
NA
NA
NA
NA
NA
NA
19O
270
135O
195O
195O
45O
185
9OO
390
14O
16O
105
no tx 9OO
no tx 140
no tx 45
no tx 22O
Frt Rm L sill
Living Rm R sill
PC 61236
P 704O
NA
NA
- P
731 446
24O P 2271
WINDOW WELLS
Frt Rm L well
Living Rm R well
C* 3O637O
p*C
NA
NA
9469 P 48438
1731 P 2192
Note: P-, P, P* = varing quantities of visible dust/particulates
were observed in the samples.
Note: C-, C, C* = varing quantities of visible chips of paint
were observed in the samples.
NA = Not Available
B-10
-------
EPA PROJECT DECONTAMINATION DWELLING 2
Apartment in Older Poorly Maintained Row Home
- original walls, floor coverings, windows
- previously and partially abated by traditional
methods (i.e. open-flame burning, not repainted)
DUST LEAD LEVELS OVER TIME (micrograms/square foot>
FLOORS
Frt Rm at R sill -wd
Frt Rm at L sill -wd
Frt Rm at entr. -wd
Hall -top of stairs -wd
Mid Rm at R sill -wd
Kitchen at center -wd
WINDOW SILLS
Frt Rm R sill
Frt Rm L sill
Mid Rm R sill
Bath Rm R sill
WINDOW WELLS
Frt Rm R well
Frt Rm L well
Mid Rm R well'
Kitchen well .
Bath Rm R well
PRE
DECONTAM
7/29/87
564O
P- 429O
3810
24 SO
20 1O
1€>2Q
5374
79S9
5935
176
936O
P-C- 85O1
2025
P- 7Q7O
-3497
POST
DECONTAM
3/2O/87
220
145
140
165
60O
P 5-iO
193
765
3 2O
49
600
1682
629
244
96
POST
CLEANUP
S/ 26/87
24O
42
66
160
170
21O
66
57
29
25
91
65
C- 11793
57
P- 526
1 MONTH
POST
9/26/87
21O
120
ISO
170
2 2O
330
1903
P- 1275
262
122
366
P- 9547
P- 1685
193
•3 ]_
Note: P-, P, P* = varing quantities of visible dust/particuiatea
were observed in the samples.
Note: C-. C. C* = v^ring quantities of visible chips of paint
were observed in the samples.
B-ll
-------
EPA PROJECT DECONTAMINATION DWELLING 3
Older Poorly Maintained Row Home
- original walla, floor coverings, windows
- previously and partially abated by traditional
methods (i.e. open-flame burning, not repainted)
DUST LEAD LEVELS OVER TIME (micrograras/square foat>
FLOORS
2nd Fl
Bk Rra at center -wd
Mid Rm at center -wd
Frt Rm at L sill -wd
Stair - 3rd - wd
1st Fl
Frt Rm at sill
Mid Rm at entrance -wd
Kitchen at bk door -wd
WINDOW SILLS
PRE
DECONTAM
7/27/87
582O
2760
5370
35OO
4329
4410
198O
POST
DECONTAM
»/2O/87
300
51
225
174
273
164
P 6OO
POST
CLEANUP
8/27/87
69O
117O
730
269
165
16O
36O
1 MONTH
POST
10/4/87
1320
630
123O
462
P 1215
360
54O
2nd Fi
Bk Rm sill
Mid Rm sii
Frt Rm L sill
1st Fi
Frt Rm sill
Mid Rm sill
Kitchen side sill
WINDOW WELLS
Mid Rm well
Frt Rm L well
11654
130510
6250
PC- 2O556
S1O3
C 8752
77
218
190
176
215
23b
295
350
178
2O4
81
154
1192
1285
333
PC 13148
P 892
247
C- 72025
C- 72650
191O C- 1OO2 C- 18539
P- 6511 C- .15156 C-P 31524
Note: P-, P, P+ * varing quantities of visible dust/particuiates
were observed in the samples.
Note: C-, C. C* * varing quantities of visible chips of paint
were observed in the samples.
B-12
-------
EPA PROJECT COMPARISON DWELLING i
Completely Renovated Row Home
- New walls, floor coverings, windows
DUST LEAD LEVELS OVER TIME Cmicroarams/square foot>
FLOORS
(carpeted except kitchen)
Kitchen tile at sill
Kitchen tile at cntr
WINDOW SILLS
WINTER SPRING SUMMER FALL
12/5/86 4/22/87 7/2/87 1O/5/87
5
8
16
9
15
1O
1st Floor:
Kitchen new wood sill
Frt Rm new wood R sill
2nd Floor:
Bk Rm new wood R sill
Bk Rm new wood L sill
WINDOW WELLS
7 10 13
(sash open)
9 2 35
21 26
(sash open >
53
3O
19
NA
(sash open)
1st t-ioor:
Kitchen - vinyl replacement P 743 P 1113 P 87O P 348
(sasn open)
Frt Rm - vinyl replacement P 1677 P 1328 723 7O2
2nd Floor:
Bk Rm -Rt vinyl replacement P 1187 p 88 P 846 P 5OO
(sash open)
Bk Rm -Lt vinyl replacement p 62t> P 117/ 15 NA
-------
EPA PROJECT COMPARISON DWELLING 2
Rehabilitated Row Home -
WINDOW WELLS
C-
C-
37O C- 394
22 85
32 P 1O4
99 PC 142
Basement living room:
- vinyl replacement
1st, -Floor:
Bk Rm -vinyl replacement
2nd Floor:
Bathrm -vinyl replacement
Sk Rm -vinyl replacement
29O
863
PC-
230 P 1515
457 p 1O56
131 P
-------
EPA PROJECT COMPARISON DWELLING 3
Fairly well maintained Older Row Home -
original walls, nearly ail windows and floors original wood
DUST LEAD LEVELS OVER TIME Cmicrograjns/6
-------
EPA PROJECT COMPARISON DWELLING 4
Older Row Hone
- original walls, nearly all windows «nd floors original
DUST LEAD LEVELS OVER TIME (micrograms/square foot)
FLOORS
WINTER SPRING SUMMER FALL
12/2/86 4/22/67 7/2/87 9/26/87
1st Floor:
Frt Rm -wd polyur at door
Frt Rm -wd polyur at kitch
Kitchen newer linol. L sill
Bk Rm - newer linol at sill
2nd Floor:
Frt Rm - wood at R sill CP
468
42
342
33
111
132
21
15
42
P 36
180
P 27O
15
33
42
1O
975
C 14OO C- 51O
14O
Frt Rm - painted wd at door 8O
Mid Rm - wood at R sill PC* 4110
CP 63 69
453 PC-750
42
165
Note: P-. P. P* = varying quantities of visible dust/particulate*
were observed in the samples.
Note: C-, C, C* = varying quantities of chips of paint
were observed in the samples.
B-16
-------
EPA PROJECT COMPARISON DWELLING 4
Older Row Home
- original walla, nearly all windows and floora original
DUST LEAD LEVELS OVER TIME (micrograms/square foot)
WINDOW SILLS
1st Floor:
Frt Rm L sill (new wood)
Frt Rm side sill cold wood)
Kitchen L sill (old wood)
Bk Rm side sill (old wood)
WINTER
12/2/66
SPRING
4/22/87
SUMMER
7/2/87
FALL
9/26/67
679 340 P 277 8O
S35 536 P 1398 677
651 PC- 1O685 C + P 138O8 C- 4767
2*1 263 301 356
2nd Floor:
Frt Rm -right (old wood) C- 15460 C-
Mid Rm - right (old wood) C 14213 C
Sk Rm right sill (new wood) 52
8545 6636 4727
4225 C* 1875O C 26250
76 P 1O6 P 155
WINDOW WELLS
1st Floor:
Kitchen - left (metal) C+P* 1664OO C* 124545
Bk Rra -side (old wood)
CP
31543 CP 2537O
C + P+ C
131818 128182
23771 C 15360
2nd Floor:
Frt Rm -vinyl replacement P
Mid Rm -right (old wood) C+
Bk Rm -side (new wood)
Bk Rm -back (new wood)
1146 P 1422 P 1015 P 615
74835 C 23636 C 126818 C 32O4S
97 350 39 230
164 215 63 32
Note: P-, P, P+ = varying quantities of visible dust/particulates
were observed in the samples.
Note: C-. C. C+ = varying quantities of chips of paint
were observed in the samples.
B-17
-------
APPENDIX C: AIR-LEAD LEVELS:
REMOVAL OF TRIM AND USE OF HEPA SANDER
C-l
-------
-------
STATE OF MARYLAND
WILLIAM DONALD SCHAEFER
Governor
WILUAM A. FOGLE. JR.
Secretary
HENRY KOELLEIN. JR.
Commissioner
Department of Licensing and Regulation
DIVISION OF LABOR AND INDUSTRY
501 ST. PAUL PLACE
BALTIMORE. MARYLAND 21202 2272
DIRECT DIAL 301/333- 4310
August 20, 1987
Mr. Mark Farfel, Outreach Associate
John F. Kennedy Institute-
707 N. Broadway
Baltimore, Maryland 21205
Dear Mr. Farfel:
As part of the Private Sector Consultation Service
that you requested, a written report is sent to the
employer on the working conditions examined by the
consultant. Attached is the written report of occupa-
tional health consultant, Maurice Wooden, who conducted
the survey of your facility on May 20, 1987.
Private Sector Consultation Service is a coopera-
tive approach to solving safety and health problems in
the workplace. It is intended to be advisory in nature
and assist you in achieving voluntary compliance through
the prompt correction of any observed hazards.
If you need further assistance or information,
please contact me by calling (3O1) 333-4210.
Sincerely,
Etta Mason, Project Manager
Private Sector Consultation
EM/rg
OUTSIDE BALTIMORE METRO AREA. TOLL FREE 1 800 W2 6226
TTY FOR DEAF. BALTIMORE METRO AREA 383 7555. D C. METRO AREA 565-0451
C-2
-------
-------
Request No. :
Survey Dates:
Consultant :
451271670
May 20 to August 3, 1987
Maurice Wooden
THE KENNEDY INSTITUTE
Request Summary;
Upon the request of 'Mark Farfel on May 15, 1987 an initial
survey visit was conducted at the project site on May 20, 1987.
Assistance was desired in evaluating employee airborne lead
exposures. The resonsibilities under Consultation Services were
discussed during the opening conference.
The employer sponsored the detoxification of a residential
dwelling as part of a project in the employer's child lead paint
poisoning program. The employer received Consultation Services'"
assistance in July, 1986 when a water based chemical was used to
remove the leaded paint of a home.
\
Description of Worksite;
The worksite was a two story townhouse in east Baltimore
where lead paint had been identified. The water based chemical
was used again, but also powered portable hand tools with local
exhaust ventilation systems were used. Monitoring for employee
exposures while using these hand tools was the emphasis of the
surveys.
Work practices consisted of manually removing door and window
frame casings, doors and window sashes, and hand tool sanding of
painted wood surfaces. Employees also applied and removed the
water based stripping chemical on painted surfaces.
Survey Methodology;
Employees were personally monitored with portable air sampl-
ing equipment. The point of air sample collection was on the
collar of the employee. The test durations were based on employee
work activities so that conclusions could be drawn about specific
operations along with 8 hour time weighted average (TWA) ex-
posures.
C-3
-------
Request No. : 451271670
Company: The Kennedy Institute
Survey Dates: May 20 to August 3, 1987
Results:
LEAD
On May 20, 1987 employees removed door and window frame
casings in a 2nd floor middle room. Nails were removed from the
woodwork, the area was dry swept and the debris manually removed
from the room. Plastic sheets were put in the room in preparation
for the water based chemical application. The results follow:
EMPLOYEE
A.A.
C.D.
TEST DURATION
(in hours)
2.4
2.0
RESULTS
(in ug/M3)
26.4
42.7
8 hr. TWA
(in ug/M-1)
8.0
10.8
A HEPA equipped vacuum was planned to be used in the room
to prevent dry sweeping, but it had not arrived at the site by
the time of the operation. The consultant believes the bulk of
the above results derived from the dry sweeping practices.
On May 26, 1987 an employee used the powered hand sander with
local exhaust ventilation attachments. The employee worked on the
1st floor front room window casings. Ventilation smoke tubes were
used and the air suction around the sanding disc was good. The
results follow:
EMPLOYEE
TEST DURATION
RESULTS 8 hr. TWA
(in ug/M3) (in ug/MJ)
(in hours)
J-L- 0.9 24.7 2.8
NOTE: Very little visible dust was observed during the operation.
On May 27, 1987 the same employee used the sander with the
attachments on the doorway separating the 1st floor front room
from the middle room. The results follow:
EMPLOYEE
J.L.
TEST DURATION
{in hours)
1.4
RESULTS 8 hr. TWA
(in ug/M3) (in ug/M")
84.3
14.9
C-4
-------
Request No. : 451271670
Company: The Kennedy Institute
Survey Dates: May 20 to August 3, 1987
NOTE: Little visible dust was observed.
On the same day, the employee used the sander on the dwelling
entrance door frame. This exterior wood surface had paint on it
that did not appear to be in as good (tight) a condition as the
previously mentioned interior surfaces. This operation generated
very visible dust particles. The results follow:
EMPLOYEE
J.L.
TEST DURATION
(in hours)
0.8
RESULTS
(in ug/M3)
79.9
8 hr. TWA
(in ug/M3)
8.0
With both tests being taken into account on Mr. L , his 3
hr. TWA exposure for lead on May 27, 1987 was 22.9 ug/M3. Mr.
L, along with the other monitored employees, wore full body
disposable suits and NIOSH approved half mask respirators with
HEPA filters. Employees used the available water on the site for
wash up purposes and had received training in respirator use and
maintenance. All employees had blood monitoring performed before
the work commenced. All employee blood leads were below 30
micrograms.
The test results show that the employee exposures were below
the MOSH 3 hr. TWA action level for lead of 30 ug/M3 and the
standard of 50 ug/M3. The results also show that if certain work
activities are performed for the majority of a workshift, the MOSH
threshold levels can be exceeded when using the specially equipped
hand sander.
C-5
-------
STATE OF MARYLAND
DEPARTMENT OF LICENSING AND REGULATION
DIVISION OF LABOR AND INDUSTRY
301/333-4210
ON-SITE CONSULTATION SERVICES REPORT
REPORT NO.: 451271670
DATE: August 20, 1987
ITEM I 1
Location: 2nd floor middle room of Project Dwelling
Standard Reference: 09.12.32.08B.(2)
A dry method was used to clean floors when
ing and wet methods were practicable choices.
vacuum-
Condition:
Employees performed dry sweeping of debris contain-
ing lead paint chips. Air monitoring revealed exposure
of 42.7 ug/M3 after two hours of performing the opera-
tion. The employer had provided a HEPA equipped vacuum
for the job, but it was not on site when the operation
was performed.
Hazard:
Dry cleaning methods create dust which can contain
lead particles. This can increase the worker's exposure
to airborne lead levels. Lead is known to cause nervous
system, reproductive system and muscular system dysfunc-
tion.
Recommendat ion:
When HEPA vacuum is not available, wet down the
debris and wet shovel it into containers. Follow • with
wet sweeping or mopping. Prohibit dry clean up on all
jobs.
Classification: Other Than Serious
Agreed Upon Correction Date: N/A - job completed.
C-6
-------
APPENDIX D: AIR LEAD LEVELS:
APPLICATION AND REMOVAL OF PEEL AUAY
D-l
-------
-------
HARRY HUOHES
GOVERNOR
STATE OF MARYLAND
DEPARTMENT OF LICENSING AND REGULATION
DIVISION OF LABOR AND INDUSTRY
OCCUPATIONAL SAFETY AND HEALTH
MttlWC H. PORNARO
COMMISSIONER
501 ST. PAUL PLACE
FREDERICK L. OtWKMiy
SECRETARY
BALTIMORE. MARYLAND &1202-2272
301/659-4210
August 27, 1986
DEPUTY COMMISSIONER
RAYMOND E. U.OVD
ASSISTANT COMMISSIONER
MOSM
Mark Farfel, Outreach Associate
John F. Kennedy Institue Lead
Poisoning Clinic
707 N. Broadway
Baltimore, Maryland 21205
Dear Mr. Farfel:
As part of the Private Sector Consultation Service
that you requested, a written report is sent to the
employer on the working conditions examined by the
consultant. Attached is the written report of occupa-
tional health consultant, Maurice J. Wooden, who
conducted the survey of your facility on June 9, 1986.
Private Sector Consultation Service is a coope-
rative approach to solving safety and safety problems
in the workplace. It is intended to be advisory in
nature and assist you in achieving voluntary compliance
through the prompt correction of any observed hazards.
If you need further assistance or information,
please contact me by calling (3O1) 659-4210.
Sincerely.
Etta Mason, Project Manager
Private Sector Consultation
EM/rg
OAiriMOnE METRO AREA «J*.*310
OUTSIDE BALTIMORE METRO ARf A
TOUFNfE l-«XM92-*22i
D-2
TTV FOK DEAF
BALTIMORE AflCA 3ia-rS35
0 C METBO AREA MS-OU1
-------
-------
Request No.:
Survey Date:
Consultant :
451279657
June 9, 1986 to August 12, 1986
Maurice J. Wooden
THE KENNEDY INSTITUTE
Request Summary;
Per Mr. Parfel's request, a consultation survey was begun
on June 9, 1986. Assistance was desired in determining employee
lead exposure during residential paint removing projects. At the
initial meeting employer responsibilities under Consultation
Services were discussed.
Description of Workplace;
The worksite involved two residential locations. They were
identified as having lead paint on woodwork surfaces. The houses
were part of a pilot project to demonstrate and evaluate various
methods of household lead paint removal. The "Peel Away" product
and method were used in the two residence.
Survey Methodology;
Personal employee air monitoring was performed on employees
performing the application and removal of the product at the first
location. The employees were also monitored during clean-up of
removed paint. The point of workroom air collection was at the
employees' shirt collar which was in their breathing zone.
At the second location area air samples were
room where the "Peel Away" removal took place.
taken in the
Results;
t
Date: July 9, 1986
Location: 2nd floor front room of Denmore Avenue dwelling
Activity: "Peel Away" application
0-3
-------
Request No.s 451279657
Company: Kennedy Institute
Survey Date: June 9, 1986
Employee
Carpenter's helper
Laborer
Test Duration
(inhours)
1.2
1.6
Results
(Concentration)
I in ug/m3)
<2.3
Date: July 10, 1986
Location: Same as July 9
Activity: "Peel Away" removal and clean-up
Employee
Test Duration
(in hours)
1.2
1.2
Results
(Concentration)
(in ug/m3)
10.9
2.2
Carpenter's helper
Laborer
Date: July 18, 1986
Location: 1st floor kitchen area of E. Madison St. dwelling
Activity: "Peel Away" removal and clean-up
Monitoring Location
near west wall
-------
Request, Ho.: 451279657
Company: Kennedy Institute
Survey Date: June 9, 1986
Discussion:
The results show very low exposure to airborne lead levels
while using the "Peel Away" method for removing lead paint. The
MOSH standard requires respirator usage and feasible engineering
controls where levels equal or exceed 50 ug/m and blood lead
testing of employees where levels equal or exceed 30 ug/m .
The MOSH standards are based on a full shift (8 hours) time
weighted average (TWA.) exposure. Because of this, the air moni-
toring test were begun when work began and ended. By testing in
this manner, the result is a true measure of exposure only while
the work is performed.
If the two employees performing the removal on July 10, 1986
worked for a full day removing the paint, one would expect their
full shift exposure to be in the 2-11 ug/m range. Because there
are breaks, lunch periods and slow periods during a day, their
actual TWA exposure wuld be even less. Many of the sections of
the Lead In Construction Work standard are not required when using
the "Peel Away" method because of the low air monitoring test
results.
Recommendations ;
1. Clean up falling debris from removal process before it
looses its moisture and dries. Cleaning up dry material
can create a dust hazard.
2. Keep employees elevated so work will remain at chest height
during the removal process. This minimizes the need for
personal protective equipment to only forearm lenght gloves,
Above the head work may require an apron and face shield
along with gloves.
3. Educate the employees on the hazards of the "Peel Away"
product such as causing burns to the skin. The material
is 90% caustic. Even though it is diluted with water,
skin irritation can develop. Use the information on the
material safety date sheet (MSDS) for guidance in this
area.
D-5
-------
Request Ho.: 451279657
Company: Kennedy Institute
Survey Date: June 9, 1986
4. Use this report as your written record of initial deter-
mination as required by the MOSH Lead in Construction Work
standard.
It is hoped that the survey and report will assist you in
your work with the Lead Poisoning Clinic. Attached are employee
hazards noted during the survey relating to the lead standard.
Thank you for the cooperation extended to me on my visits.
D-6
-------
APPENDIX E: HASTE-HATER LEAD LEVELS
AND TREATMENT PROCEDURES
E-l
-------
-------
TEST RESULTS AND OUTLINE OF WASTE WATER TREATMENT PROCEDURES USED
AT'TRACE METALS LABORATORY KENNEDY INSTITUTE
II - Cricinal wash solution frcn watsr vacuum ~.5:n Acs.ic Acid
ffi &. e
cn «* • -<
840 sen ?b
12 - Juperriatan- frc- first CH precipitation
cH 4.5 to 10.7
15 c=ai Pb
12 SN split
13 - SN frcta saccnc OH*
petr.. cf 12 SM
pH 10.7 ta 11.25
4. cent ?b
?4 - SN frsa a paraiisl CS*
p?cr. cf 12 SN
pH 10 ..7 t3 11.85
.
Nets: higher. pE —> higher Pb
SH frcr. firs- PO, s p=*-"
Oric. wash mads Bust pH 5.8 with NaQH then
50.• RGT added.
RGT - .5 n NaOE + .S.m KH,?^!
?0.s'added = 14 X Pb^~ ir» SN'to pH 5.?
bu- csrtair.lv Pb,(?0,), was net cr.lv pp
342 fi - z.
Q C yttt
z forced
SN from second P04= pptr. cf S5 SN
pH 5.9 to 6.1
[?045] « 230 X [Pb '] in SN5
< Iccn Pb
NOTE: In neither procedure dees combining cf optn sreps produ;
same results; separation cf first ppt from SN appears
necessary.
E-2
-------
RESULTS OF TW HASTE-HATER TREATMENT PROCEDURES FOR LIQUID
HASTE FROM THE "PEEL AHAY" METHOD OF ABATEMENT
(Testing done by Baltimore County Division of Pollution Control)
SAMPLE
Original Waste Water
CADMIUM
mi Hi gram/liter
(ppm)
0.62
CHROMIUM
milligram/liter
(ppm)
0.21
LEAD
11igram/liter
(ppm)
1005
Supernatant from
Sodium Hydroxide
(NaOH)Precipitation 0.48
Centrifugate from 1st
NaOH Precipitation
(pH 10.2) 0.12
Centrifugate from
2nd NaOH Precipita-
,tion (pH 10.7 to 11.9) 0.12
Centrifugate from
2nd NaOH Precipitation
(pH 10.7 to 11.2) 0.11
0.23
0.09
0.07
0.07
660
14.4
6.8
3.3 *
Supernatant from
Phosphoric Acid
(P04) Precipitation ** 0.50
Centrifugate from
1st PO. Precipitation 0.15
Centrifugate from
2nd PO. Precipitation 0.14
0.45
0.06
0.05
750
5.9
0.67 *
* Concentration is less than extraction process (EP) toxicity level of
5 ppm
** Original waste-water made pH 5.8 with NaOH then PO. reagent was added.
See page E-2 for details.
E-3
-------
APPENDIX F: WORKER BLOOD LEAD LEVELS
F-l
-------
-------
DATE
WORKER 1
HEMATOCRIT
(X)
FREE
ERYTHROCYTE .
PROTOPORPHYRIN
(micrograms per
deciliter of
red blood cells)
12/9/86
12/19/87
5/19/87
6/12/87
33
36
36
37
188
167
172
203
BLOOD LEVEL
CONCENTRATION
(micrograms
per deciliter
whole blood)
18,19
16,17
12,14
17,19
WORKER 2
12/9/86
2/16/87
5/19/87
45
45
44
73
60
70
21,19
19,20
20,21
WORKER 3
5/19/87
6/12/87
48
48
60
60
15,16
21,22
F-2
-------
-------
r
APPENDIX G: BALTIMORE CITY ABATEMENT REGULATIONS
FOR LEAD PAINT
6-1
-------
-------
w
i
o
z
ss
•0 ^ "^ *^' U ^ >M • «
= b •= g k .. -s u
l-.;=ilf*
55 ^ «S •» S •" ^^
w
S
|
S'og^o2S-|
'Jlllfii
llMiiil
.2S«»3frrir
!s.!ll ?l
iiljfiis
IfiSfll!
1 * 8.1 s B 11
4fiS**i4
• 5 s 2^-=
tali
-------
i I
.1 -2
n C
li" *
III
n\
c *•• E
" o e
s! 2
— 2 >
i: j
HI
•S S 5
5 S •»
L. = e if
S 5 Jj-g
by
.il
si
!!
l-s
* 3
I-
II
•o *
!»
I *
^ £1 *Jl
II |*
*z i-
x s s 5
2.-s
C B
= "» -K
1= -'•
S.2 8.1
•• _• Ctf ^
~ = s
III
HI*
••5 £-'
!*!•
U £.
!.2
I
5
I
7
i^iii
is-iti*
2*S5?
^•o S |.-c
!*J *
•S in T;
?€ 1
•— S 2
.§1 -
II <
g •« £ »•£ S
I2BSSi
£. C -a e ;= —
< I c •» 5 '
?l
lo
" V
a *
S-sC'I i.S
.= u
i!
^5
•5!
M «*
Ili
<^ii
e
1^
• 11
«* y
b _j
?5 2±
'•* 3
>» -
^i
a*
11
" E
"._ 3
" 7
-K b
(J .~
5Z
SI
I i.
is
1 5
~ •=
, 3
b'S
'± S
* ri
•" 2P
w —
*• s
>t V
& *
11
§!5
|S3
*I«
t* n n
^ • ™
.3j S! •— »
*2 a* -
s 5 £
•s 2-^
ll-l
e ™ ^
III
8 Js .s
"* 2'
•K -1
• £3
S-3*
•51-S1
« 55-
O <" =
^ •» -™
* ^5
^ «•£
'« = ••
b b A
S * 2
« -3 ft
>> n =
.•= ^ <— '
£2g
.sjr
S - 5
i S M
8jl
•2lf
= £5
= f
= S
•iS *"
^'
.2 -S JB
~ • •
o = ~
5 * ai-
s l = »lls^
1 il'i'icll
£ <
6-3
-------
2-3-"3
S-f *
B •«
Stt
|c |
*•« w
I1*
.1-8
= |s?
2 S ?2
u OS £
^ w ti i2
|*M
ill*
5 c.S =
all or ceiling
uitable for
ck and/or any
ms and edges
n
ro
II the w
be un
shcclr
(lie se
work and woodlrim
ent, co
or paint
ning mct
be used,
thod. Of
o accepta
d
ntai
y
Approved melhods are repl
sealed or caulked seams, a
chemical strippers not con
chloride based strippers m
lilies as a final louch-up
woodwork or woodlrim is
'induws
il
.s >
4si
luors
Hours coated wilh lead based paint musl be encapsulat
vinyl '(He or linoleum llooring. Upon written request 1
owner. Hie Commissioner may consider other appiopriate i
abating lluor surfaces.
|S*
§*
an
be
l il»c entire woi k area in coiifornm
l lloors. stair Ireads and risers mus
eck enamel or Ihc equivalent. A
um Hooting, or Ihc equivalent may
3S .
Alter cle
lloii 6 be
milyuict
vinyl lile.
Ii
5 * ¥ i - «
. e> -S. 5 = M
•E «,.8»-2.i
IPIH
i^laic
•
I ill HI
5 S5 SJS
_ s -i n - _. ^
"rs 3 ^ i " 2 3
j * s - r = ^
««= * 3.'€£
>- S "3 W -j -5
5 3 * JJ «-.£ *
S I S 1 * 5 8
•• • •— * ^
-------
£
b
*
d
•3 o
i!
!
11
***
Si =
v w-
S — —
- '5 8 9
II
ll Illl
-S £ i -i -S ^ 5
I5?! fit
L
II
= 2 * .2
5 -
.£ z 5 5 v
C -5 3 3 * .4 »
=3
ra
•5,
3*
W;
* *s
i£
I.J
11
!!? I !.••?!« II i
«t s •= -s JtS- STC3 as 35
eg
_s
£ .=
I
I
c
** 1
=g
f!
" V
N
.= <*
11
_ u
£ §
s>
1 3
— 5 - ^ £ 5
1 1
1.1
!*
1 3
Sk i i* w 1C O 3
mi i ni
S. S a -I « p -=
s g s
= 1.2
I
II?
I'Cs.f
Illl
Illl
ill5
3
rr-s
•s s 5 §
Illl
i
•j< = —
||
II
x a
i v
5 =
51
Jl
o c
u S
>i —
II
* > .
f1!
Il
^
«)
in
HI
iii
^P
Hi
5M
5^5
s t*
sS,
i;i
>>
•3ce
!^i
l-sll
±2^3
"3 "S 5 S
lllf
ill!
in so
...lr •« _.. "ll"* S **
^53
.£•* 5 .
•a-J 3 S
§*1-S
2^§ S
SljJ
i;5
t>
fiji:*
* = 1 * -3 a
*:;; «l«i|
||||
Isil IIJI'I--
s^i". s^s^i-s
ff^-881 =•«-'--
1-31 i
S5K-S
3 " «-5
l-aSS
s f v —,
-S S- » * =i ^
1
Sail!**
X W
g a
*
l s
e
1
il
.
I!
SJI
= 2
II
11
"3 -3
3 !
II
il
5 aa
« i s» i "P •
•I?iJ li
's 2 a M ^ s .a
II
"'•3
a^
m 2.l
" S S fS
i
^ £-5
: W 5
I S «
• -
I
= o
i 2 •* S
il ^1
'521:
w .S
i.sl".
st^l
flJi5i
S 5j5 =
s S T 5 .
-a - J5 « u
•1 a ? •» I
S o ^ ^ ~ C —
5 5 * •? "3 v *
5 5 .*•= = - *
2 - - - —
G-4
-------
!i
I <
If
i
•^ I a 5 •= 'i - '5 " a
£ 5 S a
Hit
5 ~ ^ —
iff!
ill
- = '-
3 5 "
•» -^ ft*
S W ^
"•=1
|l-2
v a
— a
ii
- >•
•I S
Ii
.£ -7 w
> 2 a
:! 2 a
i = = SHM
= = ^ ^; 4 21
l^illll-s
j = :.ssMi
=1111111
« — •= _
S K = 1
•s 2.a 3
S'5ll
S ^^ •*
* .;•-
a a 2>
~ ~ 5
Ii
.!•
iii
o J: -jz
la* 5
s 's •? -
sU.i
I'5I = .
<£lll
d -s s
•2 " i
1^1 s
5 "L •=
-^ -1!
§•! = 3>
1 S s « =
I IIH
! «s|
~ a * - *
s a •= •= *
- « -a - =
•3 S 2.= 5
3 -2-35 =
I
1J5
.
=
•§"0 s
5 u -
•Hi
& <
-------
-------
Baltimore
Integrated Environmental Management Project
Phase II Report:
Reducing the Hazards from Abatement of Lead Paint
Part 2 — Benefits and Costs
of Alternative Abatement Practices
Prepared by:
Elliott Hamilton
Regulatory Integration Division
U.S. Environmental Protection Agency
1987
-------
-------
TABLE OF CONTENTS - Part 2
Chapter 1:
Chapter 2:
Chapter 3:
Chapter 4:
Chapter 5:
Chapter 6:
Chapter 7:
Chapter 8:
Chapter 9:
Chapter 10:
Page
List of Tables and Figures ii
Purpose and Rationale for Study 1
Baseline Information for Baltimore City 4
Costs of Abatements 10
Reductions in Blood-Lead Levels Assumed 12
with Improved Abatement Techniques
Estimated Health Benefits for Children 16
Estimated Health Benefits for Adults 30
Estimated Health Benefits for Newborn 36
Children
Other Benefits 38
The Present Value of Future Avoided 40
Medical and Other Costs
Summary of Findings and Sensitivity 44
Analysis
References 49
-------
LIST OF TABLES AND FIGURES
Table 2-1
Table 2-2
Table 4-1
Table 4-2
Figure 4-1
Table 5-1
Figure 5-1
Table 5-2
Table 5-3
Table 5-4
Table 5-5
Table 5-6
Figure 5-2
Figure 5-3
Figure 5-4
Table 5-7
Figures
6-1, 6-2
Figure 6-3
Table 6-1
Table 9-1
Table 10-1
Table 10-2
Table 10-3
Page
CDC Risk Classification Classes 5
Baseline Information for Baltimore City 7
Children's Median Blood-Lead Levels
After Chelation Therapy by Housing Type 13
Median Blood-Lead Levels of Children
by Presence of Lead Paint in Houses 13
Adult Blood-Lead Level Associated with 15
Lead Uptake
Health Areas and Methodologies 17
Sequence of a Lead-Poisoned Child 18
Incidence of Rehospitalization by Housing 19
Type
Yearly Hospitalization Costs Avoided with 21
Better Abatement Techniques
Nonhospitalization Costs Avoided with 22
Better Abatements Techniques
Probability of Cognitive Effects Associated 23
with Class Levels
Present Value of Avoided Costs of Compensatory 24
Education for Current Children with Better
Abatement Techniques
Dose-Response Curves for Blood and Renal 25
Effects
Dose-Response Curve for Hearing Loss 27
Relationship between Blood-Lead Levels 28
and a Child's Height
Summary of Health Benefits and Costs Avoided 29
by Children Currently Living in 350 Houses
Abated by Better Techniques
Blood. Pressure Associated with Lead 31
Levels for Men Aged 40-59
Dose-Response Curves for Adult Health Effects 32
Summary of Yearly Adult Health Benefits for a 35
5-8 ug/dl Decrease in Blood-Lead Levels for
350 Better Abatements
Present and Future Quantifiable Benefits that 43
350 Better Abatements Produce
Estimated Health Benefits Resulting from 350 45
Houses Abated with Better Techniques
Estimated Current and Future Avoided Costs 46
Resulting from 350 Houses Abated with Better
Techniques
Sensitivity Analysis of Different Costs of 47
Abatements at Different Discount Rates
ii
-------
Chapter 1
PURPOSE AND RATIONALE FOR STUDY
This study estimates the benefits and costs of using improved
techiques for removing lead paint in houses. Lead poison-
ing remains a serious problem for children and some adults.
In children, it has long-term effects on the nervous system,
interferes with learning ability, damages the kidneys, and
causes blood disorders. In adults, it has reproductive
effects and neurological effects, and leads to higher blood
pressure and hypertension. Fetuses are extremely sensitive
to lead's toxic effects due to their rapidly developing
nervous system (CDC, 1985).
The main source of lead poisoning in children is paint in older
homes. Virtually all cases of lead poisoning occur in children
who live in old, deteriorated houses that were built and painted
years ago when the use of lead-based paints on housing surfaces
was widespread.
The paint in most homes built during the first half of this
century contains up to 40%-60% lead. It is estimated that over
191,000 dwelling units in Baltimore City have lead paint hazards.
Expensive older homes are also potential sources of poisoning.
Many of these homes were painted with layers of heavily leaded
paint. Renovations and remodeling and simple deterioration over
time cause lead poisoning through the lead fumes and lead dust
produced.
Although the condition of the painted surface is of some
importance in predicting risk, the paint need not be visibly
peeling or chewed on by the child to be hazardous. With age,
the surface of leaded paint starts to deteriorate and gives off
fine dust that is incorporated with the general house dust. This
inevitably becomes carried on the hands of children to their
mouths through food, toys, or normal hand-to-mouth activities.
The entire home, therefore, may be rendered hazardous (Maryland
Department of Health and Mental Hygiene, 1984).
-------
Baltimore City regulations require abatements when there is
evidence of chipping or flaking paint containing more than 7 mg/cm2
of lead on any surface, or where paint is deteriorating on easily
accessible biting surfaces. Houses are only inspected for lead
hazards once a child is identified as being lead poisoned.
Traditional abatement methods used in Baltimore are open-flame
burning, scraping, and/or sanding. The abatements are limited to
4 feet high on the walls and wood work. There is usually minimal
cleanup and no repainting of wood surfaces.
Evidence developed at the Kennedy institute in Baltimore showed
that traditional abatements often leave a house with greatly
increased surface dust-lead levels (typically 10 - 100 fold) and
increased blood-lead levels in children residing in abated homes.
For this reason, the Kennedy Institute developed new techniques
to make an abated house as safe as a house without lead paint,
to protect the workers doing the abatements, and to perform the
abatements at a reasonable cost. These improved abatement tech-
niques include:
paint removal that does not create or leave behind
fine lead bearing particulates;
better cleanup measures, including the use of
high-efficiency particle-accumulator vacuums;
sealing or covering walls and floors;
stripping wood trim and doors off-site;
repainting abated surfaces with lead-free paint;
containment and proper disposal of lead debris; and
worker training and protection.
Three previous lead studies conducted in Baltimore help to derive
the benefits of better abatement techniques:
Farfel (1987a) found increased house dust lead levels and in-
creased blood lead levels of children attributable to traditional
abatement techniques. Chisolm et. al. (1985) found abated houses
to be significantly associated with recurrences of blood-lead
levels in children greater than 49 ug/dl. Charney et. al.
(1983) found that dust control measures in abated houses led to a
decrease in blood lead levels of children. A more in-depth
examination and significance of these studies is in Chapter 6.
-------
This study estimates the benefits and costs of improved tech-
niques for removing lead paint in houses. We report the health
benefits for children and adults both as avoided health effects
and avoided medical and other costs. We also report nonhealth
benefits that result from improved abatement techniques. Since
better abated houses should also not expose future occupants to
the danger of lead paint, this study will estimate both the im-
mediate and future benefits of the improved abatements.
We use Baltimore City-specific data when available.
we use data from other cities' or national data.
Otherwise,
We rely mainly on previous EPA studies concerning the health
effects of lead. This study is not meant to present a compendium
of the health effects of lead. It is only a summary of the
health effects highlighted in the literature as being important
and quantifiable. An interested reader should go to the following
EPA studies for further information concerning lead's health
effects:
- Air Quality Criteria for Lead EPA Office of Research
and Development (1986)
Costs and Benefits of Reducing Lead in
Gasoline; EPA Office of Policy Analysis,
(1985)
Schwartz
- Reducing Lead in Drinking Water: A Benefit
Analysis; EPA Office of Policy Analysis, Levin
(1986)
- Review of the National Ambient Air Quality Standards
for Lead; Assessment of Scientific and Technical
I n for mat ion , EPA Office of Air and Radiation (1986)
- Health Score Evaluation for Pollutants in the Sa.nta
Clara Valley Project; Inorganic Lead; EPA Office of
Policy Analysis, Perlin (1986)
-------
-------
Chapter 2
BASELINE INFORMATION FOR BALTIMORE CITY
A baseline for Baltimore City serves as the level of activities
and facts against which to measure the benefits and costs of
better abatement techniques. Unless otherwise noted, we used
historical data to establish the baseline of information in the
following categories:
Number of lead poisonings per year by
class type and hospitalizations
- Number of abatements per year
Demographics of persons living in abated houses
Average blood lead levels of children and adults
A Significant Number of Lead Poisonings Occur in Baltimore City
EveryYear
The CDC defines lead poisoning in children as a blood lead level
greater than 25 micrograms per deciliter (ug/dl). Baltimore City
adopted this level in 1986 for its reporting purposes. Previously,
lead poisoning was defined at 30 ug/dl.
Table 2-1 shows the classification of affected children for pri-
ority medical evaluation, with Class IV the most serious. Class
levels are determined by both the blood lead level and by the
erythrocyte protoporphyrin (EP) level in the blood. Class I
children are classified as being at low risk. Class II children
are classified as being at medium risk. Abatements are usually
required for. Class II children, and periodic screening is recom-
mended. Class III and IV children are classified as being at
high to urgent risk. Abatements and chelation therapy are usually
required at these levels.
Approximately 32,000 screening tests for lead poisoning are done
annually in Baltimore by various clinics, with an unknown number
being repeat tests. The Baltimore City Health Department esti-
mates that these screenings cover about 20% of Baltimore City's
children "at risk" (children aged 1-6 years living in dilapidated
housing) (Maryland Dept. of Health and Mental Hygiene, 1984).
-------
Table 2-1
CDC Risk Classification Classes
Erythrocyte Protoporphyrin (EP) by Extraction
Risk Classification of Asymptomatic Children
for Priority Medical Evaluation
Erythracjrte PrMoporphyrin (EP) *
Blood Lc«J *
<35 35-109 110-249 >I50
Not done
<24
25-49
50-69
>70
1
1
Ib
••
••
•
la
II
111
•*
•
la
IN
III
IV
•
EPP+
HI
IV
IV
* - Units are in fig/41 of whole blood.
* = Blood lead test needed to estimate risk.
EPP+ = Erythropoieiic protoporphyria. Iron deficiency may cause
elevated EP levels up to JOOpg/dl, but this is rare.
** = In practice, this combination of results is not generally ob-
served; if ii is observed, immediately retest with venous
blood.
NOTE: Diagnostic evaluation is more urgent ihan the classification indi-
cates for—
I. Children wiih any symptoms compatible with lead toxicity.
2. Children under 36 months of age.
3. Children whose blood lead and EP levels place them in the
upper part of a particular class.
4. Children whose siblings are in a higher class.
These guidelines refer to the interpretation of screening results, but the
final diagnosis and disposition rest on a more complete medical and
laboratory examination of the child.
Source: CDC 1985
Erythrocyte protoporphyrin (EP) is the protoporphyriiv found in
the red blood cells. Protoporphyrin is an intermediate product
in the production of heme, which is a critical component in the
formation of normal hemoglobin and other hemoproteins that affect
cellular respiration and energetics. Lead inhibits at least two
enzymes which are necessary for the synthesis of heme, causing
a buildup of intermediate products in the blood and urine. Lead
may also interfere with the entry of iron into the mitochondria,
where iron is joined with protoporphyrin to make heme. (Perlin,
1986)
-------
Table 2-2 projects 600 annual cases of lead poisoned children.
This projection is based on the new reporting procedures begin-
ning with 1986 data and preliminary 1987 data. These cases are
broken down by class type based on newly diagnosed cases and
requirement of hospitalization, as reported by the Baltimore
City Health Department. The table is broken down into new
hospitalizations or readmissions. This breakdown reveals whether
the child is having the first chelation or a repeat treatment.
Chelation therapy consists of the administration of two drugs,
calcium disodium EDTA and penicillamine, orally and by injection-
These drugs act as chelating agents — that is, they bind with
metals, in the body. The metals are then excreted in the urine.
Because the chelation agents also bind with other metals, the
children are given iron, zinc, and copper, together with multi-
vitamins, to replace the essential metals lost through the therapy,
.The therapy normally takes three weeks, with the chelating drugs
administered daily. The children are tested weekly during the
therapy to monitor their progress.
6
-------
Table 2-2
Baseline Information for Baltimore City
Abatements^
Lead poisonings^
- Class II3
- Class III3
- Class IV3
Hospitalizations^
- New
- Readmissions
Projected
annual
350
6002
5372
56
7
128
80
48
1981 1982 1983 1984 1985 1986
235
180
58
43
7
93
NA*
NA
369
528
381
138
9
111
NA
NA
466
242
172
56
9
103
76
27
241
249
222
23
4
153
86
67
362
290
241
43
6
156
90
66
176
649
611
32
6
101
69
32
* Not Available
Notes:
1 The number of abatements are what the city required and does not
reflect any voluntary abatements. Some abatements are also done
on secondary residences of the lead-poisoned child, such as rela-
tives' houses.
No average was taken due to the unusually low number of abate-
ments in 1986, which we believe is not an accurate reflection of
future activities. Baltimore City became more hesitant to
require abatements after evidence showed that abatements may
increase the lead exposure. If safer abatements were'available,
then more abatements would be required than currently.
2 No average was taken due to changing definitions. From 1981 to
1985, lead poisoning was defined in Baltimore City at 30 ug/dl.
In 1986, the lead poisoning definition was lowered to 25 ug/dl
as suggested by guidelines from the CDC. Preliminary data for
1987 show that the number of lead poisonings will continue in
the 600 range, including greater numbers of Class II types. It
is not clear why there was such a high number of reported lead
poisonings in 1982.
3 Class types are for newly diagnosed cases, and does not reflect
more .serious Class levels a person may reach.
4 An average was taken from 1983 to 1986 due to data not being
available for new hospitalizations or readmissions in 1981 and
1982. Chapter 4 explains our estimates of "new" and "re- -
admissions."
-------
Very Few Traditional Abatements Are Projected for Future Years
Table 2-2 shows the number of abatements done in Baltimore City
for the past six years as reported by the Baltimore City Health
Department. We project 350 yearly abatements as the figure ex-
pected in the future, which is approximately the average number
of abatements from 1981 to 1985. We are not using 1986 data
because they do not accurately reflect future activities. The
1986 figure is unusually low due to'Baltimore City's being hesi-
tant to require abatements after evidence showed that traditional
abatements may actually increase the lead exposure. If safer
abatement techniques were available, the Baltimore City Health
Department would be likely to require more abatements.
We Assume Specific Demographics^ for People in Abated Houses
Virtually all of Maryland's reported lead poisonings and hospita-
lizations occur in Baltimore City. Data from the Baltimore City
Health Department show that almost all lead poisoning cases and
hospitalizations are for children between the ages of 1 and 6
years from low-income families. Screening is not done for child-
ren older than 6, because they generally have less exposure to
lead. However, we cannot conclude that lead poisoning does not
occur in older children.
No data are available on the number of adults or children living
in abated houses. Further, there is no information on how many
of the lead-poisoned children come from the same household.
Anecdotal information tells of 3 families having 27 hospitaliza-
tions in 1984, and in 1986, 2 siblings having 10 hospitalizations
between them. Using data from the 1980 Census of Population of
Housing for the Baltimore SMSA, we assumed two adults, one male
and one female, live in an abated house, two "at risk" children
currently live in an abated house, and from two to six additional
"at risk" children will live in an abated house over the next 20
years (the time period assumed in this study).
Data on Blood Lead Levels in Baltimore Are Lacking
No specific data are reported on the blood-lead levels of
Baltimore City adults and children, except for the identified
lead-poisoned children. National data on blood-lead levels are
available from the second National Health and Nutrition Examina-
tion Survey 1976-1980 (NHANES II) study. The data show that the
average blood-lead levels (ug/dl) for black adult males, females.
Communication with Jerome Troy of the Lead Program of the
Baltimore City Health Department, July 1987.
8
-------
preschool age children, and older children are 17.4, 11.8, 20.8,
and 14.6, respectively. Later in this report we assume a range
of 10-25 for adults.
Several Major Assumptions Underlie This Study'sBenefits and
Cost Calculations
We use the following assumptions to calculate the benefits and
costs of improved abatement techniques.
- 128 annual hospitalizations for chelation therapy: 80
for the first time, and 48 for any repeated time. (See
Chapter 4 for an explanation of the derivation of these
key baseline data.)
350 annual abatements.
two "at risk" (from 1 to 6 years old) children currently
live in each abated house.
- children currently living in houses abated with improved
techniques will have approximately a 10 ug/dl decrease in
blood lead levels.
- from two to six "at risk" children will live in better
abated houses over the next 20 years.
children living in houses abated with improved techniques
in the future will avoid an approximately 25 ug/dl in-
crease in blood lead levels.
3 years of compensatory education is needed by learning-
disabled children.
1 male and 1 female adult per household.
adults living in houses abated with improved techniques
will have a 5-8 ug/dl decrease in blood-lead levels.
a traditional abatement costs $1,000; a better abatement,
$5,000.
a 3% discount factor and a 20-year time period for benefits.
- benefits accrue at the beginning of a year. For example,
20 years of benefits from energy-efficient windows consist
of savings today (year 0) plus 19 years; for education,
assuming a 3 year-old receives 3 years of special education
upon entering school at age 5, the future benefits occur in
years 5, 6, and 7.
Additional assumptions will be noted in the text when used.
Chapter 10 provides a sensitivity analysis of the cost of better
abatements and the discount rate.
9
-------
Chapter 3
COSTS OF ABATEMENTS
This study assumes that better abatement techniques cost, on
average, $4,000 more per abatement than traditional techniques
for a six-room, two-story rowhouse. The following costs for
traditional and better abatement techniques are used to derive
the marginal cost.
The Range of Costs for Traditional Abatements is Broad
This study uses $1,000 as the cost of a traditional abatement,
based upon cost data in the literature and from limited Baltimore
City data.
Data on costs of traditional abatements done in Baltimore City
are limited and of variable quality, as also noted by Farfel
(1987a). Berwick and Komaroff (1982) report that the costs for
correcting only peeling and chipping lead paint hazards can range
from $200 to $2,000 in 1987. In 1984, Baltimore City estimated
that the average cost of abatements done by the City was $800,
not including repainting (Maryland Department of Health and Men-
tal Hygiene (1984).
The wide range
there are many
flame burning,
is that houses
A third factor
have their own
in cost is due to several factors. One is that
types of traditional abatement techniques (open-
scraping or sanding) with varying cost. Another
vary widely by size and degree of abatement needed-
is that property owners with many rental units may
maintenance crews doing the abatements.
Better Abatements Are More Expensive
This study uses $5,000 as the average cost expected for the
better abatement techniques, based upon cost information provided
by Farfel (1987^.!
Complete cost information is not available on the better abate-
ment techniques. Partial cost information for 4 houses abated
by the better techniques are $2,759, $3,386, $5,810 and $6,285.
Farfel reports that the $6,285 figure is not an expected cost of an
1 For more information on the improved abatement techniques and
their costs, please see the comparison report to this study.
Pilot Lead-Paint and Lead-Dust Abatement Project, Farfel (1987b).
10
-------
improved abatement, because of first-time use of an experimental
technique. The $5,810 includes costs of floor treatments, and
rehanging the trim, and painting. None of the four estimates
includes cleanup costs. Thus, actual costs may be somewhat
higher, but not markedly so.
Alternatively, the cost of improved abatements may be lower than
$5,000 if the abatements are done in conjunction with general
renovation of the dwelling. Then the floor treatments window
replacement, and cleanup procedures that are done for the improved
abatements would be done anyway and, thus, not be considered as
costs of the improved abatement techniques.
One must also note that the costs are for experimentally abated
houses. Future costs should be lower than these. One reason is
that the techniques are being revised for better efficiency and
performance. Another reason is that the techniques are new to
the workers doing the abatements.
We conducted alternative analysis of the improved abatement
techniques, assuming they cost $1,500 and $6,000 more than tradi-
tional techniques. Results are presented in Chapter 10.
11
-------
Chapter 4
REDUCTIONS IN BLOOD-LEAD LEVELS ASSUMED WITH
IMPROVED ABATEMENT TECHNIQUES
Occupants of houses abated with improved techniques should have
lower blood-lead levels than occupants of traditionally abated
houses. We assume the efficacy of the better abatement tech-
niques (described in Farfel's accompanying report) in reducing
residual dust lead levels to those of a lead-free house. Con-
sequently, we estimate children currently living in abated houses
would experience approximately a 10 ug/dl decrease, and children
living in these houses in the future would avoid approximately a
25 ug/dl increase .in blood-lead levels. We estimate adults would
experience approximately a 5-8 ug/dl decrease in blood-lead
levels due to improved abatement techniques.
This chapter explains how we determined these estimates.
Chapters 5 and 6 then use these estimates of lower blood lead
levels as the basis for estimating the health problems avoided.
Children Living in Lead-Painted Houses Have High Blood-Lead Levels
This study uses previous studies of children's residences to
estimate changes in blood-lead levels that may be associated with
traditional and improved abatement techniques.
One technique used in the improved abatement techniques is better
floor coverings to ease cleaning. Charney et, al. (1983) found
that repeated dust control measures over a one-year period reduced
children's lead levels by approximately 6 ug/dl in traditionally
abated houses. Measures included wet washing surfaces with high
phosphate detergent and standard vacuuming. Charney's study
suggests that using better floor coverings, or sealing floors for
easier cleaning as a part of better abatements, may help reduce
dust-lead levels.
As shown in Table 4-1, Chisolm et. al (1985) found that blood-
lead levels after 24-30 months for children already chelated and
sent back to traditionally abated houses were approximately 38-35
ug/dl, while those for children sent back to houses free of lead
paint were approximately 29-25 ug/dl.
12
-------
Table 4-1
Children's Median Blood-Lead Levels (ug/dl)
Af't.er_Chelation Therapy by Housing Typej^~
Hous ingType
Blood-lead levels after:
6 months(N)* 24-30 months (N)*
Incompletely abated 55 (59) 52.91
Abated by City 38 (93) 34.4
guidelines^
Homes without 29 (32) 28.2
lead paint
(3)
(70)
(38)
*N = Number of children.
1 Only three children out of 59 initial children remained
in incompletely abated housing after 24-30 months.
2 In effect prior to 7/1/87. On this date, the City enacted
regulations proscribing traditional abatement practices.
Source: Chisolm et. al., 1985.
Table 4-2 shows two previous lead studies matching housing type
to blood-lead levels, as reported by Chisolm (1985). There is
approximately a 22-25 ug/dl difference between children growing
up in houses with lead paint versus houses without lead paint.
As stated previously on page 2, this study assumes that the lead
exposure from living in a house abated by improved techniques is
equal to that of living in a house without lead paint.
Table 4-2
Median Blood Lead-Levels (ug/dl) of
Children by Presence of Lead Paint in Houses
City and Year
Deteriorated
houses with
lead paint
Houses
without
lead paint
Baltimore, 1975
Cincinnati, 1983
38
35
16.5
10
Source: Chisolm et. al., 1985.
13
-------
Why do children growing up in lead-free houses have blood-lead
levels lower than those who receive chelation and then live in
lead-free houses? The difference is due to the increased body
lead burdens of previously lead poisoned children and the slow
body turnover rate in bone. (Lead has a half-life of 20 years in
bone.) Consequently, lead levels in poisoned children are not
expected to rapidly decrease even after they receive chelation
therapy and are no longer exposed to lead. Thus, children grow-
ing up in houses free of lead paint will have blood-lead levels
12-15 ug/dl lower than children that have been lead poisoned from
houses with lead paint.
Based on Chisolm1s study, this study attributes approximately a
10 ug/dl decrease in blood-lead levels of children currently
living in houses using better abatement techniques. Further,
this study assumes children who live in the future in houses
abated by better techniques will avoid approximately a 25 ug/dl
increase in blood lead levels.
Adults Living in Lead-Painted Houses Are Also Affected
No previous studies exist that associate housing stock and adult
blood lead levels. However, estimates can be made correlating
the added exposure of lead dust in lead-painted houses to blood-
lead levels in adult males.
EPA's Air Quality Criteria for Lead estimates that an extra 17
ug/day of lead is consumed on average by an adult male living
in a lead-painted house. One approach to translate the 17 ug/day
uptake of lead into blood lead to use the rate of absorption of
lead dust through the gut. Using EPA's suggested coefficient of
lead dust absorption of .3 gives an average of 5.1 ug/dl of added
lead blood associated with adults living in houses with lead
paint.
Another approach is to translate the lead uptake by using physio-
logical modelling techniques. Figure 4-1 shows the results of
three such models for adult males. Hammond et al.'s (1981, 1982)
computations of Bernard (1977) and Rabinowitz et al.'s (1976)
physiological models show the blood-lead levels after 5 years of
lead uptake ranging from a slope of .37 to .484. Chamberlain and
Heard1s (1981) model is based on epidemiological data and has a
constant slope of .34 (EPA, State and Air Standards Division,
1986). Based on these models, the extra 17 ug/day of lead uptake
corresponds to a range of 5.1 to 8 ug/dl rise in blood-lead
levels.
14
-------
Figure 4-1
Adult Blood-Lead Level Associated with Lead Uptake
50T
blood tad
Bcrnord'3
3yr nooel
uiBfivcnBin ondltevcfs fttodc)
105.6
source: Compiled from EPA, Office of Research and
Development, 1986.
15
-------
Chapter 5
ESTIMATED HEALTH BENEFITS FOR CHILDREN
Children are a high-risk group to lead's toxicity due to their
high exposure and susceptibility. Children are exposed to lead
more than adults are because of their increased hand-to-mouth
behavior. This behavior is especially pronounced in infants and
toddlers. Children below the age of 6 are also in the home more
often than adults and older children, and are thus more frequently
exposed to lead-bearing paint and dust. Children have a higher
rate of intake of lead per body weight than adults due to their
higher metabolism. In addition, children absorb lead into their
blood at a faster rate than adults. A child's nutritional status
is also important, as deficiencies in iron, calcium, and phos-
phorous may lead to a greater absorption of lead. A child is
also more susceptible to lead's toxic effects due to physiological
differences with their developing organs and systems (EPA, Office
of Research and Development, 1986) .
Table 5-1 shows the health areas and the associated methodologies
used in this study to calculate benefits from better abatement •
techniques. We estimate that with these techniques, 55 out of
our baseline of 128 hospitalizations for chelation therapy could
be avoided, and 50 special education cases could be avoided.
Better abatements will also reduce the incidence of blood dis-
orders (154 cases), renal effects (91 cases), hearing loss (35
cases), and development effects. Finally, for those adverse
health effects to which we are able to attribute dollar values,
we estimate $1.2 million in medical costs and approximately $0.7
million in education costs are avoidable.
16
-------
Table 5-1
Health Areas and Methodologies
Health Areas
1. Hospitalization
- first time
- subsequent
2. Medical treatment
for nonhospita-
lized children
3. Compensatory
education
4. 'Renal and renal
effects
5. Hearing loss
6. Developmental
effects
Methodology Used
This study uses a combination of Farfel's
(1987) and Chisolm et al.'s (1985) stu-
dies to arrive at the number of hospitali-
zations that could be avoided due to
better abatement techniques.
Massachusetts cost estimates for children
requiring only follow-up treatment are
applied to the number of children in
abated houses.
Berwick and Kamaroff's estimates for the
probability of having learning disability
or mental retardation are used with the
number of children in abated houses.
Perlin's dose-response curves are used in
conjunction with the number of children in
abated houses.
Schwartz and Otto's (1987) dose-response
curve is used with the number of children
in abated houses.
Schwartz and Otto's and Schwartz, Angle, and
Pitcher's (1986) studies show that elevated
blood-lead levels are negatively correlated
with developmental activities.
1. HOSPITALIZATIONS
Traditional Abatements Cause Hospitalizations and Rehospitalizations
We used Chisolm et al.'s (1985) and Farfel's (1987b) studies to
estimate that 26 first-time hospitalizations and 29 rehospitali-
zations could be avoided if improved abatement techniques were
used in the abated houses in Baltimore City. These avoided
hospitalizations are based on Baltimore protocols for treatment
of lead-poisoned children. The following discussion explains
this finding.
17
-------
Figure 5-1 shows the sequence that a lead»poisoned child can
undergo. Farfel's study concerns itself with the first hospita-
lization, while Chisolm's study looks au the rehospitalizations.
Figure 5-1
Sequence of a Lead-Poisoned Child
I«ad poisoned
child identified
x
> 25 ug/dl
House
inspected
Children in Baltimore are hospitalized when their bxood-lead
levels are greater than 50 ug/dl. Chelation therapy is given to
these children to reduce the lead in their blood and tissues.
The baseline information (p. 8) shows that there are 128 hospita-
lizations per year; 80 are first-time hospitalizations, and 48
are re-hospitalizations. Dr. Chisolm, head of the Lead Poisoning
Clinic at the Kennedy Institute, says that 99% or more of the
19
-------
hospitalizations are due to deteriorated lead paint in homes.
He also states that 40% of the initially hospitalized children
have to be rehospitalized because their blood lead again rose
to over 50 ug/dll.
F i rs t-Time Ho sp it a1i z a t io ns
Baltimore City inspects the house of a lead-poisoned child for
lead paint hazards. If a lead paint hazard is found, then the
City requires an abatement. Farfel (1987) found that the abate-
ments themselves are responsible for some children having higher
blood-lead levels and needing to be hospitalized for the first
time.
Farfel followed 27 children with high blood-lead levels who had
never been hospitalized, but whose homes were traditionally
abated. He found that one-third of these children had to be
hospitalized for the first time within one month following the
abatement. Thus, we estimate that improved abatement techniques
could avoid approximately 33% of first-time hospitalizations.
This equals 26 of the 80 new hospitalizations a year expected in
Baltimore (from the baseline information, p. 8).
Rehospitaliz at ions
Chisolm et al. followed 184 children who received chelation
therapy and traced whether they went back to their traditionally
abated homes or whether they went to houses without lead paint.
Chisolm found that 123 out of 127 children who were rehospitalized
lived in traditionally abated homes, as shown in Table 5-2.
Table 5-2
Incidence of Rehospitalization by Housing Type
Housing Type
Number of Number of Readmissions Total Re-
Children 1 2 3 or more admissions
Abated housing
Houses without
lead paint
152
32
39
2
23
1
10
0
123
4
Source: Chisolm et al., 1985.
Communication with Dr.Julian Chisolro, Jr., Kennedy Institute,
Clinic for Lead Poisoning, Baltimore, May 26, 1987.
19
-------
Dr. Chisolm estimates that approximately 10% of the rehospitali-
zations can never be prevented. This is because the lead that
is stored in the bones is redistributed into the blood. Thus,
90% of the rehospitalizations in Baltimore could be avoided by
better abatement techniques.
An important finding of Chisolm1s study is that many abatements
were not performed completely according to local requirements.
This finding underscores the fact that monitoring to ensure
correct abatements is equally important as having better abatement
techniques.
Many Hospitalizations Could Be Avoided by Better Abatement
Techniques
Combining Farfel's and Chisolm's studies provides a method to
estimate the total hospitalizations in a one-year period associ-
ated with traditional abatement techniques. Since these children
will not be hospitalized at all, there is no chance they will be
rehospitalized. Farfel's study shows that 26 of the 80 (33%)
expected new hospitalizations could be avoided with better abate-
ment techniques. Thus, instead of 48 {from the baseline informa-
tion, p. 8) expected rehospitaliations, there will only be
approximately 32 rehospitalizations. This assumes a 33% reduction
in rehospitalizations, comparable to the 33% reduction in new
hospitalizations.
Using Chisolm1s finding that 90% of the rehospitalizations
could be avoided, together with Farfel's finding that 32 re-
hospitalizations will occur, produces approximately 29 re-
hospitalizations that could be avoided with better abatement
techniques.
Adding Farfel's 26 new hospitalizations with Chisolm's 29 hospi-
talizations results in an estimate of 55 total hospitalizations
that could be avoided with better abatement techniques.
Costs of Hospitalizations Could Also Be Avoided
Data from the Kennedy Institute, which handles almost all of the
lead-poisoning hospitalizations in Baltimore, show that hospita-
lized lead-poisoned children stay an average of 26 days at $570/
day, or $14,820 total for inpatient treatment per child. The
inpatient costs include chelation therapy as well as a thorough
developmental workup, clinical psychology, hearing and speech,
and social service referral. The inpatient costs may drop 30%-50%
in the future by using a hospice rather than a hospital bed to
house the child until either the abatement is completed or alter-
native housing is found. ^ Consequently, the reported benefits of
avoided hospitalizations may be too high.
Communication with Dr . J^ Chisolm, Jr., 1987.
20
-------
Children receive outpatient care until their blood-lead levels
stabilize or improve, or until 6 years of age. For children
going back to abated houses, outpatient care is currently almost
always given until age 6 as their blood-lead levels remain danger-
ously high. Kennedy Institute data show that an average of 3.2
outpatient visits are performed per patient per year, costing
$104 for each visit. This study assumes that one year of out-
patient care will be required. The annual outpatient cost, thus,
is $333 per admission or a total of $18,315 a year for the 55
extra hospitalizations. (We did not discount these outpatient
costs to present dollars due to the small amount involved.)
We estimate approximately $833,000 in avoidable costs of hospita-
lization. Table 5-3 presents this information in summary form.
The cost of hospitalization does not include the possibility of
adverse effects from the medical treatment (chelation therapy
can cause renal damage).
Table 5-3
Yearly Hospitalization Costs Avoided with
Better Abatement Techniques
Avoidable 55
hospitalizations
Inpatient cost per $14,820
hospitalization
Total inpatient cost $815,100
Outpatient cost per $333
hospitalization
Total outpatient cost • $ 18,315
Total hospitalization $833,415
costs avoided
2. MEDICAL TREATMENT COSTS FOR NONHOSPITALIZED CHILDREN
Children who are lead poisoned but are not hospitalized also
incur medical treatment costs. A recent study by the Conserva-
tion Law Foundation of New England, Inc., (1987) on lead poisoning
reports that the average cost of treating a child requiring only
follow-up treatment is $1,343. This cost estimate comes from
actual costs charged at seven hospitals in Massachusetts.
21
-------
This study assumes 572 children currently living in better abated
houses who are not hospitalized could avoid one-half of the
follow-up medical treatment costs (350 abated houses with two
children per house = 700). Of these, 128 require hospitalization.
Of the remaining 572, all are lead poisoned to some extent. Better
abatements will enable them to avoid one-half of nonhospitalized
treatment, since they will not get as sick as they would in a
traditionally abated house. For this group we estimate approxi-
mately $384,000 in one-time avoidable medical costs.
Children who live in better abated homes i_n the future would
avoid also such costs. Chapter 9 presents the value of these
avoided costs.
Table 5-4
Nonhospitalization Costs Avoided
with Better Abatements
Benefits
Nonhospitalized
number of children
Medical treatment
cost avoided
572 x
$672 = (.5x $1343)
Total Non hospitalization $384,098
cost avoided
3. COGNITIVE DAMAGE - COMPENSATORY EDUCATION
Lead readily enters the brain and is retained for long periods
of time, even after external exposure ends. The sensitivity of
the brain in infants tends to magnify the severity of the long-
term effects of lead. These effects may be irreversible (EPA,
Strategies and Air Standards Division, 1986). In terms of cogni-
tive damage, lead exposure leads to mental retardation, learning
disability, behavior problems, IQ loss, and reduced attention
span. To estimate the value of cognitive abilities lost, this
study considers the costs of compensatory education needed by
children.
Approximately 50 annual cases of compensatory education result
from lead exposure in traditionally abated houses. The total
education costs associated with the 50 children are almost
$613,000. The following sections explain how we calculated the
number of cases and the associated costs.
22
-------
With Beter Abatements,Fewer ChildrenWould NeedSpecial
Education
Children with high blood-lead levels are seven times more likely
to repeat a grade or be referred for psychological counseling
than children with low blood-lead levels (EPA, Schwartz, 1986).
The special education that lead-poisoned children need is one
method used to account for lead's cognitive effects.
Mo data are available on the number of children in special
education programs in Maryland due to lead poisoning. This
study uses Berwick and Komaroff's (1982) estimates to determine
the number of children suffering from cognitive effects of lead.
Table 5-5 shows the probability of learning disability and mental
retardation associated with class levels.
Benefits are estimated separately for the 128 hospitalized
children and the other 572 children currently living in abated
houses (from baseline information, p. 8). This study assumes
that one-half of the 128 hospitalized children will be brought
from a Class III to a Class I risk level with better abatement
techniques. Also, one-third of the 572 children in abated
houses are assumed to be brought from a Class II to a Class I
risk. These assumptions take into account the 10 ug/dl decrease
in blood-lead levels that children experience with better abate-
ment techniques as calculated in Chapter 4. Using the probabil-
ities in Table 5-5 and the number of children with reduced risk,
we estimate approximately 2 case of mental retardation and 48
cases of learning disability that could be prevented each year
with better abatement techniques.
Table 5-5
Probability of Cognitive Effects
Associated with Class Levels
Risk
level
Class I
Class II
Class III
Probability of learning
disability even if
detected
.10
.25
.40
Probability of mental
retardation even
if detected
.02
.02
.05
Source: Berwick and Komaroff, 1982.
23
-------
Significant Compensatory EducationCosts Could Be Avoided
Schwartz's Costs and Benefits of Reducing Lead in Gasoline
estimates that the additional cost of part-time special education
for learning-disabled children who remain in regular classrooms
is $5,000 per year per pupil, adjusted to 1987 dollars. Schwartz
estimated that a minimum of three years is required for learning-
disabled children. This study assumes that the "at risk" child
is aged 3 years and, upon beginning school at age 5, needs 3
years of special education from that point. The present value of
this education, using a 3% discount rate, is approximately $14,150.
Table 5-6 shows that the total cost of three years of compensa-
tory education for 50 children is approximately $708,000.
Table 5-6
Present Value of
Avoided Costs of Compensatory Education
with Better AbatementTechniques
for Current Children
Types ofCosts
Cost for
Number of 3 years Total
cases/year per child costs
Mental retardation 2
Learning disability 48
Total Costs
$14,150 $ 28,300
$14,150 $679,200
$14,150 $707,500
The education costs are a conservative estimate. The cost for
special education is based on likely and not preferred practice.
The additional education costs do not include the costs of addi-
tional years of schooling due to children being held back a
grade. Also, many children may need more than three years of
compensatory education. Finally, absent better data, we assumed
the same costs of special education for the retarded and the dis-
abled.
4. BLOOD AND RENAL EFFECTS
We estimate approximately 70 cases of anemia, 84 cases of
elevated erythrocyte protoporphyrin (EP), and 91 cases of renal
effects can be avoided in children with a 10 ug/dl reduction in
blood-lead levels, as calculated in Chapter 5.
Cases of anemia, elevated EP (which is a measure of blood disorder),
and renal effects are estimated using Perlin's (1986) dose-response
curves, as shown in Figure 5-2. Perlin's dose-response curves
are a rough estimate of the health effects.
24
-------
Figure 5-2
Blood and Renal Effects Dose-Response Curves
10
!5 20 25 30
MEAN 8LOOO LEVa UG/tt.
50
source: EPA, Perlin, 1986
Many Cases of Blood Effects Could Be Avoided with Better
Abatements
This study looks at two blood disorders: anemia and elevated EP.
Anemia is often the earliest symptom of lead poisoning. Symptoms
of anemia in children include pallor, sallow complexion, fatigue,
irritability, and decreased play activity. Children with anemia
are also more susceptible to infections. Figure 5-2 shows that
a 10 ug/dl reduction in blood lead levels is associated with
approximately a .10 decreased probability of anemia. Assuming
700 children currently living in the abated houses, we estimate
70 cases of anemia could be avoided with improved abatement
techniques.
Elevated EP (which FEP is a measure of) in children impairs heme
and hemoprotein formation for red blood cells. Besides its role
in forming hemoglobin, heme is also active in liver function,
vitamin D metabolism,and the nervous system. Figure 5-3 shows
that a 10 ug/dl reduction in blood lead is associated with
25
-------
approximately a .12 decreased proability of elevated EP levels in
children. Assuming 700 children living in abated houses, we
estimate 84 cases of elevated EP levels that could be avoided if
better abatement techniques were used.
Many Cases of Renal Effects Could Be Avoided with Better
Abatement Techniques
Lead exposure in children can interfere with a variety of
physiological processes that are associated with normal renal
function. At low doses, lead impairs mitochondrial functions,
including respiration, oxidative phosphorylation and synthesis
of heme, proteins, nucleic acids, and vitamin D hormone. Epidem-
iological studies have suggested that lead exposure in children
may be followed by later kidney damage, but this remains disputed.
The total effects of low-level exposure on renal functions have
not been adequately investigated for either children or adults
(EPA, Perlin, 1986).
Figure 5-3 shows a dose-response curve for renal effects based
on lead's interference with vitamin D metabolism, much of which
is controlled by the kidney. For a 10 ug/dl blood-lead decrease,
there is a corresponding .13 decreased probability of renal dys-
function. Assuming 700 children currently living in abated
houses, we estimate 91 cases of impaired renal function avoided
by the use of improved abatement techniques.
5. HEARING EFFECTS
Schwartz and Otto (1987) analyzed the NHANES II data for slight
hearing loss associated with blood-lead levels in children.
They found that lead levels across a wide range of exposure were
significantly related to decreased hearing ability. Figure 5-3
shows that a 10 ug/dl reduction in blood-lead levels lowers the
probability of a child's having elevated hearing threshold for 2
kHz levels by approximately 5%. Assuming 700 children, we esti-
mate 35 cases of decreased hearing ability are avoidable due to
improved abatement techniques.
26
-------
Figure 5-3
Dose-Response Curve for Hearing Loss
-------
Schwartz, Angle and Pitcher (1986) found that increasing blood-
lead levels are negatively correlated with height, weight and
chest circumference. Figure 5-4 shows that for children aged -7
years and younger, a 10 ug/dl reduction in lead levels corre-
sponds to approximately a 1.2 cm increase in height.
Figure 5-4
Relationship Between Blood-Lead Levels
and a Child's Height
Source: Schwartz, Angle, and Pitcher, 1986.
28
-------
SUMMARY OF HEALTH EFFECTS
Table 5-7 is a summary of the quantifiable health costs for
children currently in traditionally abated houses that could be
avoided with better abatement techniques. Chapter 9 presents the
quantifiable health costs that could be avoided for current and
also future children over 20 years.
Table 5-7
Summary of Health Effects and Costs Avoided by Children
Currently Living in 350 Houses Abated by Better
Techniques
(rounded to 000's)
Health
Area
Hospitalization (1)
Non-hospitalization
costs (1)
Compensatory (2)
education
Anemia (3)
Elevated EP (3)
Renal effects (3)
Hearing loss (3)
Height, weight (3)
and chest
circumference
Health Cases
55
286
50
70
84
91
35
NA
Avoided Costs
$833,000
$384,000
$708,000
NA
NA
NA
NA
NA
Total dollars
$1,925,000
NOTE: Estimates of health cases and avoided costs are partial
estimates of benefits. Refer to text in Chapter 5 for
discussion of nonquantifiable benefits.
(l) One-time benefit for current residents.
(2) Future benefit for current residents.
(3) Recurring benefit for current residents.
NA: Data not available to provide quantified estimate.
29
-------
Chapter 6
ESTIMATED HEALTH BENEFITS FOR ADULTS
Better abatement techniques can result in significant health
benefits to adults. The lower blood-lead levels associated with
the better abatements reported in Chapter 4 are used along with
Perlin1s (1986) dose-response curves to produce the health bene-
fits. Perlin's dose-response curves associate blood-lead levels
with the incidence of health effects. Perlin's work has not been
peer-reviewed; the dose-response curves should not be seen as
definitive, but only as an attempt to estimate the incidence of
health effects.
The following adverse health effects are seen at low to moderate
blood-lead levels.
Blood pressure elevation
- Reproductive effects
Neurological effects
Elevated erythrocyte protoporphyrin (EP)
There are few in-depth studies of the X'isks to adults from low-
level exposure to lead. Thus, there are inadequate data to estab-
lish cause/effect relationships for adults. This is especially
true for women, for workers doing the abatements, for blood
pressure effects in nonwhite men, and for all adults exposed to
chronic low levels of lead (EPA, Schwartz, 1985). Consequently,
many of the health risks may be under-reported, andour estimates
of the healthproblems avoided may be similarly under-reported.
We estimate that better abatement techniques may enable adult
men living in abated houses to avoid approximately 7 cases of
hypertension (aged 40-59), 11 cases of reproductive effects, 17
cases of neurological effects, and 28 cases of elevated erythrocyte
protoporphyrin (EP). Women living in abated houses in Baltimore
City can annually avoid 17 potential cases of neurological effects
and 46 potential cases of elevated EP. Finally, workers perform-
ing abatements using the improved techniques should be exposed to
lower dust air-borne lead. This chapter explains how we derived
these estimates.
BLOOD PRESSURE ELEVATION
Blood-lead, even as low as 7 ug/dl, levels can affect blood
pressure, as shown in Figures 6-1 and 6-2.
30
-------
Figures 6-1 and 6-2
Blood Pressure Associated with Lead Levels
for Men Aged 40-59
I •
II 14 I* Z2 M W tt
TiP BIOOQ HAD LfVIU 'iMICROaR
HOOD u*o trait UUCWOMMUDICIIITMI
Source: EPA, Schwartz, 1985.
High blood pressure is linked to a variety of health effects,
including hypertension, myocardial infarction, stroke, and death.
The present data show that lead appears to affect blood pressure
in men, but not in women. Past analysis has only focused on men
in the age group 40 to 59 because it is very hard to differentiate
the effects of aging from lead's effect on blood pressure. In
addition, of all health effects asociated with blood pressure,
only hypertension has been associated with nonwhites; there are
inadequate data on the other blood pressure health effects among
nonwhites. Consequently, the estimates of adult male benefits
are likely to be understated significantly, especially for older
males and nonwhite males of all ages (EPA, Schwartz, 1985).
31
-------
Benefits due to a lower incidence of hypertension are calculated
for all males age 40 to 59 living in abated houses. Figure 6-3
shows that an associated drop of 5.1-8 ug/dl of blood lead
results in approximately a .07 decrease in the probability of
hypertension across blood-lead levels of 10-25 ug/dl that are
commonly found in urban males.1 Assuming 350 abated houses per
year, a 30% chance of an adult male age 40 to 59 living in an
abated house,2 and a .07 reduced probability of hypertension, we
estimate a decrease of approximately 7 hypertension cases per
year due to better abatement techniques.
Figure 6-3
Dose-Response Curves for Adult Health Effects,
P
P
0
6
A
8
0.9
0.8 •
0.7 •
0.6 •
0.5
0.4 •
0.3
0.2
0.1 I
0.0
FEP/WOMEN
FEP/MEN
HYPERTENSION/
MEN
NEUROLOGICAL/
ADULTS
5 10 15 20 25 30 35 40 45 50
MEAN BLOOD LEAD UG/DL
Here, and elsewhere following the values for decreaesed
probability of the effect from Perlin's work (1986).
Calculated from 1980 Census of Population andHousing,
Baltimore SMSA, U.S. Bureau of the Census.
32
-------
EPA'S Costs and Benefits of Reducing Lead in Gasoline study
estimated that the annual cost per hypertension case is $285,
adjusted to 1987 dollars. This cost includes drugs, physician
visits, hospitalization, and lost wages. Multiplying $285 times
7 fewer hypertension cases per year yields $1,995 in yearly bene-
fits due to reduced hypertension in adult males age 40 to 59.
These costs avoided by better abatement techniques are recurring
benefits.
REPRODUCTIVE EFFECTS
Lead has been linked to a decrease in male fertility. Female
exposure to lead has been associated with menstrual disorders,
infertility, spontaneous abortions, stillbirths, and neonatal
deaths. The reproductive curve in Figure 5-3 shows the incidence
of damaged sperm (reduced numbers and less vigor) in males,
based on a study by Lancranjan et al. (1975). No similar inci-
dence curve has been established for female reproductive effects
due .to inadequate data (EPA, Perlin, 1986).
Assuming a 5-8 ug/dl decrease in blood lead, Figure 6-3 shows a
.03 decrease in the probability of damaged sperm in adult males.
Assuming 350 abatements and one adult male in each abated house,
we estimate approximately 11 fewer cases per year of reproductive
damage in males due to a reduced exposure to lead-painted houses.
NEUROLOGICAL EFFECTS
The nervous system is a critical target for the toxicity of lead
exposure. Lead can effect the brain and spinal cord and the
sensory nerves of the peripheral nervous system. Disturbance in
oculomotor function, reaction time, visual-motor performance,
hand dexterity, IQ scores, memory, learning ability, mood, and
nervousness have been observed in workers with lead-blood levels
of 50-80 ug/dl and, in some cases, as low as 27-52 ug/dl for
weighted time averages (EPA, Perlin, 1986). The incidence curves,
as shown in Figure 5-3, are based on a study by Seppaainen et
al. (1979) and refer to slowed peripheral nerve condition for
men and women.
Assuming a 5-8 ug/dl decrease in blood levels for men and women,
Figure 6-3 shows a .05 decrease in the probability of slowed
peripheral nerves. Assuming 350 abatements and one adult male
and one adult female living in each abated house, we estimate
approximately 35 cases of neurological damage for men and women
avoided by improved abatement techniques.
33
-------
ELEVATED EP (erythrocyteprotoporphyrin) EFFECTS
One of the first biochemical changes associated with blood lead
is an increase in FEP (which measures EP). High levels of EP
impair heme and hemoprotein formation in many tissues. Heme
helps in forming hemoglobin and is active in liver function,
vitamin D metabolism, and the nervous system. The incidence
curves for men and women shown in Figure 6-3 are based on a study
by Roels et al. (1975) and measure adults' having some lead-
induced disturbance in the hemoglobin synthesis due to an in-
crease in EP. The health consequences of small increases of
EP are controversial, as there are no obvious symptoms associated
with the increases.
Figure 6-3 shows a .08 decrease for men and a .13 decrease for
women in the probability of having elevated levels of EP,
assuming an increase in lead-blood levels of 5-8 ug/dl. Assuming
350 abatements, we estimate approximately 28 fewer cases of ele-
vated EP for men and 46 fewer cases for women due to reduced
exposure to lead.
GASTROINTESTINAL AND RENAL EFFECTS
Gastrointestinal and renal effects are two other health areas
associated with lead exposure. No benefits will be reported in
this study for these health areas due to inadequate data on the
low-level chronic exposure that would be experienced in lead-
painted houses. Gastrointestinal signs and symptoms caused by
lead intoxication include constipation, diarrhea, abdominal
pain, nausea, and indigestion. Mild symptoms have been associated
with lead levels in the 50-70 ug/dl range and as low as 30 ug/dl.
Renal effects have been associated with blood-lead levels greater
than 40 ug/dl. However, the effects of chronic low-level lead
exposure in adults or children have not been adequately investi-
gated (EPA., Office of Research and Development, 1986).
BENEFITS TO WORKERS DOING THE ABATEMENTS
There are virtually no data on the blood-lead levels of workers
performing the traditional abatements for property owners. There
is evidence that sanding and burning lead paint, as done in the
traditional abatement methods, can cause dangerously high blood
lead-levels for the workers (personal communication, Dr. James
Keogh).
34
-------
SUMMARY OF HEALTH BENEFITS
Table 6-1 shows the quantifiable health benefits to adults of a
5-8 ug/dl reduction in blood lead due to reduced exposure to
lead-painted houses. As stated previously, the benefits are
underestimated due to inadequate data for adults in general, as
well as for older men, workers doing the abatements, and non-
whites . Also, we were unable to quantify the dollar benefits
associated with reproductive, neurological, and elevated EP
problems.
Table 6-1
Summary of Yearly Adult Health Benefits for
a 5-8 ug/dl Decrease in Blood Lead Levels~
for 350 Abated Houses
Health Probability Decrease
Area Male
Hypertension
Reproductive
effects
Neurological
effects
Elevated EP
.07*
.03
.05
.08
Female
NA
NA
.05
.13
Reduction
in Cases
7
11
35
74
Cost/
Case
$285
NA
NA
NA
Dollar
Benefits
$1,995
NA
NA
NA
* Age 40-59.
NA: No data available.
35
-------
Chapter 7
ESTIMATED HEALTH BENEFITS FOR PRENATAL AND NEWBORN CHILDREN
The effects of lead exposure on fetuses is a matter of increasing
interest and concern in light of recent studies. The available
evidence supports the conclusion that fetal exposure to lead at
low and prevalent concentrations can have harmful effects on
infant mental development, length of gestation, and possible
other aspects of fetal development (EPA, Office of Research and
Development, 1986).
Fetuses are the highest risk group to regard to lead's toxic
effects because of their rapidly developing nervous system. In
fact, the risk to fetuses from exposure to lead may be even
higher than their mother's blood level would indicate. While
previous studies have generally found a high correlation between
maternal and umbilical cord blood-lead levels, Levin (1986)
reports that in one-fourth of the cases, the cord blood-lead
level was higher than the mother's.
Elevated Blood-Lead Levels Cause Neurobehayioral Damage
Several studies have examined the relationship between maternal
and fetal blood-lead levels and subsequent mental development in
infants. These studies show a consistent and significant
inverse relationship between blood-lead levels and infant develop-
ment, even at blood-lead levels of 10 ug/dl and lower. Levin
(1986) reports that Bellinger et -al. (1984 and 1987) and Vimpani
et al. (1984) both found test scores on the Bayley Mental Develop-
ment Index to be inversely related to umbilical cord blood-lead
levels. Bellinger found that there was a significant difference
on the test scores between low (< 3 ug/dl) blood-lead levels in
umbilical cords and high (> 10 ug/dl) umbilical blood-lead levels.
Follow-up tests show that the association between test scores and
cord blood-lead levels continues for at least two years.
In addition to mental development, other studies show an inverse
relationship between blood-lead levels and other neurobehavioral
effects. Ernhart (1985 and 1986) showed that lead exposure at
three months of age is correlated with jitters and hypersensiti-
vity. Winneke et al. (1985) showed a significant relationship
betwen prenatal blood-lead levels and one measure of psychomotor
ability at ages 6-7 (EPA, Levin, 1986).
36
-------
Elevated Blood-Lead Levels Also Inhibit EarlyDevelopment
The evidence from several studies indicates that gestational age
appears to be reduced as prenatal lead exposure increases, even
at low blood-lead levels below 15 ug/dl. Levin (1986) reports
that Moore et al. (1982) found that fetal blood-lead levels of
12 ug/dl corresponded to a significant level of premature births.
McMichael et al. (1986) found that women with blood-lead levels
greater than 14 ug/dl were four times more likely to deliver
pre-terra than women with blood-lead levels less than 8 ug/dl.
Excluding cases of stillbirths, the relative risk increased to
over 8.
Lead has also been implicated in complications of pregnancy,
including first-trimester bleeding, early births and stillbirths,
and possibly, low-level congenital anomalies (EPA, Levin, 1986).
37
-------
Chapter 8
OTHER BENEFITS
In addition to the health benefits for adults and children, other
potential benefits are associated with better abatement techniques.
These include:
energy savings from efficient windows,
better health of family pets,
better maintenance and living conditions in general,
- avoidance of income loss and inconvenience to family members,
- avoidance of anxiety to family members, and
improved property values and reduced insurance rates for
owners.
Efficient Windows Save Energy
The new abatement techniques provide for a complete refinishing
of all windows with lead paint in a house. The refinishings
will not only reduce the lead hazard, but also result in greater
energy efficiency. Greater energy efficiency comes from general
maintenance of the windows that results in tighter fitting win-
dows.
The Baltimore City Jobs and Energy Office, which does similar
window refinishings and replacements as part of its program,
estimates that each tighter window saves approximately $34 in
energy costs per year. The program states that to calculate a
house's yearly energy savings, one divides the $34/window by two
due to the airflows in a house. This study assumes that the
equivalent of two windows will be upgraded, resulting in energy
savings to an abated house of $34 yearly. Assuming 350 abated
houses per year, the total yearly energy savings come to $11,900.
These cost savings are a recurring benefit and will be assumed to
last 20 years. Chapter 9 presents the total present value of
these savings.
Better Living Conditions May Result
Traditional abatements often left debris in the houses and
unsightly and dangerous burnt wood trim and doors. Improved
abatement techniques require extensive cleanup as well as better
maintenance and repairs in general. These improvements, while
required for health reasons, also provide for a better quality
J>f—li-ving^and improved aesthetics for those in the houses.
Income Loss and InconvenJence,,to Family Members Are Avoided
A child requiring hospitalization has tB^spend an average of 26
38
-------
days in the hospital. In addition, many children require re-
hospitalization due to traditional abatements, totalling many
months in the hospital. Family members may have to take off
work as well as change their normal daily patterns to attend to
the child.
Anxiety for Family Members Is Avoided
Families of lead-poisoned children can suffer much mental anguish
as they wonder whether their children will be mentally and be-
haviorally impaired throughout their lives.
Property Values^ May Increase and Insurance Rates May Decrease
Correctly abating a dwelling can improve its property value
because it removes a future liability associated with the pre-
sence of lead paint. Future buyers, thus, do not have to face
the potential costs of lead poisonings, lawsuits, and abatements.
Owners may also receive lower insurance rates as they no longer
have the liability of lawsuits from parents of lead-poisoned
children.
'Family Pets AreHealthier
Lead can harm the health of family pets, just as it harms health
of humans. The Committee on Lead in the Human Environment of the
National Academy of Sciences concluded that animal sensitivity to
lead might equal or exceed that of humans (EPA, Strategies and Air
Standards Division, 1986). The exposure of household cats and
dogs to lead dust would be equal to or greater than that of
infants. This is due to pets' licking their dust-laden fur, pica
activity and time spent inside near dusty floors. Fish are also
be exposed to lead's danger, as lead dust falls into their tank.
Studies have shown that fish are very sensitive to lead. Goldfish
have shown neurological and behavior changes at 10-100 ug/1 lead
water levels. Other symptoms found in fish include black tails
(indicating spinal deformity) and spinal curvature (which in-
creases mortality and prevents successful reproduction).
39
-------
Chapter 9
THE PRESENT VALUE OF FUTURE AVOIDED MEDICAL AND OTHER COSTS
In Chapter 4 we presented information on the nature of the adverse
effects of elevated blood lead levels for children and adults.
We attributed reductions in the level of lead in blood for child-
ren and adults to better abatement techniques. In Chapters 5 and
6 we quantified some of the costs of adverse health effects in
terms of dollars of medical, educational, or other costs incurred
in treating these effects. We have assumed that these costs are
avoidable if better abatement techniques are employed. We define
these avoidable costs as the "monetized benefits" (i.e., value in
dollars) of better abatements.
Some benefits of better abatements are "one-time" benefits, such
as an avoided hospitalization. Others are "recurring" {i.e.,
annual) benefits, such as energy savings from more efficient
windows or lower blood pressure. Better abatements may create
such benefits both now and in the future both for current and
for future residents.
To capture more fully the complete set of possible monetized
benefits resulting from better abatements, we try to estimate
these future benefits, in addition to those immediately occurring.
This chapter presents our estimates of the present (1987) dollar
value of expected future benefits we are able to monetize.
Table 9-1 (p. 43) summarizes the present value benefits that
abatements produced. We estimate a range of $3.6 - 6.5 million
in avoided costs for those benefits we were able to monetize.
We have probably underestimated the value of these benefits
because of our inability to quantify all of the health effects
and monetize them.
Present Value of the Future Benefits Realized by Better Abatements
o Children living in better abated houses.
Hospitalization
We have assumed that a major benefit of better abatements is a
reduction in the number of children requiring either first-time
or repeat hospitalizations for chelation therapy (see pp. 18-22).
We estimated the total "immediate" value from the avoided in-
patient and out-patient care of these cases is approximately
$833,000. There are no recurring benefits for current children
from this improvement (unlike the case of adult hypertension).
40
-------
In addition, we have assumed there are no benefits for future child
residents. Our reasoning is that the traditional abatement aggra-
vates the environment for current residents—seriously enough to
require hospitalization. We have made the conservative assumption
that future residents, however, will not require hospitalization
from today's traditional abatement.
Non-hospitalization
As.we noted in Chapter 5 (p. 22), children not hospitalized may
still incur costs for medical treatment from lead poisoning. The
average cost for follow-up treatment is $1,343.
This study assumed an average of two children in the "at risk"
age group (1-6 years) currently living in the 350 annually abated
houses. We estimated the total "immediate" value of this avoided
cost at approximately $384,000. Again, these are one-time benefits
for this group.
Most abatements are done on rental units that have high turnover
rates. Consequently, it is likely that other children will live
in the house in the future. Lacking any data on how many of these
children there might be, we assumed a range of 2 to 6 children in
the "at risk" age group who might live in a house in the future
(defined as the next 20 years). For 350 better abated houses,
this results in an estimate of 700-2,100 future child residents
in the "at risk" group.
Unable to predict exactly when in the 20-year future these
children might reside in the house, we arbitrarily assumed resi-
dency at a point 10 years in the future. We again assumed they
avoid one-half of the one-time, nonhospitalization costs of
$1,343.
The present value of these benefits to the "at risk" children who
might live in the better abated houses in the future is approxi-
mately $360,000 - $1,080,000.
Compensatory education
As previously presented (pp. 23-25), we estimated that better
abatements would avoid 50 cases of cognitive damage, valued at
approximately $708,000 for current child residents.
Children residing in better abated homes in the future will also
avoid costs of compensatory education. We assume they will avoid
a 25 ug/dl increase in blood-lead levels (as estimated on p. 17).
41
-------
We have assumed that these are nonhospitalized children and are
in the Class II risk level (p. 34). By virtue of their residence
in the better abated houses,-they will move from Class II to
Class I, corresponding to a 15% decrease in the probability of a
learning disability (p. 34). (Note there is no reduction in the
probability of mental retardation in a move from Class II to
Class I.) As before, we estimated a range of 700-2,100 (350
abatements times 2-6 children/house) possible future child resi-
dents. Using the 15% reduction in the probability of a learning
disability, we estimated a range of 105-315 possible avoided
cases of compensatory education for children living in the better
abated homes in the future.
Again, assuming these children are living in those homes in 10
years and that the required special education (3 years duration)
begins 2 years later, we estimated a present value for one
case of avoided special education costs of $10,520. Over the
range of 105-315 possible cases, this results in an estimate of
$1,105,000 - $3,313,000 in future benefits for future child residents.
o Adults living in better abated houses
Hypertension
We estimated that better abatements might eliminate 7 cases of
hypertension and produce a total "immediate" benefit of $1,995 in
avoided medical costs (pp. 19-21).
We assumed a representative individual aged 49 in the 40-59 affected
age group. Over 20 years, the present value of the total future
benefits of the avoided medical costs is approximately $31,000.
o Energy-efficient windows
We estimated "immediate" energy savings for better windows at
$11,900 per year (p. 39). We assume these savings will last for
20 years which results in a present value of $177,000.
42
-------
Table 9-1
Current and Future Quantifiable Benefits That 350 Better Abatements Produce
(1987 dollars) .-
Benefits
Immediate
Future
Savingsl
Total
Savings-^-
Hospitalization
Nohhospitalization
Conpensatory
Education
Hypertension
Energy-Efficient
Windows
Total Savings
$833,000 (2) $833,000
$384,000 $ 360,000 - $ 1,080,000 $ 744,000 - $1,464,000
(3) $1,813,000 - $ 4,021,000 $1,813,000 - $4,021,000
$ 2,000 31,000
$ 12,000 $ 177,000
$ 33,000
$ 189,000
$3,612,000 - $6,540,000
tfote: Data limitations preclude estimating all health effects or assigning
dollar^ values for them. These figures probably underestimate the total
avoided costs.
(1) Future and total savings reflect the following assumptions:
- from 2 to 6 "at risk" children (aged 1-6 yrs.) may reside in the house
in the future, a range of 700-2,100 children, given 350 abatements;
- the time period for analysis is 20 years;
- the discount rate for present value analysis is 3%; and
- benefits occur at the beginning of a year; for example, 20 years
of benefits from energy-efficient windows consist of savings today
(year 0) plus 19 years; or for education, assuming a 3-year-old who
receives 3 years of special education upon entering school at age 5.
The future benefits occur in years 5, 6, and 7.
(2) As discussed (p. 42), we assumed no future children vnuld require
hospitalization. Thus, all benefits are "one-time" and accrue only
to current children.
(3) As previously discussed (pp. 25 and 43), all costs of compensatory education
occur in the future for both current and future children.
43
-------
Chapter 10
SUMMARY OF FINDINGS AND SENSITIVITY ANALYSIS
Tables 10-1 and 10-2 show the quantifiable health benefits and
avoidable costs associated with better abatement techniques. As
can be seen,' the dollar benefits range from $3.6 million to 6.5
million, depending on the number of children assumed to benefit
in the future. The benefit/ cost ratio associated with better
abatement techniques ranges from 2.6:1 to 4.7:1. These estimates
are probably low, as many health effects could not be quantified
or monetized. Also, many intangibles associated with the tradi-
tional abatement techniques could not be accounted for. These
include the extreme pain associated with chelation therapy, the
behavioral changes of a person, and the health effects not yet
known due to inadequate data.
Another limitation on calculating the benefits is that mone-
tizing the actual avoided costs associated with improved abate-
ments may inherently underestimate the health benefits. This
is because medical costs do not reflect the cost of lost wages
or other opportunity costs that are not easily monitized. An
individual is often willing to pay more than the medical costs
to avoid the adverse health effect. In general, willingness-to-
pay studies indicate that individuals are willing to pay two (or
more) times the cost of medical treatment (e.g., U.S. Environ-
mental Protection Agency. "Oxidants and Asthmatics in Los Angeles:
A Benefits Study." Addendum. March 1986). Thus, the approximate-
ly $1.6 - $2.3 million in medical costs that we find associated
with traditional abatements may mean society is actually willing
to pay $3.2 or more million to avoid the medical cost.
44
-------
Table 10-1
Estimated Current and Future Health Benefits
Resulting from 350 Homes Abated with Better
Techniques
Benefits
Estimated Health Benefits*
(cases avoided)
Current Children
Future Children
Hospitalizations 55
Non-Hospitalizations 572
Compensatory Education 50
Elevated EP (2) 84
Anemia (2) 70
Renal effects (2) 91
Hearing loss (2) 35
(1)
700-2100
105-315
(1)
(1)
(1)
(1)
Benefits Current Adults
Blood pressure (2) 7
Reproductive effects (2) 11
Neurological effects (2) 34
Elevated EP (2) 74
Future Adults
(1)
(1)
(1)
(1)
* Note. Not all benefits could be quantified. See Chapters 5-6
for discussion.
(1) Assume none. See chapter 9. Under alternate assumption, we
would estimate same values as for "current."
(2) These are annually recurring benefits for the affected
individual.
45
-------
\
Table 10-2
Estimated Current and Future Avoided Costs**
Resulting from 350 Homes Abated with Better Techniques
(1987 dollars)
Hospitalizations
Non-hospitalizations
Compensatory Education
Hypertension
Energy Efficient
Windows
Estimated Benefits
Current
Future*
$833,000 (1)
$384,000 $360,000-$!,080,000
(2) $1,813,000-$4,021,000
2,000 31,000
12,000 177,000
Total*
$833,000
$744,000-$!,469,000
$1,831,000-$4,021,000
$ 33,000
$ 189,000
$3,612,000-$6,540,000
Benefit/Cost Ratio: Approximately 2.6-4.7:1
Net Benefits: $2.2 - $5.1 million
(assumes 350 abatements at additional cost of $4,000 per abatement.
Note. For those health effects we are able to quantify. Not all
effects could be estimated nor could dollar values be assigned
to all. These figures probably underestimated avoided costs.
** Future and total savings reflect the following assumptions:
- from 2-6 "at risk" children (aged 1-6 yrs.) may reside in the house
in the future, a range of 700-2100 children, given 350 abatements
- time period for analysis is 20 years
- discount rate for present value analysis is 3%
- benefits occur at the beginning of a year; for example, 20 years of
benefits from energy efficient windows consist of savings today
(year 0) plus 19 years; or for education, assuming a 3-year old who
receives 3 years of special education upon entering school at age 5.
The future benefits occur in years 5, 6, and 7.
(1) As before, all benefits of hospitalizations avoided are assumed to accrue
only to current child residents for whom they are one "one-time" benefits.
See chapter 9, p. 42 for discussion.
(2) Although both current and future children avoid costs of compensatory
education, we define these as future (in time) benefits (see pp.25 and 43)
46
-------
Sensitivity Ana1ysis of Benefits and Costs
We conducted a limited sensitivity analysis of our efforts to
quantify the dollar value of the reductions in adverse health
effects.
We assumed the average cost of the abatements might be as high
as $7,000 per house and as low as $2500. The former adjusts up-
ward for costs we omitted (cleanup, repainting, etc.). The latter
adjusts downward for gains in efficiency.
We also assumed a discount rate of 7%. At 3%, society is saying
the future benefits are pretty important? in effect, it values
those benefits enough to defer present consumption for them. At
7%, the balance shifts towards the present; in effect, society
says those future benefits are less important.
This is particularly important because to the extent our ^naj.ysjls
is able to quantify benefits, a substantial part of the benefits
we report occur in the future, as opposed to today. For example,
the bulk of the non-hospitalization and compensatory education
benefits estimated derive from the future child residents we
projected.
Table 10-3 presents a summary of our analysis assuming discount
rates of 3% and 7% and marginal costs for better abatements of
$1,500; $4,000; and $6,000.
Estimated Benefits
(From tables 9-1&10-2)
at 3% $3,600,000
$6,500,000
Table 10-3
Net Benefits
(1987 dollars)
Marginal Cost of 350 Better Abatements at
$1.5 K/house
$525,000
$3,100,000
$6,100,000
$4.0 K house $6.0 K/house
$1,400,000 $2,100,000
$2,200,000
$5,100,000
$1,500,000
$4,400,000
at 7% $2,800,000
$4,800,000
$2,300,000
$4,300,000
$1,400,000
$3,400,000
$ 700,000
$2,700,000
at 3%
Benefit/Cost Ratios
6.9
12.4
2.6
4.6
1.7
3.1
at 7%
5.3
9. 1
2.0
3.4
1.3
2.3
47
-------
s.
Not surprisingly, more costly abatements and higher discount
rates reduce the net benefits and the benefit/cost ratios.
However, two observations are important. First, net benefits
remain positive, even with the more expensive abatements and
the higher discount rate. Second, as we have repeatedly stated,
our benefits are most likely underestimated due to a lack of
knowledge of the health effects of lead on adults in general, and
our inability to put dollar values on many of the health effects we
estimated.
Finally, a simple break-even analysis indicates that better abate-
ments could cost, on average, as much as $10,000 - $18,000 ($9,000-
$17,000 at the margin) at a 3% discounat rate an d still be worth
while. At 7% they could cost from $5,000 to $9,000 on average
($4,000 - $8,000 at the margin) and still result in positive benefits.
Distributional Effects
Who really pays for the cost when only traditional abatements are
done? The physical costs is borne by the patient and family.
Typically this is a low-income group. As a result neither they nor
an insurer pays the cost of medical treatment. To the contrary the
financial cost of care for the vast majority of children treated
for lead poisoning in Baltimore is borne by the public via Maryland
Medical Assistance Program. Similarly the cost of compensatory
education for such children is found in the public school system.
Thus the critical economic finding of this study emerges from con-
sideration of the distribution of costs of the problem. The public
pays the costs of increased lead exposure from traditional abatements
While the reduced lead exposure of better abatement techniques can
result in net benefits to sociery, it does not necessarily follow
that all segments of the population will share these benefits
equally. The benefits, better health quality and resultant lower
costs, will be received by the children and adults living in the
houses, their families and to the extent medical and compensatory
education costs are covered by public funds, the tax payers. The
costs of the abatements are borne by the landlord or home owner.
In the case of a middle class family that owns a house, most of the
costs and benefits will fall on the family, and there will be
economic, if not emotional, reasons for the family to undertake the
better abatements. In the case of landlord-owned housing, however,
the costs and benefits fall to different individuals or groups of
individualsi
In this latter case, a common situtation in Baltimore City, the
landlord has no preexisting economic incentive to perform better
abatements. The landlord may recover some costs, of the better
abatements by increasing the rent and through lower liability
insurance costs due to the decreased risk. Realistically, some
public enforcement mechanism such as regulation, will be required
to motiviate the landlord to incurr the" costs of better abatements,
if society chooses to reap the benefits. In Baltimore regulations
that incorporate many of the features of our better abatements were
put into effect on July 1, 1987.
48
-------
-------
REFERENCES
Berwick, D., and Komaroff, A., "Cost Effectiveness of Lead
Screening," The New England Journal of Medicine, June, 1982;
306: 1392-1398.
Centers for Disease Control, Preventing Lead Poisoning in
Young Children, 1985; U.S. Department of Health and Human
Services, Atlanta, GA.
Charney, E., Kessler, B., Farfel, M., and Jackson, D.,
"Childhood Lead poisoning: a controlled trial of the effect
of dust-control measures on blood lead levels," New England
Journal of Medicine, Nov. 3, 1983; 309: 1089-1093.
Chisolm, J. J. Jr., Mellits, E. D. , and Quaskey, S. A.,
"Relationship between level of lead absorption in children
and type, age, and condition of housing," Environmenta1
Research, 1985; 38: 31-45.
Conservation Law Foundation of New England, Inc., A Silent
and Costly Epidemict The Medical and EducationalCosts of
Childhood Lead Poisoningin Massachusetts, July, 1987; Boston
MA
EPA, Office of Research and Development, Air Quality Criteria
for Lead; Volume^ I-IV, 1986; Research Triangle Park, N.C.
EPA, Strategies and Air Standards Division, Review of the
National Ambient Air Quality Standards for Leadt Assessment
of Scientific and Technical Information, 1986; Research
Triangle Park, N.C.
Levin, R. , Reducing' Lead irP'brinkTng Water; A Benefit Analysis,
1986; EPA, Office of Rblicyi" 'Planning and Evaluation, Washington,
p. /-, .'••• i. ,; ' , .,, /!._;, ',-1
D.C.
Farfel, M. (1987a), Evaluation of Health and Environmental
Effects of Two Methods for Residential Lead Paint Removal,
doctoral dissertation for John Hopkins University, Baltimore,
Md.
49
-------
"
Farfel, M. (1987b), Pilot Lead-Paint and Lead-Dust Abatement
Project, Multi-Media Metals Committee,Integrated Environmental
Management Agency, EPA.
Maryland Department of Health and Mental Hygiene, Lead
Poisoning; Strategies for Prevention, Report to the Maryland
General Assembly, 1984.
Perlin, S., Health Score Evaluation for Pollutants in the
Santa Clara Valley Project, 1986; EPA, Washington, D.C.
Schwartz, J., Leggett, J. , Ostro, B., Pitcher, H., Levin,
R. , Costs and Benefits of Reducing Lead in Gasoline, 1985;
EPA, Washington, D.C.
Schwartz, J., Angle, C., Pitcher, C., "Relationship Between
Childhood Blood Lead Levels and Stature," Pediatrics, March
1986; vol. 77, no. 3, p. 281-288.
Schwartz, J., and Otto, D., Blood Lead Levels, Hearing
Threshold, and Neurobehavioral Development in NHANES II
Children and Youth, 1987; Office of Policy Analysis, EPA,
Washington, D.C.
U.S. Environmental Protection
fclbrfiry. Room 2404 PM-Slt-A
401 M Street, S.W.
Washington. DC 20460 .
50
Government Printing Office J 1988 - 516-002/80073
-------
AU6 2 I 1995
-------
.=•&•?
-------