KELLOGG REVISITED.- 1983
              Childhood  Blood  Lead and Environmental Status Report
                                                          MATERIAL BELONGS TO:
                                                          US EPA TOXICS LIBRARY
                                                            40', MSTSW/TS-793
                                                          WASHINGTON. DC 20460
                                                               (202) C50-3944
                      Panhandle  District Health Department
                     Idaho Department of Health and Welfare
          Center for Environmental Health, Centers for Disease Control
                      U.S.  Environmental Protection Agency
                                   July 1986
This report was supported in part  or whole by  funds from the Comprehensive
Environmental Response,  Compensation,  and Liability Act trust fund by
interagency agreement with the  Agency  for Toxic Substances and Disease
Registry, U.S. Public Health Service.
 EJED
I EPA-
 S3O/
 1986.1

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Agency Recommendations and
 Guidelines  Concerning the
  Findings of  this  Report

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    ' r                            FEB 03 1986

    •   M/S 525
Vernon Houk, Director
Center for Environmental Health
Centers for Disease Control
1600 Clifton Road
Atlanta, Georgia  30333

Dear Dr. Houk:

     This letter concerns the final report of the lead ^ealth study
conducted in 1?83 in northern Idaho (the "Kellogg Revisited" study) by the
Center for Environmental Health - Centers for Disease Control (CEH-r,DC),
Idaho Department of Health and Welfare (IDHW), Panhandle Health District,
anc the Environmental Protection Agency (EPA).  The geographic area of that
study, otherwise known as the Bunker Hill  Superfund site, is the focus of
both ongoing lead screening and health intervention efforts by t^e agencies
listed above, and evaluation and implementation of appropriate remedial
actions by EPA and IDHW.  The findings of the 1983 study, which have not yet
been issued in a final report, were a major impetus to these ongoing efforts.

     IDHW has developed recommendations and guidelines for effecting
reduction in children's lead absorption in the affected geographic area  (see
enclosed January 14, 1S86, letter from Fritz Dixon, M.D., State Health
Officer, and Lee Stokes, Ph.D., Division of Environment Administrator).  EPA
supports these recommendations and believes that they are warranted by the
1983 health study results.

     We request tliat CDC review these recommendations.  If ycu concur, we
request that a final report on the 1983 study, incorporating these
recommendations and guidelines, be issued as soon as possible.

                                     Sincerely,
                                     Charles E. Findley, Director
                                     Hazarcous Waste Division
Enclosure

cc:  Steven Margolis, CEH-CDC
     George Buynoski, CEH-CDC
     Fritz Dixon, ICKW
     Lee Stokes, IDHW
     Larry Belmcnt, Panhandle Health
     Joel Kulder

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  STATE  OIF   IDAHO
DEPARTMENT  O'f HEALTH  AND  WELIARE
 January  14, 1986
 Mr.  Charles Findley
 U.  S.  Environmental Protection Agency
 1200 Sixth Avenue, M/S 529
 Seattle, WA  98108

 Dear Mr. Findley:

 The  final report of the 1983  lead survey conducted  in northern Idaho is
 nearly completed.  Final  changes and suggestions  made by  the review
 committee are being merged into the final report.

 This survey, along with others, have shown that there is  excessive amounts
 of  lead in the environment of the Silver Valley.  As a follow-up to this
 survey, some specific recommendations for the reduction of lead absorption
 by  children living in the area must be made.   These recommendations are
 more permanent and go beyond  what individual  parents can  do to protect
 their  children.  Through the  cooperation of health  officials and the
 community, we have developed  some practical recommendations and guide-
 lines  that parents can use to reduce their children's absorption of lead
 and  prevent unnecessary illness.  You will recognize these recommendations
 as  the same actions incorporated into the Public  Health Intervention
 Program being conducted in cooperation with your  office and the Centers
 for  Disease Control.  These recommendations and guidelines are as follows:

 1.   Wash children's hands frequently to remove dirt and dust.

 2.   Keep non-food items out of children's mouths.

 3.   Do not eat locally grown  leafy or root vegetables that contain high
     lead levels.

 4.   Thoroughly wash or peel all locally grown fruits prior to eating.

 5.   Do not allow children to  chew on painted surfaces or  printed materials.

 6.   Do not allow children to  eat snow or icicles.

 7.   Remove lead base paints from peeling surfaces.

 8.   Reduce household dust by  frequent wet-mopping or dusting with a damp
     ClOth.                                            1-^,1	, ,	,	;

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                                                            J&N  17   &,


                    EQUAL OPPORTUNITY EMPLOYER          HAZARDOUS MATERIALS DIV

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9.
10.
     Children  should eat a  well-balanced  diet.
     encouraged for children.
                                                Vitamin supplements are
     Children, ages 1-5 years, should undergo annual  screening for blood
     lead absorption.
The results of the 1983 survey also support the following recommendations
for reducing environmental  exposure to lead through the elimination of
sources in the area.   These recommendations are more permanent and are
consistent with the goals and objectives of the current Superfund efforts.
These recommendations are as follows.

1.  Maintain ambient  air lead levels at the lowest practical  level.  The
    ambient air lead  level  must not exceed the current standard of 1.5 ug/m3.

2.  Reduce children's contact with contaminated play areas by sodding,
    seeding, paving,  or replacing soils in areas of heavy lead contamination.
    Fencing areas with heavy lead contamination to prevent access into these
    areas by children is also recommended.

3.  Reduce the quantity of contaminated soil and dust that can be blown
    throughout the community by routinely washing paved areas and imple-
    menting dust suppression measures in unpaved contaminated areas
    contributing to blowing dust.

4.  Maintain a community awareness and education program for adults and
    children designed to increase their awareness of ways to reduce
    absorption of lead from environmental sources.

These recommendations and guidelines being made by the Department of Health
and Welfare are most  likely in agreement with any recommendations that EPA
would make regarding  the continued reducing of childhood lead exposure in
the Kellogg area.

If you are not in agreement with our recommendations and guidelines,
please let us know by February 1, 1986.

                        Sincerely,
                        Fritz M Wxon,
                        State Health Officer
FRD:LS:aeb

cc:  Rose Bowman
     Larry Belmont
     Joel Mulder
                                                 Lee Stokes, Ph.D.,
                                                 Administrator,
                                                 Division of Environment

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                                                              April 14,  1986
Charles E. Findley
Director
Hazardous Waste Division
U.S. Environmental Protection Agency
Region 10
1200 Sixth Avenue
Seattle, Washington  98101

Dear Mr. Findley:

As you requested, the Center for Environmental Health (CEH),  Centers for
Disease Control (CDC), has reviewed the recommendations and guidelines which
the Idaho Department of Health and Welfare made on January 14,  1986, regarding
lead exposures in the Silver Valley.  CEH agrees that these recommendations
and guidelines are sound.

                                       Sincerely yours,
                                       LX>^
                                       vernon N. Houk, M.D.
                                       Assistant Surgeon General
                                       Director
                                       Center for Environmental Health

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                                EXECUTIVE  SUMMARY


In 1983, an integrated epidemiclogic study was conducted in the Silver Valley
of Idaho to assess children's blood lead (BL) levels and the relationship of
these levels to the levels of lead in different environmental media.  Blood
samples, environmental samples, and questionnaire data were collected for 364
children living at various distances from a nonoperating primary lead smelter
in Smelterville, Idaho.  Analyses of these samples showed that children who
lived close to the smelter had higher BL levels (20 micrograms per deciliter
(ug/dl), geometric mean) than children who lived farther away (11 ug/dl,
geometric mean).  Univariate and multiple regression analyses showed that the
differences in BL levels reflected differences in soil lead (3,474 vs 481
parts per million (ppm), geometric means)  and dust lead levels (3,933 vs 1,138
ppm, geometric means) near and far away from the smelter.  Very little lead
was found in other environmental media, indicating that the positive
association between house dust lead contamination and children's BL levels was
likely to have occurred as a result of the soil lead contamination.  Eleven
(26%) children living near the smelter and two (2%) living farther away had
lead toxicity, i.e., BL levels >. 25 ug/dl and EP levels > 35 ug/dl.  The
results of this study support the conclusion that, in the absence of
significant air lead contamination (0.28 micrograms per cubic meter), children
who are exposed to heavily leaded soils may develop lead toxicity.

An earlier version of this report underwent peer review.  This version
incorporates the additional information and analyses recommended by the
peer-review committee.

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                                TABLE OF CONTENTS
                                                                         Page
INTRODUCTION AND BACKGROUND  	 1

PROJECT ORGANIZATION AND RESPONSIBILITIES 	 3

     Idaho Department of Health and Welfare 	 3
     Panhandle District Health Department 	 A
     Centers for Disease Control  	 4
     Environmental Protection Agency  	 4

SURVEY METHODS  	 5

     Survey Population and Survey Areas 	 5
     Numbering of Blocks and Residences 	 5
     Selection of Survey Teams and Staff  	 6
     Presurvey Publicity  	 6
     Training of Survey Teams 	 6
     Home Visits	6
     Survey Questionnaire 	 7
     Blood Drawing and Analysis 	 7
     Environmental Sampling and Analysis  	 8

          Soil	8
          Household Dust	9
          Garden Vegetation  	 9
          Residential Paint Analysis  	   10
          Ambient Air	10

     Sample Bank Procedures  	   11
     Quality Assurance Plan and Data Validation	12
     Response to Participants and the Public	13
     Digitalization of House Locations  	   13

RESULTS	14

     Blood Lead and Erythrocyte Protoporphyrin Levels 	   14
     Soil Lead, Cadmium, and Zinc Levels	16
     Special Soil and Organic Litter Results  	   17
     Vacuum Cleaner Dust Samples	17
     Filtered Dust Samples	18
     Lead, Cadmium, and Zinc Levels in Garden Vegetation	19
     Lead-Based Paint 	   19
     Ambient Air Analysis	19
     Socioeconomic Status 	   20
     Associations of Environmental Lead Levels and
       Questionnaire Variables With Blood Lead Levels 	   20

          Soil Lead	20
          Percentage of House Yard Covered by Grass 	   21
          House Dust Lead	21

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                           TABLE OF CONTENTS  (Cont.)
                                                                        Page

          General Housekeeping 	  21
          Lead Paint	22
          Use of Storm Windows	22
          Lead-Related Hobby in Household  	  23
          Use of Neighborhood Produce	23
          Use of Dietary Supplements	24
          Type of Play Area Surface	2A
          Household Member Smoking 	  25
          Mouthing Habits  	  26

     Correlations Among Environmental and Biologic Variables 	  27

          Correlations Among Environmental Variables 	  27
          Correlations Among Sibling Blood Lead Levels 	  29

     Model for Explanation of Current Blood Lead Levels	30

DISCUSSION	34

     Associations Between Environmental Characteristics
       and Blood Lead Levels	34
     Associations Between Behavioral Characteristics and
       Blood Lead Levels	35
     Current Situation in Silver Valley  	  38
     Comparison of 1983 Idaho Blood Lead Data to National
       Blood Lead Data	39
     Comparison of 1983 Idaho Blood Lead Data to Earlier
       Idaho Data	40

REFERENCES	41

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                                 List of Tables

Number	Title	Page

  1         Mean and Range Blood Lead Levels of Smelterville (Area 1)
            Children Ages 1-9, 1974-1982	43

  2         Number of Kellogg Area Children Ages 1-12 Tested and Their
            Mean Blood Lead Levels in April 1980, October 1980,
            August 1981, and August 1982	44

  3a        ESA Laboratory Performance in the CDC Blood Lead Proficiency
            Testing Program, August-October, 1983 	  45

  3b        Mean and Range Blood Lead Levels in Children Who Participated
            in the August 1983 Kellogg Survey	46

  4a        ESA Laboratory Performance in the CDC Erythrocyte
            Protoporphyrin (EP) Proficiency Testing Program, August-
            October, 1983	47

  4b        Mean and Range Erythrocyte Protoporphyrin (EP) Levels
            of Children Who Participated in the August 1983
            Kellogg Survey 	 48

  5         Mean Blood Lead (BL) and Erythrocyte Protoporphyrin (EP)
            Levels of 1983 Survey Participants by Area and Age	49

  6a        Mean Blood Lead by Area for Children <2 Years and
            >2 Years	49

  6b        Number of Children Belonging to Two Different Age Categories
            (<2 Years and >6 Years)	50

  6c        Geometric Mean Blood Lead Levels (ug/dl) According to
            Children's Age Categories (<2 Years and >6 Years)  	  50

  7         Rank Order Listing of August 1983 Blood Lead Levels of
            364 Children by Area	51

  8         Proportion of Children Found To Be Lead Toxic, August 1983 .  . 52

  9         Number of Household Premises From Which Composite Front and
            Back Yard Soil Samples Were Collected	53

  10        Lead Levels in Soil and Organic Litter Samples Collected
            During the 1983 Kellogg Survey	54

  11        Cadmium Levels in Soil and Organic Litter Samples Collected
            During the 1983 Kellogg Survey	55

  12        Zinc Levels in Soil and Organic Litter Samples Collected
            During the 1983 Kellogg Survey	56

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                           List of Tables (Continued)

Number	Title	Page

  13        Lead Levels in Special Soil and Organic Litter Samples
            Collected During the 1983 Kellogg Survey	57

  1A        Cadmium Levels in Special Soil and Organic Litter Samples
            Collected During the 1983 Kellogg Survey 	 58

  15        Zinc Levels in Special Soil and Organic Litter Samples
            Collected During the 1983 Kellogg Survey 	 59

  16        Number of Households From Which Vacuum Cleaner Bag Dust
            Samples Were Collected 	 60

  17        Lead Levels in Vacuum Cleaner Dust Samples Collected During
            the 1983 Kellogg Survey	60

  18        Cadmium Levels in Vacuum Cleaner Dust Samples Collected During
            the 1983 Kellogg Survey	60

  19        Zinc Levels in Vacuum Cleaner Dust Samples Collected During
            the 1983 Kellogg Survey	61

  20        Lead, Cadmium, and Zinc Levels in Filtered Dust Samples
            Collected From One Square Meter of Household Carpet, Kellogg
            Survey, 1983	62

  21a       Lead Content (ppm) of Dust in 20 Homes:  Samples From Household
            Vacuum Cleaner Bags and From Special Vacuum Filters	63

  21b       Comparisons of Lead Contents in Household Dust Found by Different
            Sampling Methods:  Correlation Analyses 	  64

  21c       Comparisons of Lead Contents in Household Dust Found by
            Different Sampling Methods:  A Series of Linear Regression
            Models for Predicting Vacuum Bag Grab Sample Dust Lead .... 65

  22        Lead Levels in Carrots, Beets, Lettuce, and Garden Soil
            Samples Collected During the 1983 Kellogg Survey 	 66

  23        Cadmium Levels in Carrots, Beets, Lettuce, and Garden Soil
            Samples Collected During the 1983 Kellogg Survey 	 67

  24        Zinc Levels in Carrots, Beets, Lettuce, and Garden Soil Samples
            Collected During the 1983 Kellogg Survey 	 68

  25        Maximum Daily Lead Allowance and the Amount of Lead in a Single
            Serving of Garden Produce Needed To Exceed the Maximum Daily
            Allowance	69

  26        Number of Surfaces Found To Contain Lead-Based Paint During
            August 1983 Kellogg Survey 	 70

  27        Lead, Zinc, and Total Suspended Particulates (TSP) in Air
            Samples Collected at Five North Idaho Sites During August,
            September, and October, 1983	71

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                           List of Tables (Continued)

Number	Title	Page

  28        Mean Blood Lead Levels (ug/dl) According to Lead Content
            (ppm) of Front and Back Yard Composited Soil Samples	72

  29        Mean Blood Lead Levels (ug/dl) According to Lead Content
            (ppm) of Side Yard Soil Samples	73

  30        Mean Blood Lead Levels (ug/dl) According to Average Lead
            Content (ppm) of Front, Back, and Side Yard Soil Samples ... 74

  31        Mean Blood Lead Levels (ug/dl) According to Lead Content
            (ppm) of Flay Area Soil Samples	75

  32        Mean Ages (Years) of Children Whose Mean Blood Lead Levels
            Are Displayed in Table 26	76

  33        Mean Ages (Years) of All Children Interviewed According to
            Lead Content of Front and  Back Yard Composited Soil
            Samples	76

  34        Numbers of Households According  to Yard Grass Coverage  .... 77

  35        Mean Blood Lead Levels (ug/dl) According to Yard Grass
            Coverage	77

  36        Mean Blood Lead Levels (ug/dl) by Area and Dust Lead
            Content (ppm)  	  78

  37        Mean Blood Lead Levels (ug/dl) According to General
            Levels of Housekeeping 	 79

  38        Mean Blood Lead Levels (ug/dl) by Level of Housekeeping
            and Area	79

  39        Mean Blood Lead Levels (ug/dl) According to the Absence
            or Presence  of Lead Paint  in  the Household	80

  40        Mean Blood Lead Levels (ug/dl) According to the Absence
            or Presence  of Chipping or Peeling Lead Paint in the
            Household	80

  41        Households With and Without Storm Windows	81

  42        Mean Blood Lead Levels (ug/dl) According to Household
            Storm Window Usage	81

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                           List of Tables (Continued)

Number	Title	Page

  43        Mean House Dust Lead Levels (ppm) According to
            Household Storm Window Usage 	 82

  44        Children in Households With and Without Active Lead
            Hobbyists	83

  45        Mean Blood Lead Levels (ug/dl)  According to the Presence
            or Absence of Lead-Related Hobbies 	 84

  46        Mean EP Levels (ug/dl) According to the Presence or Absence
            of Lead-Related Hobbies 	  84

  47        Children's Frequencies of Eating Neighborhood-Grown Fruits
            or Vegetables	85

  48        Mean Blood Lead Levels (ug/dl)  According to Frequency of
            Eating Neighborhood-Grown Fruits or Vegetables 	 85

  49        Mean EP Levels (ug/dl) According to Frequency of Eating
            Neighborhood-Grown Fruits or Vegetables  	  86

  50        Children's Use of Vitamins, Minerals, or Other Dietary
            Supplements	87

  51        Mean Blood Lead Levels (ug/dl)  According to Use of Vitamins,
            Minerals, or Other Dietary Supplements  	 88

  52        Mean EP Levels (ug/dl) According to Use of Vitamins, Minerals,
            or Other Dietary Supplements 	 89

  53        Children's Use of Grassy and Nongrassy Play Surfaces 	 90

  54        Mean Blood Lead Levels (ug/dl)  According to Children's Use of
            Grassy and Nongrassy Play Surfaces 	 91

  55        Mean EP Levels (ug/dl) According to Children's Use of Grassy
            and Nongrassy Play Surfaces	92

  56        Children in Households With and Without Household Members
            Who Smoked	93

  57        Mean Blood Lead Levels (ug/dl) According to the Presence or
            Absence of a Household Member Who Smoked 	 94

  58        Mean EP Levels (ug/dl) According to the Presence or Absence  of
            a Household Member Who Smoked  	  95

  59        Households With and Without Smokers	96

  60        Households With and Without Smokers According to Annual
            Family Income	97

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                           List of Tables (Continued)

Number	Title	Page

  61        Households With and Without Smokers According to Head
            of Household's Educational Level 	 98

  62        Children's Habits of Taking Food Outside 	 99

  63        Mean Blood Lead Levels (ug/dl) According to Children's
            Habits of Taking Food Outside	100

  64        Mean EP Levels (ug/dl) According to Children's Habits
            of Taking Food Outside	101

  65        Children's Habits of Using a Pacifier, Sucking a Thumb,
            or Chewing Fingernails 	  102

  66        Mean Blood Lead Levels (ug/dl) According to Children's
            Habits of Using a Pacifier, Sucking a Thumb, or Chewing
            Fingernails	103

  67        Mean EP Levels (ug/dl) According to Children's Habits of
            Using a Pacifier, Sucking a Thumb, or Chewing Fingernails  .  . 104

  68        Correlations Among Log-Transformed Lead Levels in Soil and
            Dust Samples, All Areas	105

  69        Correlations Among Log-Transformed Lead Levels in Vacuum
            Bag Dust Samples and Soil Samples	106

  70        Correlations Among Log-Transformed Mean Blood Lead Levels
            of Siblings, All Areas	107

  71        Principal Component Analysis of Child Behavior Variables  .  .  108

  72        Principal Component Analysis of Outdoor Activity  	  109

  73        Log Blood Lead Multiple  Regression Results:  Soil Lead and
            Other Main Effects Only  (Dust Lead Excluded)	110

  74        Main Effect  Variables With Sufficient Data  for Inclusion
            in Regression Models	Ill

  75        Log Blood Lead Multiple  Regression Results:  Including
            Main and Interaction Effects  (All Children)  	 112

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                           List of Tables (Continued)

Number	Title	Page

  76        Log Blood Lead Multiple Regression Results:  Including
            Main and Interaction Effects (Children Who Remain Home
            All Day)	113

  77        Final Series of Regression Models for Assessing the Independent
            Significance of Soil Lead and Dust Lead in Predicting Blood
            Lead Levels	114

  78        Testing for the Influence of Hand-to-Mouth Activity 	 115

  79        Final Log Blood Lead Multiple Regression Model
            (All Children)	116

  80        Comparison of the Average Blood Lead Levels of Children in
            Areas 1, 2, and 3—1974, 1980, and 1983	117

  81        Percent of Children in Areas 1, 2, and 3 with Blood Lead Levels
            of 30 ug/dl or Greater, 1974 and 1983	117

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                                 List of Figures

Figure
Number	Title	Page

  1         The Percentage of Children With Lead Toxicity  (Blood
            Lead Level >. 25 ug/dl and EP >. 35 ug/dl) in Each Study
            Area                                                         118

  2         Mean Blood Lead Levels According to the Lead Content of
            Front and Back Yard Soils                                    119

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                               List of Attachments
Attachment
Number         Title
  1            Participant Consent Form

  2            Questionnaire

  3            Soil Sampling Procedures

  4            X-Ray Fluorescence Data Sheet

  5            Environmental Data Sheet

  6            Master Sample Log

  7            Letters to Parents (First)

  8            Letter and Authorization to Physician

  9            Printout of Data

 10            Letter to Parents (Second)

 11            Agenda and Public Meeting Material

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                            KELLOGG REVISITED - 1983
              CHILDHOOD BLOOD LEAD AND ENVIRONMENTAL STATUS REPORT

                      Panhandle District Health Department
                     Idaho Department of Health and Welfare
          Center for Environmental Health, Centers for Disease Control


INTRODUCTION AND BACKGROUND

An extensive survey of childhood lead absorption and heavy metal contamination
surrounding a northern Idaho lead and zinc smelter was conducted in 1974.
This investigation documented widespread absorption of lead among area
children (1).  Over 98 percent of 172 children living within 1 mile of the
smelter had blood lead levels exceeding 40 micrograms per deciliter (ug/dl).
The only two children with blood lead levels less than 40 ug/dl had recently
moved into the area.  The survey was conducted following the discovery of a
3-year-old girl and her 2-year-old sister with blood lead levels of 68 and 89
ug/dl, respectively.

Air lead levels in 1974 were as high as 30 micrograms per cubic meter
(ug/m3), or 20 times the current ambient air lead standard of 1.5 ug/m3.
Soil lead concentrations were as high as 24,000 parts per million (ppm) (2.4
percent) and averaged 7,000 ppm within 1 mile of the smelter.  A model was
developed that related childhood blood lead levels and environmental exposure
(2).  The five variables shown to be related to blood lead levels included
ambient air lead, soil lead, age of child, dustiness of the home, and
occupational status of the parents.  Soil lead levels above 1,000 ppm and
30-day mean air lead levels greater than 2 ug/m3 were found to be
unacceptable.

The results of the 1974 study prompted immediate steps to reduce the
children's exposure to their hazardous environment.  The smelter was
temporarily closed while emission control equipment was repaired and
upgraded.  Homes closest to the smelter were purchased and destroyed after the
families had relocated.  Heavily contaminated lawns were covered with new soil
and either sodded or seeded.  Equipment used to reduce dust on paved
playgrounds and streets was obtained and used extensively throughout the
community.

By 1975, an abrupt decrease in the blood lead levels was noted.  The mean
blood lead level of children tested annually continued to decline until 1979.
The number of children who were tested annually also declined from 919 in 1974
to only 27 in 1979.  No random selection of children for testing was done
between 1976 and 1982.  As a result, the sampling may not accurately represent
all children in the community.  Comparing blood lead levels obtained from
these biased samples may not be representative of all children in the area.

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In 1979, the blood lead (BL) levels of Kellogg area children appeared again to
be increasing.  The quarterly mean air lead levels also increased
significantly during 1979.  The apparent increase in BL levels can be
explained by the selection bias towards children known to have elevated BL
levels before testing.   In 1980, all children between the ages of 1 and 12
years of age who lived in Smelterville (Area 1) or Kellogg, Uardner, and Page
(Area 2) were invited to have their blood tested for BL and erythrocyte
protoporphyrin (EP).  Each of the 450 children who volunteered to be tested
was paid $15.00 cash by the Bunker Hill Company.  Follow-up volunteer BL
surveys were conducted in October 1980, August 1981, and August 1982.  Results
of these surveys suggest that BL levels of Kellogg area children continued to
decline (Tables 1 and 2).

The closure of the smelter during the last calendar quarter of 1981 resulted
in a rapid decline in the ambient air lead levels.  For the first time since
air monitoring was initiated in this area, the air lead levels fell below the
1.5 ug/m-* standard.  Since a significant air component was no longer
involved in childhood exposure to lead, the situation lent itself to studying
the relationships between the children's BL levels and non-air environmental
lead sources.

The Idaho Department of Health and Welfare (IDHW) proposed conducting a
comprehensive survey of childhood BL levels and current environmental factors
during 1983.  The survey was designed to obtain data that would be comparable
to the 1974 and 1975 surveys conducted in Idaho and also comparable to a 1983
survey conducted in the Helena Valley of Montana.  Input into the survey
design was provided by the Centers for Disease Control (CDC) and the U.S.
Environmental Protection Agency (EPA).  The Panhandle District Health
Department (PDHD) also participated in the planning of the survey.  The survey
was conducted during August of 1983.

The specific objectives of the survey were:

     1.   To determine the current BL levels of children aged 1-9 in the
          Silver Valley area.

     2.   To compare the BL levels of that population to national norms.

     3.   To study the relationship between children's BL levels and
          environmental exposures under current conditions.

     4.   To identify sources, transport mechanisms, and factors important to
          lead absorption under current conditions.

     5.   To document the health and environmental improvements achieved since
          1974.

     6.   To provide a data base for future public health and environmental
          decisions.

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PROJECT ORGANIZATION AND RESPONSIBILITIES

The August 1983 survey was a joint effort undertaken by the Idaho Department
of Health and Welfare, Panhandle District Health Department, Centers for
Disease Control, and the Environmental Protection Agency.  The contribution of
each of these agencies is listed below:

     Idaho Department of Health and Welfare

     1.  Developed study protocol and provided for its review.

     2.  Provided personnel to supervise all phases of the survey in the
         Kellogg area.

     3.  Furnished suitable space for the operations center in Kellogg and for
         the survey training.

     4.  Contracted with the PDHD to provide survey team participants.

     5.  Provided information to the public about the survey's purpose and how
         the survey would be conducted.

     6.  Prepared and printed instructions, maps, questionnaires, consent
         forms, and other materials used in the study.

     7.  Contracted with Silver Valley Medical Arts Clinic to draw blood
         specimens, ship specimens to Environmental Sciences Associates, Inc.
         (ESA), and distribute $15.00 to each child who participated in the
         survey.

     8.  Furnished equipment and containers for collecting environmental
         samples.

     9.  Provided ambient air sampling at six locations and provided the
         analysis of the air samples.

    10.  Contracted with an approved laboratory (Silver Valley Laboratory,
         Osburn, Idaho) to do the environmental analyses.

    11.  Implemented quality control practices throughout the project.

    12.  Provided data to CDC in a confidential format for analysis and
         assisted with the statistical analysis and data interpretation.

    13.  Provided follow-up on all children with elevated BL and EP levels.

    14.  Notified all study parents of the results of blood and environmental
         tests and provided an interpretation.

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15.  Participated in writing draft and, final project reports.

16.  Contracted with ESA Laboratories, Bedford, Massachusetts, to provide
     BL and EP testing.
 Panhandle District Health Department

 1.  Recruited and hired survey team participants.

 2.  Assisted the IDHW in contacting families having children with
     elevated BL and EP levels for follow-up.

 3.  Promoted the cooperation and participation of local residents.

 4.  Assisted in providing information to the public explaining the
     purpose of the survey and the procedures to be followed.

 5.  Paid for survey team participants and costs for local transportation.

 6.  Participated in writing draft and final project reports.


 Centers for Disease Control

 1.  Provided assistance in developing the survey protocol.

 2.  Assisted in training the survey team members.

 3.  Furnished lead paint analyzers.

 4.  Furnished samples of field sampling and data processing forms.

 5.  Performed data coding, data processing, and statistical analysis of
     all data and furnished the IDHW with a documented magnetic tape of
     raw survey data.

 6.  Provided interpretation of the survey data.

 7.  Assigned a CDC project officer to provide consultation and assistance.

 8.  Participated in writing draft and final project reports.


 Environmental Protection Agency

 1.  Reviewed the survey protocol.

 2.  Performed up to 50 total analyses of split environmental samples.

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     3.  Furnished audit samples and blanks that were injected into the sample
         flow.

     4.  Provided sampling, handling, and analytical assistance upon request.

     5.  Assisted with review of survey reports and summaries.

     6.  Provided a quality assurance plan for the proposed survey.

This study was funded by the Agency for Toxic Substances and Disease Registry
using monies from the trust fund established by the Comprehensive
Environmental Response, Compensation, and Liability Act.


SURVEY METHODS


Survey Populations and Survey Areas

Three survey areas were identified.  Area 1 (Smelterville) included all
residences located within 1.0 mile (1.6 kilometers) of the smelter.  Area 2
(Kellogg, Wardner, and Page) included residences between 1.0-2.5 miles (1.6
and 4 kilometers) of the smelter.  Area 3 (Pinehurst) included residences that
were 2.5 to 6 miles (4 to 10 kilometers) west of the smelter.  All areas were
defined the same as in the 1974 and 1975 surveys.  Area 3 was chosen to serve
as the source of a control population.

Numbering of Blocks and Residences

Before the survey was conducted, block maps of all three survey areas were
obtained and blocks within each area were numbered.  Area 1 blocks were
assigned consecutive numbers beginning with 100.  Area 2 blocks were assigned
consecutive numbers 200 to 299 and 400 to 419.  Area 3 blocks were numbered
300 to 356.

The initial survey protocol called for including all Area 1 residences and
every third Area 2 and Area 3 residence in the survey population.  The
protocol was subsequently modified to include every other residence in Area 2
and Area 3.  This change was needed to assure an adequate number of
participants in the survey.

Houses on each block were numbered consecutively, beginning with the house on
the most northeastern corner of the block.  The houses were numbered
counterclockwise going around the block.  The first house on the block was
alternatively assigned a "1" or a "2" so that the first house would be

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selected half of the time.  Each selected residence was assigned an
identification number.   The identification number began with a three-digit
block number and was followed by the letter "R" and a two-digit house number.
For example, identification number 210R09 referred to residence number 9 in
block 210.

Selection of Survey Teams and Staff

The Panhandle District Health Department contracted with IDHW to interview and
hire survey team members and project staff.  Four survey teams were selected.
Each was composed of a team leader (usually a registered nurse), two
environmentalists, and one person to operate the X-ray fluorescence (XRF)
detectors.  In addition, the Panhandle District Health Department provided a
survey coordinator, a sample bank officer, and a project secretary.

Presurvey Publicity

Three weeks before the planned survey, numerous meetings were held with local,
county, and state elected officials to describe the purpose of the proposed
survey.  Local physicians and the Lead Surveillance Advisory Committee were
informed about the proposed survey.  The mayors of Kellogg and Smelterville
assisted in making two 30-second radio spots promoting participation in the
survey.  Articles were prepared for local newspapers.  Widespread community
support for the survey was obtained before the survey began.

Training o_f_ Survey Teams

All survey team members participated in two days of training before the
survey.  The purpose of the survey was explained, in detail, to the team
members so they would be able to answer most questions that participants would
ask.  The administration of the questionnaire and the collection and handling
of environmental samples were explained and demonstrated.  Before beginning
the actual survey, the survey teams practiced their interviewing and sampling
techniques with persons in two residences outside the survey areas.

Home Visits

Each survey team was assigned a specific area to begin the door-to-door
survey.  All residences in Area 1 and every other residence in Areas 2 and 3
were visited to find children between the ages of 1 and 9 years of age.  In
homes where eligible children were found, parents were encouraged to
participate in the survey.  One survey team member explained the purpose of
the survey and the need to collect blood samples from children and
environmental samples from the residence.  A consent form (Attachment 1) was
then signed by the parent or guardian before the questionnaire was
administered or environmental samples were collected.  While one team member

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was administering the questionnaire, the other three team members were
collecting environmental samples or checking painted surfaces for lead-based
paint.  During the home visit, an appointment was made for the children to
have their blood drawn at a local clinic.

Survey Questionnaire

The Center for Environmental Health, CDC, developed the 18-page questionnaire
used by the survey team.  The questionnaire was similar to ones used by CDC in
other surveys of children living near lead smelters.  The questionnaire was
designed to be administered to an adult household member.  If the children in
the household had lived at the address for 3 months or less, the interview was
terminated and the children were not included in the survey.

The questionnaire collected child- and household-specific information.  Name,
age, sex, and information on daily play habits were collected for each child.
Parental occupational histories, as well as information on lead hobbies and
the age and type of the housing structure, were collected for each household.
A copy of the questionnaire is included as Attachment 2.

Blood Drawing and Analysis

An appointment card, as shown below, was given to the participant during the
home visit.  The participants were instructed to take their eligible children
to the Silver Valley Medical Arts Clinic in Kellogg to have their children's
blood specimens drawn at the scheduled time.  The blood drawing was scheduled
within two weeks of the home visit.  A second appointment was arranged for
participants who did not keep their first appointment.  Each child was given
$15.00 in cash after having his or her blood drawn.
                      in Kellogg for
                      at
                      Present this card at the clinic  to

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All blood samples were collected in lead-free vacutainer tubes manufactured by
Becton-Dickinson.  Blood samples were shipped to ESA Laboratories, Inc.,
Bedford, Massachusetts, every other day.  Blind control blood samples were
included with the bloods sent to ESA.  All blood samples were tested for BL by
using the anodic stripping voltametry (ASV) method (3) and for EP by using an
extraction procedure (4).  As part of its normal operating procedure, ESA
Laboratories participated in nine external quality control programs for BL and
EP measurements.  During this time, ESA also provided reference laboratory
services for five other lead testing programs.  ESA performed duplicate
analyses of BL and EP for each sample submitted.  Whenever the results of
these duplicate analyses differed by more than ±10%, the analyses were
repeated.  For additional internal quality control, ESA inserted spiked,
reference, blank, and pooled samples into its sample stream at the rate of
15%.  For further external validation of ESA analyses, 21 blind, duplicate
blood samples were sent to ESA, and 25 duplicate samples were sent to the
Clinical Chemistry Division (now the Division of Environmental Health
Laboratory Sciences), Center for Environmental Health, CDC, for analysis.
Hemoglobin was not measured.

Environmental Sampling and Analysis

Soil.  Soil samples were collected at each residence where participating
children lived.  The top 1 inch of mineral soil was collected by using a JMC
conventional T-handle core sampler (Clements Associates, Inc., Newton, Iowa
50208).  Four subsamples from the front yard and four subsamples from the back
yard were composited for a single soil analysis (soil 1).  All subsamples were
taken at least 1.5 meters from the street, curb, or sidewalk, and at least 1.5
meters from the house.  Four additional subsamples of soil taken within 1.0
meter of the side of the house were composited for a single analysis (soil
2).  Similar soil samples were collected from play areas (soil 3) and from
gardens.

At every seventh residence included in the survey, duplicate soil samples were
obtained by using the core samplers.  In addition, special soil samples were
collected by using a 5-inch hand trowel as was done during earlier surveys in
Idaho (5).  Organic litter samples composed of the top layer of grass and
decaying vegetative matter were also saved for analysis at every seventh
participating residence.

Soil sampling equipment was washed thoroughly with soap and water after soils
were collected at each residence.  Scalpel blades, used to separate organic
layers from mineral soil, were changed for each residence.  The sampling
equipment was washed and then rinsed with deionized distilled water.  Samples
of the rinse water were analyzed to determine how thoroughly the equipment was
being cleaned.

Soil and litter samples were placed in 27-oz. whirlpacks and labeled to show
the type of sample, the identification number of the residence, the address of
the residence, the site sampled, the collection date and time, and the name of
the person collecting the sample.  The soil samples from each residence, along
with the other environmental samples from that residence, were placed in a
large paper grocery bag for transport to the sample bank.

Details of the soil sampling procedures for this survey are included in
Attachment 3.

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Soil samples were analyzed for lead, cadmium, and zinc by using an atomic
absorption procedure similar to that described by Fairell (6) and found to be
acceptable by the Environmental Monitoring Systems Laboratory (EMSL) in Las
Vegas, Nevada.  The soil samples were dried overnight and passed through an
80-mesh stainless steel sieve.  The pulverized samples were weighed (+ 5 mg)
and digested with 1:1 nitric acid (HN(>3) and tetrafluoroboric acid
(HBF^).  The extract was allowed to settle, and the supernatant was analyzed
by atomic absorption.  All soil results were reported on a dry weight basis in
parts per million (ppm).

Household dust.  Two types of household dust samples were collected during
this survey.  One dust sample was collected from vacuum cleaner bags available
at the participating residences.  This dust sample was used as a
semiquantitative measurement of the amount of lead, cadmium, and zinc found in
house dust.  This vacuum bag sample was the same as that used during the 1974
and 1975 surveys in Idaho.

Survey participants were requested to allow a team member to obtain a dust
sample from their vacuum cleaner bag.  In most instances, the entire vacuum
was taken outside and the vacuum bag removed.  A 27-oz. whirlpack bag was
filled with dust taken from the vacuum bag.  The vacuum was reassembled and
returned to the participant.  The dust sample was labeled and transported to
the sample bank.  No dust sample was collected if the vacuum had been used
outside the residence since the bag had last been changed.

Vacuum bag dust samples were analyzed for lead, cadmium, and zinc by an atomic
absorption procedure similar to that described for soils.  The dust samples
were digested with 1:1 HN03 and HBF4, and the supernatant was analyzed by
atomic absorption.  The results were reported on a dry weight basis in parts
per million (ppm).

A specifically designed vacuum filter system was also used to collect another
household dust sample at 40 residences.  The device employed a high-volume air
sampler and a fiberglass filter to trap the dust removed from one square meter
of living room carpet.  This sample represented a more quantitative
measurement of the amount of dust in a given area.  A plexiglass template was
used to identify a one square meter area for vacuuming.  This area was then
vacuumed for one minute.  The dust was trapped on a preweighed fiberglass
filter.  The filter was carefully removed and placed in a plastic bag for
transport to the laboratory.  These dust samples were analyzed by the Montana
Department of Health and Environmental Services, Helena, Montana.

Garden vegetation.  The survey teams inquired about gardens used by the survey
participants.  If the participants had a garden and were eating carrots,
beets, or lettuce from their garden, samples of vegetation were collected for
analysis.  Disposable gloves were worn when garden produce was collected to

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reduce contamination of the produce.   Lettuce was clipped above any visible
splash line or at least 4 centimeters above the ground.  Only edible portions
of the plant were taken.  One large handful of lettuce was collected and
placed in a small paper bag.  Three or four carrots were collected when
available.  The tops of the carrots were removed, and the edible portion was
saved for analysis.  Three or four beets were likewise collected; however, the
entire beet, including the top, was saved for analysis.

All vegetation samples were washed thoroughly before analysis by atomic
absorption at the Silver Valley Laboratory.  The lead, cadmium, and zinc
levels in the vegetation were reported on a dry weight basis in parts per
million.

Residential paint analysis.  Interior and exterior painted surfaces in the
homes surveyed were tested for the presence of lead-based paint by using a
portable X-ray fluorescence (XRF) instrument (Princeton Gamma Tech, Princeton,
NY, Model XK3).  The instrument measured the milligrams of lead per square
centimeter (mg/sq cm) in painted surfaces without destruction of the surface.
Any reading above 0.7 mg/sq cm was considered positive for lead.  All XRF
readings were recorded on the X-ray fluorescence data sheet (Attachment 4).

Ambient air.  Ambient air samples were collected at five sites during the
months of August, September, and October, 1983, by the Idaho Division of
Environment.  The five sampling sites included:  (1) Silver King
School—adjacent to the smelter complex, (2) Smelterville City Hall—0.5 miles
west of the smelter, (3) Silver Valley Medical Arts Clinic—1.5 miles east of
the smelter, (4) Pinehurst Elementary School—3.5 miles west of the smelter,
and (5) the Osburn radio station—8 miles east of the smelter.  All sites
except the Smelterville site were ongoing state air monitoring sites.

Samples were taken every third day for 24 hours plus or minus 15 minutes,
midnight to midnight.  Samplers were standard General Metal Works (Cleves,
Ohio, Model 2000H), high-volume particulate samplers fitted with mechanical
timers, flow recorders, and elapsed time indicators.  Standard high-purity
fiberglass particulate filters (Whatman EPM-2000, Clifton, NJ) were used to
collect the particulates for laboratory analysis.  IWDH analyzed these filters
for total suspended particulates (TSP), lead, cadmium, and zinc by using an
atomic absorption method (7).

The ambient loading was calculated by using the standard technique:

(n)(3.5311 x 104j^ = Average 24-hour ambient pollutant loading
         (t) (f)                 (ug/m3)

where n = net weight of pollutant on filter (mg)
      t = elapsed time in minutes
      f = adjusted flow through samples (cubic feet/minute)
                                     10

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Sample Bank Procedures

Individual survey  team  members were responsible for collecting appropriate
environmental  samples,  labeling the samples correctly, and transporting  the
samples back to  the  sample bank/survey headquarters.  All environmental
samples were labeled with the sample tag as shown below:
                                 KELLOGG 1983

                         Saaple Bank Ho.

                          Soil     Dust    Vegecaeion
                         Sample Bank No.
                           Soil
                                  Dust
                                         Vegetation
                                          123
1 2 3 S G   12

ID*	

Address or Location:


Sice: Home  Playground   Other
                        Date:
                                       Tine:
                        Sampler:

                        Remarks:
All samples  from a single residence were placed  in a  large paper bag, along
with a  completed environmental data sheet (Attachment 5)  showing the type and
number  of  samples collected at each residence.   The environmental data sheet
was signed by the survey team member who collected the samples and assured
that all samples were included in the bag.  The  environmental data sheet was
placed  in  the bag with the samples before the bag was sealed with staples.

When bags  of samples arrived at the sample bank, the  sample bank officer
verified that all samples listed on the environmental data sheet were received
and assigned a sample bank number to each sample.  The sample bank number was
written on the top and bottom portion of the sample tag shown above, on the
environmental data sheet, and in the master sample log (Attachment 6).  The
                               11

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sample tags were then cut on the dotted line to remove the sample
identification information.   This assured that the laboratory had no knowledge
of the source of the sample, or which samples were duplicates or quality
control samples.

The environmental samples were sorted by sample type and placed in large paper
bags for transport to the laboratory.  After the samples were rechecked
against the master sample log, the pink and yellow copies of the sample log
were placed in the bag of samples and the bags sealed.  The environmental
samples were taken to the laboratory where they were checked against the
sample log by the laboratorian who accepted the samples.  These extensive
chain of custody procedures were undertaken to assure that samples were not
lost between collection and analysis.

Quality Assurance Plan and Data Validation

A quality assurance project plan for this survey was prepared by the staff of
the Environmental Monitoring Systems Laboratory (EHSL) in Las Vegas, Nevada
(8).  In addition to the chain of custody procedures described above, the plan
also specified quality assurance procedures for the laboratory analyses and
the use of quality control samples.  EHSL staff also conducted an evaluation
of the Silver Valley Laboratory on September 28-29, 1983.  From this
evaluation, EMSL concluded that the Silver Valley Laboratory could
satisfactorily analyze the environmental samples for lead, cadmium, and zinc.
The minimum detection levels for soil and dust were set at 100 ppm for lead, 5
ppm for cadmium, and 100 ppm for zinc.  For vegetation samples, the detection
levels were 10 ppm for zinc, 1 ppm for lead, and 1 ppm for cadmium.

Duplicate soil, dust, and vegetation samples were collected at every seventh
residence that participated in the survey.  Quality control materials,
consisting of river sediment (NBS SRH 1645), urban particulate matter (NBS SRM
1648), control soil samples, and control vegetation samples (water hyacinth),
were obtained from EHSL and analyzed with each batch of environmental samples.

All results of the soil, dust, and vegetation samples were submitted to EHSL,
along with the results of reagent blanks, spiked samples, duplicate analyses,
field blanks, and the Silver Valley Laboratory's quality control data.  EHSL
staff found these data to be acceptable and concluded that the work was
performed according to the quality assurance plan.

Twenty-nine soil samples were analyzed by the Silver Valley Laboratory and by
the EPA Region X laboratory.  Interlaboratory comparability of the results
indicated acceptable performance by both laboratories.
                                        12

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Response to Participants and the Public

The parents of each child who participated in the survey received two letters
explaining the results of the survey.  The first letter was mailed to the
parents as soon as the BL and EP levels became available.  The first letter
gave parents their children's BL and EP levels, along with an interpretation
of the results (Attachment 7).  If any child had an elevated BL or EP, a copy
of the letter and results was also sent to the family physician, along with an
authorization for the physician to evaluate the child and obtain additional
laboratory tests (Attachment 8).

A second letter, along with a computer printout of all environmental data, was
mailed to the parents of each participating child in May 1984.  An example of
the printout sent to parents is included as Attachment 9.  The letter
(Attachment 10) contained a brief summary about limiting consumption of
locally grown garden produce and an invitation to attend a public meeting on
June 13, 1984.

A public meeting was held at the Kellogg Junior High School on June 13, 1984,
to answer any questions parents or other members of the community had about
the results of the survey.  Fewer than 12 parents attended.  A copy of the
agenda and material presented at this public meeting is included as Attachment
11.  Before the public meeting, a meeting with local elected officials and one
with local physicians were held to present the results of the survey.

Digitalization of House Locations

IDHW digitalized the locations of 219 households from a map containing both
the households and the smelter.  The distance from each of these households to
the smelter was then determined to the nearest tenth of a mile.  This set of
actual distance data was merged with each child's record by the household
identification number.
                                    13

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RESULTS

Blood Lead and Erythrocyte Protoporphyrin Levels

The numbers of eligible children, i.e., those who met the age and residence
criteria, were 46 in Area 1, 223 in Area 2, and 131 in Area 3, giving a total
of 400 eligible children.  Participation rates were 94% in Area 1, 90% in Area
2, and 94% in Area 3, giving an overall participation rate of 91%.

Forty-three Area 1, 199 Area 2, and 122 Area 3 children had their BL levels
determined.  The BL levels ranged from 1 to 45 ug/dl.  Analyses of BL levels
were within acceptable quality control limits at ESA Laboratories during the
months in which these samples were analyzed, as documented by ESA performance
in the CDC BL proficiency testing program (Table 3a).  Blood samples from 25
children were analyzed by both ESA Laboratories and CDC.  No statistically
significant difference was found between the natural log transformations of
the BL levels reported from the two laboratories (Paired-comparisons t test: t
= 1.58, d.f. = 24, p = 0.13).

The mean BL level was 21 ug/dl for Area 1 children, 17 ug/dl for Area 2
children, and 12 ug/dl for Area 3 children (Table 3b).  Natural log
transformations of individual BL values were used in all statistical
comparisons among study areas in order to normalize BL and EP distributions.
Mean log-transformed BL values were significantly different among the three
study areas (F = 34.92, d.f. = 2, p = 0.001).

A simple, first-order inverse linear relationship was demonstrated between
children's BL levels and the distance in miles between the smelter and the
children's homes (F = 45.04, p = 0.0001; r2 = 0.1204). The estimated
response function was found to be

                              Y = 2.9544 - 0.1468 X
where
                                     Y = Ln (BL)
                             and X = Number of miles

Forty-three Area 1, 199 Area 2, and 121 Area 3 children had their EP levels
determined.  The EP levels ranged from 11 to 153 ug/dl.  Analyses of EP levels
were within acceptable quality control limits at ESA Laboratories during the
months in which these samples were analyzed, as documented by ESA performance
in the CDC EP proficiency testing program (Table 4a).  Blood samples from 25
children were analyzed by both ESA Laboratories and CDC.  Natural log
transformations of the EP levels reported by CDC were significantly less than
those reported by ESA Laboratories (Paired-comparisons t test: t = -11.77,
d.f. = 24, p = 0.0001).  This discrepancy is likely to be due to the EP
                                    14

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levels' being relatively close to the detection,limits of both laboratories.
                                               r.
For the 25 shared samples, the reported geometric mean EP levels were 1A.5
ug/dl (CDC) and 18.0 ug/dl (ESA).

The mean EP levels were 35, 27, and 22 ug/dl for Area 1, 2, and 3 children,
respectively (Table 4b).  Mean log-transformed EP values were significantly
different among the three study areas (F = 11.10, d.f. = 2, p = 0.0001).

When examined by age, the BL and EP results showed that the highest mean
values generally occurred in the 1- to 5-year-olds in each area.  The 2- to
5-year-olds from Area 1 had higher mean BL and EP levels than the 2- to
5-year-olds from Area 2.  The 2- to 5-year-olds from Area 2 likewise had
higher mean BL and EP levels than the 2- to 5-year-olds from Area 3.  Area 1
children between the ages of 1 and 5 years had mean BL levels about two times
those of similar aged children from Area 3 (Table 5).

One- and two-year-old children in Area 1 had a mean BL level of 22 ug/dl, a
value similar to the mean BL level of older children in the same area (21.1
ug/dl) who were born before the'smelter closed (Table 6a).   Similarly, the BL
levels of children less than or equal to 2 years old were not significantly
different from those of children 6 years old or older in any of the three
study areas (Tables 6b, 6c).

Eighty-six percent of the children had a BL level less than 25 ug/dl.  Only
1.4 percent had a BL level of 40 ug/dl or greater.  A rank order listing of
all BL levels is shown in Table 7.  The 25th percentile of the BL frequency
distribution was 10 ug/dl; the 50th percentile was 14 ug/dl; and the 75th
percentile was 20 ug/dl.

Four major risk classifications have been established for children who have
been exposed to lead (9).  These have been useful in setting priorities for
medical evaluation of screening results.  The risk classifications are based
on EP and BL levels.  No children were identified to have either of the two
highest risk classifications (Class III or IV).  Thirty-one children, 11 from
Area 1, 18 from Area 2, and 2 from Area 3, were classified as having lead
toxicity.  These children had a BL of at least 25 ug/dl and an EP of at least
35 ug/dl.  The proportion of children in each area who were lead toxic is
shown in Table 8.  Figure 1 graphically displays the percentage of children
within each area.  The marked differences shown in Figure 1 reflect the
significant differences in BL and EP values among the three study areas.
                                     15

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Soil Lead. Cadmium, and Zinc Levels

Table 9 gives the number of households from which composite samples of
front and back yard soils were collected in each study area, according to
the levels of soil lead found.

Table 10 shows that the soil lead levels ranged from 83 to 18,400 ppm in
Area 1; 53 to 41,200 ppm in Area 2; and 37 to 6,370 ppm in Area 3.  These
results indicate that the distribution of soils with high lead levels is
not uniform throughout the valley.  For the various types of soil samples
collected, Area 1 mean soil lead levels were 1,000 to 2,000 ppm higher
than Area 2 mean soil lead levels.  The mean Area 1 soil lead levels were
about 4,000 ppm higher than the mean Area 3 soil lead levels.  The high
mean lead for soil sample type number 2, those collected within 1.0 meter
of the house walls, may reflect the presence of lead paint that had
fallen from house walls.

Because of the skewed distribution of the soil lead levels, geometric
means provided more appropriate estimates of the central tendencies of
these data.  Comparisons of the geometric mean soil lead levels by
analysis of variance showed statistically significant differences for
composite samples of front and back yard soils across all three study
areas (F = 126.5, d.f. = 2, p = 0.0001).

For comparison, soil lead levels of 500-1,000 ppm appear to be
responsible for increasing BL levels in children above background levels
(9).  Garden soil lead levels in a recent metropolitan study were as high
as 10,900 ppm and had a median value of only 100 ppm (10).

The cadmium levels in soil averaged about 100 times less than the lead
levels (Table 11).  Cadmium levels ranged from 2 to 160 ppm in Area 1,
from 3 to 125 ppm in Area 2, and from 3 to 119 ppm in Area 3.  Cadmium
levels in Area 1 averaged about twice the cadmium levels in Area 2 and
four times the cadmium levels in Area 3.  For comparison, Mielke et al.
(10) recently described cadmium levels in inner-city soils to be as high
as 13.65 ppm and to have a median value of 0.56 ppm.  These values
reported by Hielke are consistent with those reported elsewhere.  The
mean cadmium concentration found in 1,642 soil samples collected from
relatively uncontaminated areas in different parts of the world was 0.62
ppm, and the individual values ranged from less than 0.005 to 10 ppm (11).

The zinc levels in soil were about one-third the lead levels.  Zinc
levels ranged from 115 to 8,287 ppm in Area 1, from 92 to 9,847 ppm in
Area 2, and from 62 to 9,120 in Area 3 (Table 12).  Zinc levels in
Mielke's study ranged from 0.30 to 4,880 ppm, with a median level of 92
ppm.  For further comparison, the mean zinc concentration found in 7,402
soil samples collected from different parts of the world was 59.8 ppm,
and the individual values ranged from 1.5 to 2,000 ppm (11).
                                 16

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Special Soil and Organic Litter Results

Special soil samples and organic litter samples were collected at every
seventh participating residence.  The special soil samples were collected
by using the same techniques used in the 1974-1975 surveys.  The
geometric mean lead level in the special soils from Area 1 (3,684 ppm)
was about the same as the geometric mean lead level in Area 1 core
samples (3,474 ppm).  The geometric mean lead level in the special soils
from Area 2 (3,410 ppm) was greater than the level in core soil samples
from Area 2 (2,632 ppm).  In Area 3, the geometric mean lead level in
special soil samples (509 ppm) was nearly the same as that in core soil
samples (481 ppm).  Numbers of special soil samples tested and the ranges
of lead levels found in them are listed in Table 13.  Further comparisons
of the two soil sampling techniques will allow soil data obtained in
earlier surveys to be more accurately compared with those obtained in
August 1983.  The cadmium and zinc levels in the soil samples collected
by using the two different techniques were nearly the same (Tables 14 and
15).

Organic litter samples were composed of the grass and decaying vegetative
matter found on top of the mineral soil.  The thickness of the organic
litter layer varied from 0 to 4 cm.  Geometric mean lead levels in the
litter portion of the core samples were less than the lead levels in the
soil portion in all three areas (Table 12).  The relationship between the
geometric mean lead levels in the litter and soil portions of special
samples varied across all three study areas (Table 13).  In Area 1, the
geometric mean lead level was higher in the organic litter than in the
soil portion of the special samples.  In Area 2, the geometric mean lead
levels in the organic litter and the soil portion were approximately
equivalent.  In Area 3, the geometric mean lead level in the organic
litter was less than that in the soil portion.  The relationships between
the levels of cadmium and zinc in the litter and soil portions of core
and special soil samples also varied among the three study areas (Tables
11, 12, 14, and 15).

Vacuum Cleaner Dust Samples

Table 16 displays the number of households from which samples of vacuum
cleaner bag dust were collected by study area and the lead content of
these house dust samples.  As with soil lead levels, geometric means
provided better estimates of the central tendencies of house dust lead
levels.  Table 17 gives arithmetic and geometric means and standard
deviations for the house dust lead levels in each area.  Statistical
comparisons of geometric mean house dust lead levels showed significant
differences among all three study areas (F = 58.80, d.f. = 2, p = 0.0001).
                                         17

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 !he lead levels ranged from 221 to 10,395 ppm and were highest in samples
r'rom Area 1 and lowest in samples from Area 3.  For comparison, house
dust containing lead levels over 1,000 ppm or 50 micrograms per square
meter has been determined by other investigators to present an
unnecessary hazard for children (12).  The geometric mean lead level in
dust from Area 1 (3,933 ppm) and Area 2 (2,489 ppm) were slightly less
than the mean lead levels found in soils from the same areas.  The
geometric mean dust lead level found in Area 3 (1,138 ppm) was about two
times greater than the mean lead levels found in soil samples in that
area (481 ppm).

The geometric mean cadmium levels in dust from Area 1 and Area 2 were
approximately the same as those in soil from these areas (Table 18).  The
geometric mean cadmium level in dust from Area 3 (25 ppm) was more  than
twice that found in soil from Area 3 (10 ppm).

Dust geometric mean zinc levels were twice the soil levels in Areas 1 and
2 and three times the soil levels in Area 3 (Table 19).

Filtered Dust Samples

Household dust samples collected from one square meter of carpet were
analyzed by the Montana Department of Health and Environmental Sciences
(MDHES).   MDHES pelleted the excess dust from each of the most heavily
Loaded of these special vacuum filters for XRF analysis.  The lead,
ladmium,  and zinc levels found in these pelleted dust samples are shown
in Table 20.  Tables 21a-c compare the lead contents of dust samples from
special vacuum filters with those from household vacuum cleaner bags.
These tables list resuspended coarse (2.5 to 15 micron diameter) and fine
(0 to 2.5 micron diameter) particulates as two types of samples from the
special vacuum filters.  MDHES produced these coarse and fine particulate
samples by resuspending dusts from the glass fiber filters used in  the
special vacuuming procedure in Idaho.  These resuspended dust particles
were collected on Teflon filters for XRF analyses.  Both the mean and the
upper range of the lead content found in fine particulates were
substantially greater than those found in either the coarse particulates
or the grab samples of dust from household vacuum cleaner bags.
Correlation analyses (Table 21b) and linear regression analyses (Table
21c) confirm that the lead contents of coarse particulates and vacuum bag
grab samples are significantly correlated in a positive linear fashion.
The lead content of fine particulates, however, is uncorrelated with the
lead content of grab samples from household vacuum cleaner bags.
                                         18

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Lead. Cadmium, and Zinc Levels in Garden Vegetation

Carrots, beets, and lettuce from gardens in each study area were tested
for lead (Table 22), cadmium (Table 23), and zinc (Table 24).
Calculations based on the maximum daily allowance (MDA) for lead (Table
25) show that a single half cup of a 4-oz. serving of garden produce,
with a lead content of only 15 ppm, would exceed the MDA for a child
under 2 years of age.

Lead levels in vegetation ranged from 6 to 246 ppm (dry weight).  Cadmium
levels ranged from 1 to 66 ppm (dry weight), and zinc levels ranged from
30 to 1,332 ppm (dry weight).  Although the zinc levels were found to be
higher than the lead and cadmium levels, the zinc levels are not believed
to be significant because of the lower toxicity of this metal.  Zinc is
an essential mineral for which a daily dietary allowance of 10 milligrams
has been recommended for children between the ages of 1 and 10 years
(13).  Nevertheless, given the limited exposure data that were collected
in this study on cadmium and zinc, no definitive health risk conclusions
can be drawn for these two metals.

Lead-Based Paint

Painted surfaces at nearly 400 residences were tested for the presence of
lead-based paint.  Of the 2,319 surfaces tested, 1,801 (78%) did not
contain detectable levels of lead-based paint (i.e., they had less than
0.7 milligrams of lead per square centimeter (mg/sq cm)).  Of all
surfaces tested, 9.5% had moderate to high levels of lead-based paint
(i.e., 3.0 mg/sq cm or more).  Since several surfaces were tested in each
house, the percentage of houses with moderate to high levels of
lead-based paint was considerably less than 9.5%.  These results are
summarized by area in Table 26.

Ambient Air Analysis

Air samples were collected during August, September, and October at four
different sites in the survey area and one site (Osburn radio station)
outside of the survey area.  All 143 samples were analyzed for total
suspended particulates, lead, zinc, and cadmium.  Air lead levels ranged
from nondetectable to 0.94 ug/cubic meter.  The mean air lead level? by
area ranged from 0.10 to 0.28 ug/cubic meter.  Mean air zinc levels by
area ranged from 0.05 to 0.11 ug/cubic meter (Table 27).
                                        19

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Socioeeonomic Status

The proportion of participating households that reported total annual
family incomes of less than $10,000 was similar among all three study
areas (chi-square = 6.12, p = 0.19).  The proportion of participating
households that reported that the head of the household had not completed
high school also was similar among all three study areas (chi-square =
0.497, p = 0.78).  By these measurements, the participating households in
all three study areas were similar in terms of socioeconomic status.

Associations of Environmental Lead Levels and Questionnaire Variables
With Blood Lead Levels

Soil Lead

Tables 28-31 display the mean BL levels of children within each of the
three study areas according to the lead levels found in various soils
around their homes.

The soil lead levels categorized in Table 28 represent samples of front
and back yard soils composited before analysis.  Within both Areas 1 and
2, children with the most highly contaminated front and back yard soils
(>10,000 ppm) had the highest mean BL levels.  Furthermore, within both
Areas 1 and 2, children with less contaminated front and back yard soils
tended generally to exhibit a dose-response effect between their soil
lead categories and mean BL levels.  Figure 2 illustrates this upward
trend in mean BL levels seen with increasing soil lead categories in
Areas 1 and 2.  Figure 2 also illustrates the relative constancy of mean
BL levels among all soil lead categories in Area 3.

The soil lead levels categorized in Table 29 represent side yard soil
samples.  As shown by these data, children within Area 2 who had more
highly contaminated side yard soils tended, in general, to have higher
mean BL levels.  The soil lead levels categorized in Table 30 are the
averages of the composited front and back yard soil samples and the side
yard soil samples.

The soil lead levels categorized in Table 31 represent samples taken from
children's play areas.  For those soil lead categories with observations
for more than 10 children, mean BL tended to increase with increasing
soil lead within each area.
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Table 32 gives the mean ages of children whose BL levels are displayed in
Table 28.  For all area and soil lead categories in which the number of
children tested was 10 or more, mean ages were similar and ranged between
4.5 and 6.1 years.  Table 33 lists the mean ages of all children
interviewed according to the lead content of front/back yard soil samples.

Percentage of_ House Yard Covered bŁ Grass

Table 34 shows the distribution of households in the three study areas
according to the percentage of the house yard covered by grass.  The
larger proportion of Area 3 houses having complete or nearly complete
ground cover is statistically significant (chi-square = 16.75, d.f. = 6,
p = .01).

Table 35 gives the mean BL levels of children within each study area
according to the percentage of the the house yard covered by grass.
Within each of the three study areas, mean BL levels showed no consistent
variation with the percentage of grass covering the yard.  In Areas 2 and
3, mean BL levels were highest where grass cover was 25% or less.  In
Area 1, mean BL levels were similar among all categories of yard grass
coverage.

House Dust Lead

Table 36 .gives the mean BL levels of children within each of the three
study areas according to the lead levels found in vacuum cleaner bag
samples collected from their homes.  In Area 1, dust samples collected
for 22 of 28 children (78%) had lead levels of 2,501-5,000 ppm.
Inadequate sample representation among the other house dust lead
categories in Area 1 prevents assessing how the mean BL level might have
varied with respect to house dust lead level in this area.  In Area 2,
dust samples collected for 121 of 142 children (85%) had lead levels of
1,001-2,500 ppm or 2,501-5,000 ppm.  For these two dust lead categories
in Area 2, the higher mean BL level was associated with the higher dust
lead category.  In Area 3, dust samples collected for 77 of 86 children
(87%) had lead levels of 501-1,000 ppm or 1,001-2,500 ppm.  For these two
dust lead categories in Area 3, the higher mean BL level was associated
with the higher dust lead category.

General Housekeeping

Observations on general housekeeping were recorded by the
environmentalist members of the field data collection teams.  These
observations represented subjective impressions of overall levels of
housekeeping.
                                        21

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table 37 gives the mean BL levels of children within each of the three
study areas according to the general level of housekeeping observed.  As
Table 37 shows, few children in Area 1 lived in households classified as
having poor or excellent housekeeping.  To obtain adequate numbers for
statistical comparisons of housekeeping practices among the three study
areas, we combined the households classified as "poor" and "fair" and
those classified as "average" and "excellent," as shown in Table 38.  We
found no difference among the three study areas with respect to the
proportions of houses with less than average or better housekeeping
(chi-square = 2.97, d.f. = 2, p = 0.22).  We did find, however, that
children living in Area 3 in houses with less than average housekeeping
had a statistically higher mean BL level than children living in houses
with average or better housekeeping (t = 2.86, p = 0.005).

Lead Paint

Tables 39 and 40 classify the mean BL levels of children within each
study area according to (1) whether lead was detected by XRF on any
interior or exterior surface of the child's home and (2) whether lead
paint was detected along with a chipping or peeling surface in the home.
Within each area, mean BL levels were similar for (1) children living in
homes with and without detectable lead paint and (2) children living in
homes with and without detectable lead paint that was chipping or
peeling.  The relevant Student's t statistics and associated
probabilities for these comparisons of log-transformed mean BL levels are
listed in Tables 39 and 40.  Corrections were made for unequal variances.

Use of Storm Windows

Table 41 gives the numbers of houses with and without storm windows in
each study area.  All areas had similar proportions of houses with storm
windows (chi-square = 0.33, d.f. = 1, p = 0.84).  Table 42 gives the mean
BL levels of children within each study area according to whether they
lived in houses with or without storm windows.  Comparisons of the log
transformations of these mean BL levels in Areas 1 and 2 showed
statistically significant differences between children living in houses
with storm windows and children living in houses without storm windows.
The difference in mean BL levels between these two groups in Area 3
approached statistical significance.  The statistics of these comparisons
are listed in Table 42.  In all three areas, children living in houses
without storm windows had higher BL levels.
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Table 43 gives the mean house dust lead levels within each study area
according to household usage of storm windows.  Comparisons of the
log-transformations of these mean house dust lead levels showed a
statistically significant difference in Area 2 between households that used
storm windows and households that did not, with the higher house dust lead
level in households that used storm windows.  The statistics of the
comparisons for each study area are listed in Table 43.

Lead-Related Hobby in Household

Table 44 gives the number of children within each area who lived in a
household where at least one family member had practiced a lead-related hobby
often during the 3 months before the study.  The proportion of children who
lived in a household with an active lead hobbyist was similar in all three
study areas (chi-square = 2.475, d.f. = 2, p = 0.29).

Table 45 gives the mean BL levels of children within each study area according
to whether or not they lived in a household with an active lead hobbyist.  We
found no significant difference between the log-transformed mean BL levels of
children living in the presence or absence of lead-related hobbies in Area 2
(t = 0.13, p = 0.90) or in Area 3 (t = 0.79, p = 0.43).  A statistically
significant difference did exist between the log-transformed mean BL levels of
these two groups in Area 1 (t = 2.73, p = 0.01), where the higher mean BL
level was associated with the absence of a lead-related hobby.

Table 46 gives the mean EP levels of children within each study area according
to whether or not they lived in a household with an active lead hobbyist.  We
found no significant difference between the log-transformed mean EP levels for
these two groups in Area 1 (t = 1.27, p = 0.21) or Area 3 (t = 0.05, p =
0.96).  In Area 2, children living in households with an active lead hobbyist
had a statistically significantly higher log-transformed mean EP level than
children living in households without an active lead hobbyist (t = 2.47, p =
0.01).

Use 
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Table 48 gives mean BL levels for children within each study area according to
how frequently the children were reported to eat locally grown produce.
Comparisons of the log-transformed mean BL levels for these two groups showed
no statistically significant differences within any study area.  Table 48
lists the relevant statistics for these mean BL level comparisons.

Table 49 gives mean EP levels for children within each study area according to
how frequently the children were reported to eat locally grown produce.
Comparisons of the log-transformed mean EP levels for these two groups showed
a statistically significant difference in Area 2, where children who did not
frequently eat neighborhood produce had a higher mean EP level.  Table 49
lists the relevant statistics for these mean EP level comparisons.

Use of Dietary Supplements

Parents reported that 224 of 400 (56%) children surveyed had been taking
vitamins, minerals, or some kind of dietary supplement during the 3 months
before the study.  Table 50 gives the numbers of children within each study
area according to whether or not they had been taking any of these dietary
supplements showed no statistically significant difference among the three
study areas (chi-square = 2.05, d.f. = 2, p = 0.36).

Table 51 gives mean BL levels for children within each study area according to
their use of dietary supplementation.  Comparisons of the log-transformed mean
BL levels for the two groups within each area showed no statistically
significant differences in Area 1 (t = 1.73, p = 0.09) or in Area 2 (t = 0.59,
p = 0.56).  In Area 3, children taking some form of dietary supplementation
did have a significantly lower mean BL level than those not taking such
supplementation (t = 3.58, p = 0.0005).

Table 52 gives mean EP levels for children within each study area according to
their reported use of dietary supplementation.  Comparisons of the
log-transformed mean EP levels for the two groups within each area showed no
statistically significant differences in any study area.  Table 52 lists the
relevant statistics for each of these comparisons.

Type of_ Play Area Surface

Table 53 gives the numbers of children within each study area according to
whether the ground surface where they usually played outdoors around their
homes was mainly grassy or nongrassy.  Nongrassy surface types included
concrete, asphalt, dirt or soil, and sandboxes.  We combined these nongrassy
surface types into one category for the following reasons:  (1) as contrasted
with grassy surfaces, which tend to trap lead-contaminated soil particles

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within vegetative growth and thereby reduce the likelihood of children's
exposure to these particles, nongrassy surfaces tend to be dusty; and (2)
collapsing this multiple-response question into a binary variable simplified
the number of independent observations for regression on the dependent
variables of BL and lead toxicity (see Section "Model for Explanation of
Current Blood Lead Levels").  Comparisons of the proportions of children who
played on grassy surfaces showed no statistically significant difference among
the three study areas (chi-square = 2.24, d.f. = 2, p = 0.33).

Table 54 gives mean BL levels for children within each study area according to
whether they played on grassy or nongrassy surfaces.  Comparisons of the
log-transformed mean BL levels for the two groups within each area showed
statistically significantly higher mean BL levels for children who played on
nongrassy surfaces in Area 1 and Area 2.  Table 54 lists the relevant
statistics for the comparison of the means within each area.

Table 55 gives the mean EP levels for children within each study area
according to whether they played on grassy or nongrassy surfaces.  Comparisons
of the log-transformed mean EP levels for the two groups within each area
showed a statistically significantly higher mean EP level for children who
played on nongrassy surfaces in Area 2.  Table 55 lists the relevant
statistics for the comparison of the means within each area.

Household Member Smoking

Table 56 gives the number of children within each area who lived in a
household where at least one family member smoked.  The proportion of children
living in households with one or more smokers was significantly higher in Area
1 than in the other areas (chi-square = 7.595, d.f. = 2, p = 0.0224).

Table 57 gives the mean BL levels of children within each study area according
to whether or not they lived in a household where someone smoked.  Comparisons
of the log transformations of these mean BL levels showed statistically
significantly higher levels for children living with smokers in Area 1 and
Area 2.  The statistics of the comparison for each study area are shown in
Table 57.

Table 58 gives the mean EP levels of children within each study area according
to whether or not they lived in a household where someone smoked.  Comparisons
of the log transformations of these mean EP levels showed statistically
significantly higher levels for children living with smokers in Area 1 and
Area 2.  Comparison statistics for each study area are listed in Table 58.

The variable of having a smoker in the household made an important
contribution to explaining the dependent variable of BL (see Section "Model
for Explanation of Current Blood Lead Levels" below).  The variable of area
                                     25

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also made an important contribution to explaining the dependent variable of
BL.  To test whether household member's smoking served as a surrogate for
study area, we compared the proportions of households with and without smokers
among the three study areas.  As shown by Table 59, similar proportions of
households with smokers occurred in all study areas (chi-square = 3.24, p =
0.19).  Thus, the contribution to explaining BL made by having a smoker in the
household was non-area-related.

Similarly, to evaluate whether having a smoker in the household served as a
surrogate for income and/or education level of the head of household, we
compared the proportions of households with and without smokers according to
two family income categories and two education categories.  Table 60 shows
that (a) similar proportions of households with smokers in all three study
areas had annual family incomes of less than $10,000 and (b) similar
proportions of households without smokers in all three study areas had annual
family incomes of less than $10,000.  Table 61 shows that (a) similar
proportions of households with smokers in all three study areas had
head-of-household education levels of high school graduation or higher, and
(b) similar proportions of households without smokers in all three study areas
had head-of-household education levels of high school graduation or higher.
Thus, we found no interaction between (a) the variable of having a smoker in
the household and (b) either the variable of family income or the variable of
head of household education level.  Therefore, such interactions did not serve
as surrogates for study area.

Mouthing Habits

Table 62 gives the numbers of children within each study area who were
reported to (a) often take or (b) not often take some food or a bottle with
them when they went outside to play.  Comparisons of the proportions of
children who took food outside showed significant differences among the three
study areas, with the greatest proportion occurring in Area 3 (chi-square =
4.5, d.f. = 2, p = 0.0001).

Table 63 gives the mean BL levels of children within each of the three study
areas according to whether or not the children often took some food or a
bottle with them when they went outside to play.  Comparisons of the
log-transformed mean BL levels for the two groups within each area showed a
statistically significantly higher mean BL level for children who often took
food outside in Area 3.  Table 63 lists the statistics for these comparisons
of means within each area.

Table 64 gives the mean EP levels of children within each of the three study
areas according to whether or not the children often took some food or a
bottle with them when they went outside to play.  Comparisons of the
                                      26

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log-transformed mean EP levels for the two groups within each area showed no
statistically significant difference in any study area.  Table 64 lists the
relevant statistics for each of these comparisons.

Table 65 gives the numbers of children within each study area who were
reported:  (a) to have the habits of often using a pacifier, often sucking
their thumbs or fingers, or sometimes chewing their fingernails; or (b) not to
have these habits.  Comparisons of the numbers of children in these two groups
showed all three study areas to have similar proportions (chi-square = 1.08.
d.f. = 2, p = 0.6).

Table 66 gives the mean BL levels of children within each of the three study
areas according to whether or not the children often used a pacifier, often
sucked their thumbs or fingers, or sometimes chewed their fingernails.
Comparison of the log-transformed mean BL levels for the two groups within
each area showed a statistically significantly higher mean BL level for
children who had these oral habits and lived in Area 2.  A similar difference,
although not statistically significant at the p = 0.05 level, was present in
Area 3.  Table 66 lists the relevant statistics for each of these comparisons.

Table 67 gives the mean EP levels of children within each of the three study
areas according to whether or not the children often used a pacifier, often
sucked their thumbs or fingers, or sometimes chewed their fingernails.
Comparisons of the log-transformed mean EP levels for the two groups within
each area showed a statistically significantly higher mean EP level for
children who had these oral habits and lived in Area 2.

Comparison of the proportion of children who took food outside and who lived
with smokers with the proportion who did not live with smokers showed no
statistical difference (chi-square = 2.60, d.f. = 1, p = 0.10).  A similar
comparison showed no statistical difference in the proportions of children who
used pacifiers, sucked their thumbs, or chewed their fingernails, and lived in
the presence of a smoker (chi-square = 0.003, d.f. = 1, p = 0.95).

Correlations Among Environmental and Biologic Variables

Correlations Among Environmental Variables

Table 68 gives Pearson correlation coefficients for the lead levels found in
four types of soil samples and one type of dust sample collected from all
study areas.  Significant correlations were found between:  (1) the
log-transformed lead levels found in front and back yard composite soil
samples and those found in side yard soil samples, play area soil samples,
garden soil samples, and vacuum-bag dust grab samples; (2) the log-transformed
                                       27

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lead levels found in side yard soil samples and those found in play area soil
samples, garden soil samples,  and vacuum-bag dust grab samples; and (3) the
log-transformed lead levels found in play area soil samples and vacuum-bag
dust grab samples.  No significant correlation existed between the
log-transformed lead levels in:   (1) play area soil samples and garden soil
samples or (2) vacuum-bag dust grab samples and garden soil samples.

Of the soil samples in Area 1, only the correlation between the
log-transformed lead levels in front and back yard composite soil samples and
side yard soil samples was statistically significant (r = 0.44, p = 0.0178).
The correlation between the log-transformed lead levels in front and back yard
composite soil samples and the levels in play area soil samples, although not
statistically significant, was strong and positive (r = 0.56, p = 0.09).
Small sample sizes among all soil sample types in Area 1 reduced the
likelihood of correlations being detected among the lead levels of these
samples.

Of the soil samples in Area 2, the log-transformed lead levels in front and
back yard composite soil samples correlated significantly with the levels in
side yard soil samples (r = 0.54, p = 0.0001) and with the levels in garden
soil samples (r = 0.51, p = 0.036).  No correlations, however, were found in
Area 2 between the log-transformed lead levels in play area soil samples and
those in any other soil sample type.

Of the soil samples in Area 3, strong and statistically significant positive
correlations were found between the log-transformed lead levels in:  (a) front
and back yard composite soil samples and ,side yard soil samples (r = 0.55, p =
0.0001), (b) front and back yard composite soil samples and garden soil
samples (r = 0.63, p = 0.0028),  (c) play area soil samples and side yard soil
samples (r = 0.66, p = 0.0002),  (d) play area soil samples and garden soil
samples (r = 0.80, p = 0.03, and (e) side yard soil samples and garden soil
samples (r = 0.59, p = 0.0064).

Table 69 gives Pearson correlation coefficients between the lead levels found
in vacuum-bag dust grab samples and the four different soil sample types
collected in each area.  As shown by the values in this table, none of the
correlations between the log-transformed lead levels in dust and in any soil
sample type was significant in Area 1.  The absence of significant
correlations and the unstable nature of the correlation coefficients may
reflect the small number of samples obtained in Area 1.  In Area 2, the
log-transformed lead levels in vacuum-bag dust grab samples correlated
positively and statistically significantly with the levels in front and back
yard composite soil samples and also with the levels in side yard soil
samples.  In Area 3, no correlation was found between the log-transformed lead
levels in vacuum-bag dust grab samples and any soil sample type.
                                       28

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The above correlations can be summarized by the following statements:

     1.   The levels of lead in various soil sample types were most consistent
          in Area 3, suggesting a more uniform distribution of lead in the
          soils in Area 3 than in the soils of the other two areas.

     2.   The levels of lead in front and back yard composite soil samples and
          in side yard soil samples had significant correlations in all three
          study areas.

     3.   The levels of lead in garden soil samples reflected area-wide soil
          lead distributions in Area 2 and Area 3.

Correlations Among Sibling Blood Lead Levels

For all households from which siblings participated in the study, we analyzed
the correlation between the BL levels of these siblings when their ages
differed by 3 years or less.  Since the study population ranged from 1 to 9
years of age, individual sibling pairs included in this correlation analysis
of BL levels could range from 1- to 4-year-old pairs to 6- to 9-year-old
pairs.  Table 70 gives the mean BL levels of the two siblings in each pair and
the Pearson correlation coefficients for the log transformations of these lead
levels by the difference in ages of the two siblings.  As the table shows,
siblings whose ages differed by 1 year had very similar BL levels.  Siblings
whose ages differed by more than 1 year also had similar BL levels, although
the extent of the correlations decreases as the difference in the ages
increases.  These data provide an internal measurement of the quality of the
BL data since siblings, who share the same environment and who are close in
age and therefore share similar behaviors, should have similar BL levels.  The
absence of perfect correlation between these sibling' BL levels may reflect
slight differences in nutritional, behavioral, or environmental
characteristics of the individual siblings.  In every category of age
differences between siblings, the mean BL level of the younger siblings was
higher than that of the older siblings, a finding consistent with the
previously established inverse relationship between age and likelihood of
exposure to lead.
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Model for Explanation of Current Blood Lead LHVR!S
Multiple Regression Analyses

The major goal of these analyses was to determine if soil and house dust
were significant predictors of BL after the effects of other variables
known or suspected to cause elevations in children's BL levels were
accounted for.  From other studies, well-documented correlates of
children's BL levels include environmental sources, such as leaded paint,
lead derived from home hobbies, lead in food, and lead in ambient air.
Likely correlates of BL levels in children include the children's play
behaviors, play locations, intensity of outdoor play, mouthing behaviors,
house characteristics, and nutritional and family characteristics.
Sample Size Considerations

From the survey questionnaire, we selected data on the environmental
pathways and other factors most likely to affect BL levels.  All of these
variables taken jointly reduced the workable sample size for analysis
because of the scattered nature of missing data.  Therefore, when
univariate analysis showed a large proportion of missing data and/or no
relationship between the variable and BL, we excluded the variable from
the following regression analyses.
Principal Components

The number of children with measurable BL levels restricted the number of
explanatory variables which could be considered in the regression
analyses.  To reduce the number of explanatory variables, we formed two
composite variables using principal components analyses.  Eight variables
related to mouthing and play behavior formed one composite variable, and
three variables related to intensity of outdoor play formed another.  For
a given child, the variables which formed either composite were likely to
be significantly correlated.  To create an uncorrelated vector variable
from these presumably correlated variables, we used principal components
analyses to transform the two sets of related variables, i.e., mouthing
behavior and outdoor play habits.
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An important feature of principal components is that although the
complete set of components will reproduce the correlation matrix exactly,
and thus account for all the variance in the vector variable, a subset of
the components may be just as useful.  The subset of choice is that which
explains more of the variance of the vector variable than any other
subset of n orthogonal factors.

Table 71 displays the first three principal components or factors formed
by using the eight mouthing questions, and Table 72 shows the first
component formed by using the three outdoor/indoor questions.  The
weightings in Table 71 indicate that factor MOUTH1 scored highest for
children who mouthed furniture or paint chips and who swallowed or
mouthed other things.  HOUTH2 factor loaded heaviest on mouthing
furniture, eating food out of doors, and on the oral behavior
question—i.e., using a pacifier, thumb sucking, etc.  The three
components or factors accounted for 64% of the variance in the
eight-question battery.

Table 72 shows that the first component formed by the three-question set
accounted for 52% of the variance.  A high score on this vector variable
resulted when a child spent many hours outdoors, spent no time away from
home, and spent little or no time on the floor.  The signs for the
weighting coefficients of time outdoors (+ CPOHR) and time on the floor
(- CORIFL) make sense.  Children who spent many hours outdoors could not
be spending many hours on the floor indoors.  This analysis supports the
validity of parental responses to these questions.

Both component vector variables were entered into the regression analyses
as explanatory variables.  This simplified the regressions while
retaining most of the information contained in both batteries of
questions.
Statistical Procedures

Multiple linear regression models were used to determine which variables
were significantly related to BL.  The general procedure for variable
selection was as follows.  First, variables representing each possible
pathway of exposure were analyzed jointly, with no interaction effects or
second order terms included.  The composite variables described above
were then included in the regression equations.  Variables that were
significantly related to BL were retained for more intensive analysis.
After the first order effects were examined and the regression functions
simplified, selected higher order terms and interaction effects were
introduced.

The natural log of BL was more normally distributed than untransformed
BL.  All the results reported here are for the natural log of BL, but
regressions using lead on the untransformed scale gave very similar
results.  Age was also modeled as a single variable instead of age and
age-squared, with no change in results.
                                  31

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Computer programs available through the Statistical Analysis System (SAS)
were used in this analysis.  The standard unweighted multiple linear
regression routine in the Proc REG was used to confirm the joint
relationship among variables, Proc PRINCOMP was used for the principal
components analysis of child behavior variables and intensity of outdoor
activity, and Proc STEPWISE was used for subsequent variable selection
with a backward elimination.

Sibling Analysis

We examined the effect on the multivariate analyses by excluding, on a
randomly selected basis, one member from each sibling pair.  No change in
the regression solution, order of variable entry, or magnitude of
R-square resulted.  Me concluded that sibling multicollinearity caused no
meaningful effect on the resulting regression parameters.  Thus, all
regression results reported here include all children for whom BL levels
were measured.
Results

The first model (Table 73) regressed BL on soil lead and all other main
effects for which there were sufficient data, except dust lead.  The
model included children up to 9 years old.  The variables for this model
ire defined in Table 74.  The regressions were done to determine whether
BL levels were significantly associated with soil and dust lead after
controlling for age, child behavioral factors, and family
characteristics.  Soil lead was significant (p <.01) in all regressions,
and in the model of main effects 11 variables had significant
associations with BL (r-square = .355).  In addition to high soil lead,
living in Areas 1 or 2, having high scores on mouthing and outdoor play,
and having a smoker in the household were positively associated with
higher BL levels.  Age and age-squared were also significant, indicating
that older children would have lower estimated BL levels because of the
negative coefficient on age-squared.

The main effects model was expanded to incorporate selected interaction
effects, with particular attention paid to the stability and significance
of the soil lead coefficient.  Table 75 presents these results and shows
that the soil lead coefficient was essentially unchanged and that two
interaction effects became significant—the interaction of income with
smoking and the interaction of age with vitamin use.  Smoking and
presence of storm windows were no longer significant predictors.
                                     32

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These models were rerun, excluding children who were reported to spend
some time during the day away from home.  Table 76 shows that the sample
size decreased from 319 to 292.  The significance and composition of the
resulting regression equation remained unchanged.  In this study, most
families with young children did not place their children in day care
settings.  For our purposes, therefore, we assumed that the environmental
measures used in the regressions did present an equally realistic picture
for all children studied.

A series of regression models was constructed to assess the independent
significance of soil lead and dust lead in predicting BL levels.  The
sequence of this series of regressions and the variables introduced in
each model are listed in Table 77.  Both SAS backward stepwise
elimination and maximum R-square stepwise improvement (MAXR) approaches
were used.  As Table 77 shows, the coefficient of soil lead diminished
from Model 1 to Model 4 to Model 6, as questionnaire data, air lead, dust
lead, and home location were added to the model.  Whenever soil lead was
introduced as an independent variable, however, it appeared to be a
statistically significant contributor to explaining BL, with the
exception of the backward stepwise regression in Model 7.  In this case,
air lead and home location replaced soil lead.  Since air lead levels
were so low, we consider their substitution for soil lead to be a
statistical artifact.  Table 77 also shows that both the coefficient and
the statistical significance of dust lead remained relatively stable
among Models 2 to 5 to 6 to 7, as questionnaire data, air lead, dust
lead, and home location were added to the model construction.  Finally,
the MAXR approach to Model 7 failed to find either variable designating
home location as significant.  Hence, the other variables, i.e., soil and
dust lead, adequately accounted for the between-area variance in BL
levels.

To test for the influence of age-related hand-to-mouth activity, we
performed two additional regression analyses involving interaction terms
(Table 78).  Each consisted of the variables found to be significant in
Model 7 of the series described above.  The first of these two models
included an interaction term between age and the natural log
transformations of soil lead levels.  The second model included an
interaction term between age and the natural log transformations of dust
lead levels.  Neither interaction term appeared as a significant
contributor to BL levels.  These results were consistent with the
area-specific univariate analyses reported in Tables 6b and 6c, which
showed that young children (<2 years) and older children (6-9 years)
shared similar BL levels.  Taken together, these findings suggest that
the hand-to-mouth and indoor activities of young children in this
community do not preferentially involve soils or dusts with either low or
high lead concentrations.
                                      33

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Table 79 displays the final regression model for predicting children's BL
levels in this study.  This model shows that both soil and dust lead made
significant contributions to explaining BL, but, when taken jointly, dust
lead contributed more—the partial regression coefficients were 0.250 for
dust and 0.0616 for soil.  The model estimates that children with a
smoker in the family were at greater risk of having a higher BL.  The
single variable for average hours spent out of doors each day (CPOHR), by
itself, was just as powerful as the outdoor play combined score
variable.  Thus, for ease of interpretation, CPOHR was used in the final
regression series that produced this model.  The age-squared and vitamin
usage variables had negative coefficients.  Therefore, when other factors
are held constant, the model predicts that older children and children
who use vitamins, minerals, or other dietary supplements will tend to
have lower BL levels.
Discussion

Associations Between Environmental Characteristics and Blood Lead Levels

Children living closer to the smelter had higher BL levels than children
living farther away.  The following discussion addresses possible sources
of lead to which these children may have been exposed and the
associations between these lead sources and the children's BL levels.

Soil lead contamination was associated strongly with children's BL levels
in Shoshone County, as evidenced by the following observations:  (1)
highly significant differences existed among the three study areas in the
lead levels of most soil sample types; these differences mirrored similar
highly significant differences in BL levels; (2) children whose mean BL
levels were compared according to the category of soil lead found around
their homes had similar ages; thus, the positive association between mean
BL levels and soil lead level categories was free of the confounding
effect of age and age-related behavior characteristics; (3) the
persistence of soil contamination in the environment and the ongoing
exposure of children to this source were consistent with the finding that
children born before and after the smelter closed in 1981 had similar BL
levels; and (4) with the exception of house dust lead contamination, lead
in soil was the only environmental source shown to be statistically
associated in biologically meaningful ways with children's BL levels.
All other environmental lead sources that might have been expected to
contribute to the explanation of children's BL levels failed to
demonstrate this type of association, as discussed below.
                                     34

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Higher BL levels occurred in higher house dust lead categories.   Lead
contamination in house dust may reflect:  (1) soil lead that enters the
house from outside, (2) paint lead that chips or peels off walls or
moldings, and (3) lead filings or scraps from lead-related hobbies.  Very
little leaded paint was present in these homes, and lead paint on intact
or chipping and peeling surfaces had no statistically meaningful
association with children's BL levels.  With respect to lead-related
hobbies, we found higher BL levels among children in Area 1 who lived in
the absence of lead-related hobbies.  This difference must reflect a
difference in lead exposures unrelated to lead hobbies.'  Thus, lead from
painted surfaces and from hobby activities provided no explanation of BL
differences within or between study areas.  The positive association
between house dust lead contamination and children's BL levels was,
therefore, likely to occur as a result of soil lead contamination.

Not finding an association between lead-based paint or lead-related
hobbies and children's BL levels suggests that high soil and dust lead
levels obscured the contributions of these other environmental sources.
Where soil, dust, and air lead levels are low, exposures to lead-based
paint and lead-related hobbies may be more important.

Two municipal water systems serve the residents of the survey areas.  The
Central Shoshone Water District provides water for Kellogg, Smelterville,
and Wardner residences.  The Pinehurst Water District provides water for
Pinehurst residences.  The lead levels found in water provided by these
two water districts have consistently been less than 0.01 mg/1 since
1981.  The maximum allowable level of lead in drinking water is 0.05 mg/1.

The purpose of the question on- storm window usage was to evaluate whether
children living in homes with storm windows had lower BL levels.  The
assumptions were that:  (1) the use of storm windows may decrease the
amount of lead-contaminated dust entering the house from outside and,
thereby, lessen the house dust lead exposure of children in these homes;
and (2) the use of storm windows may provide a surrogate measure of
housing quality.  Since we conducted this study during the month of
August, the study participants were unlikely to have used storm windows
for the 3-month period before the study.  Thus, the only assumption
regarding storm windows that we were able to evaluate was that of a
surrogate measure of housing quality.  In all three study areas, children
living in households with storm windows had lower BL levels.  If having
storm windows does indicate better housing quality, then this finding is
consistent with previous studies that have shown that children living in
better housing are likely to have lower BL levels.

Associations Between Behavioral Characteristics and Blood Lead Levels

Certain behavioral characteristics may predispose children to ingest more
lead from various sources in their environments or to absorb more of the
lead they do ingest.  In the following discussion, we describe the
associations found between these behavioral characteristics and
children's BL levels in this study.
                                  35

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The lead levels found in the garden produce are important, since they can
contribute significantly to a child's exposure to this metal.  Even
though the produce was washed thoroughly before being analyzed, the mean
lead levels found were unacceptably high.  Thus, children who eat these
fruits and vegetables may ingest more lead than those who do not.  In
this study, however, we found that children's habits of eating fruits and
vegetables grown in their neighborhoods had no statistically meaningful
associations with either their BL levels or their EP levels.  In
addition, only a minority of children were reported to frequently eat
fruits and vegetables grown in their neighborhoods.  Nevertheless,
because of the possibility for lead exposure, we recommended that
children not eat leafy vegetables (lettuce, chard, turnip greens, etc.)
or root vegetables (carrots, beets, potatoes, onions, etc.) grown
locally.  Although fruits, such as apples, pears, and plums, and other
vegetables, such as tomatoes, peas, beans, and corn, were not tested
during this survey, these fruits and vegetables are unlikely to
contribute significantly to a child's BL level and may be eaten after
carefully being washed or peeled.

Animal studies have shown that intestinal lead absorption may: (1)
decrease when calcium and certain other minerals are present in the
intestine and (2) increase with iron deficiencies.  To explore the
relationship between children's nutritional status and BL levels, we
included questions on the use of vitamins, minerals, and other dietary
supplements in the questionnaire for this study.  The responses to these
questions showed that the use of these dietary supplements was similar in
all three study areas.  Only in Area 3 did children who were taking some
form of dietary supplementation have statistically significantly lower BL
levels.

Children who usually play on nongrassy surfaces may have greater
exposures to lead-contaminated dust by inhalation and ingestion than
children who play on grassy surfaces.  In support of this hypothesis, we
found that children who played on nongrassy surfaces in the most heavily
contaminated areas, that is, Areas 1 and 2, had statistically
significantly higher mean BL levels than children who played on grassy
areas.

Children who exhibit more mouthing activities may have greater exposures
to lead-contaminated soil or dust particles.  These increased exposures
result from chewing or sucking on objects that have soil or dust
particles on their surfaces.  To explore the relationship between
children's mouthing activities and their BL levels, we asked several
questions about the children's oral habits.  We found that more children
than we expected often took some food or a bottle with them when they
                                         36

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went outside to play in Area 3.  Correspondingly, children who took food
outside in Area 3 had a statistically significantly higher mean BL level
than those children who did not take food outside.  Children who had the
habits of often using a pacifier, often sucking their thumbs or fingers,
or sometimes chewing on their fingernails and children who did not have
these habits had similar mean blood levels in Areas 1 and 3.  In Area 2,
however, the mean BL level of children with these oral activities was
higher than for children without these oral activities.  In summary, we
found no strong associations between these questionnaire variables on
mouthing activities and BL levels.

To evaluate whether the presence of a smoker in the household was
associated with increased mouthing activities in children, we compared
the proportions of children with oral activities who lived in the
presence and absence of smokers.  No difference in proportions was
found.  These results are inconsistent with the hypothesis that watching
a family member smoke increases a child's mouthing activities.

Less than half of the variance in BL levels was explained by multiple
regression analyses.  There are several possible reasons for this.  The
soil lead levels used in the regression were only a rough measure of the
children's soil exposures.  Soil lead levels in Areas 1 and 2 showed very
high levels intermixed with much lower levels within the same
neighborhood.  Because of this pattern, the household-specific soil
samples used in these analyses described only part of what the children
were exposed to.  The study is further limited in that no measure of
breathing zone air lead was taken.  Therefore, we cannot discuss in
detail the specific pathway mechanisms that account for the measured BL
levels.

Nevertheless, the multiple regression models for explaining children's BL
levels support several conclusions.

First, in the Kellogg communities, soil lead was a significant
contributor in explaining children's BL levels.  Although the ability to
explain variation in the observed BL levels was limited, (r-square for
the models was less than  .40), a significant and positive relationship
was found between BL levels and soil lead levels.  This relationship
remained even when other factors known to be related to BL were taken
into account.

Second, household dust lead levels, as measured by a grab sample from
vacuum cleaners, were significantly associated with BL and had an effect
upon BL beyond that of soil lead.  That is, both variables, soil and
dust, appeared to make independent contributions to explaining BL levels.
                                   37

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Third, when dust lead was excluded from consideration, other variables,
such as vitamin use, area, income, lead-related hobbies, and mouthing,
became significant.  This probably occurred because of the
interrelatedness of the variables.  Children living in areas with the
most highly contaminated soil who put their mouths on toys and furniture,
who lived in households where lead-related hobbies were practiced, and
who were not given vitamin supplements had higher BL levels.  However,
when the most important environmental variables, vacuum dust and soil
lead, were considered jointly, these other factors become less
important.  Older children appeared to be at lower risk than younger
children, as evidenced by the significance and sign of the age-squared
term.

In summary, both the univariate and multiple regression analyses showed
that the differences in BL levels reflected differences in soil lead and
dust lead levels near and far away from the smelter.  Very little lead
was found in other environmental media, indicating that the positive
association between house dust lead contamination and children's BL
levels was likely to have occurred as a result of the soil lead
contamination.  The results of this study support the conclusion that, in
the absence of significant air lead contamination, children who are
exposed to heavily leaded soils may develop lead toxicity.

Current Situation in Silver Valley

The Bunker Hill lead smelter has not operated since late 1981.  The
smelter complex has been sold, and the current owners have not indicated
when they intend to reopen the smelter.  Many former employees of the
smelter have left the community in search of other employment.  According
to the current owners of the smelter complex, any reopening of the
smelter depends upon an improvement in metal prices and the final Federal
Implementation Plan (FIP) required to meet the Ambient Air Quality
Standards established by EPA.

Local residents do not generally perceive the current conditions in
Silver Valley as a significant threat to their health.  One of their main
concerns involves the economics of the community and the need for more
jobs.

Region X, EPA, and IDHW have negotiated a site agreement to address
respective roles and responsibilities for conducting a remedial
investigation/feasibility study (RI/FS) under the provision of the
Comprehensive Environmental Response, Compensation, and Liability Act of
1980 (CERCLA or "Superfund").  EPA will be the designated lead agency for
the site, however, IDHW will have responsibility for specific tasks
involved in the RI/FS.  The proposed RI/FS may take 18 to 24 months to
complete.  In the interim, IDHW and PDHD are continuing to screen
children for elevated BL levels and to work with families who have
children with elevated BL levels.

During August 1984, free BL testing was made available for children, ages
1 through 5 years old, who lived in Areas 1 and 2.  In addition, free BL
tests were also made available to any Silver Valley children who had a BL
                                   38

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of 25 ug/dl or greater during 1983.  Parents of all children aged 1
through 5 years and parents of children found to have a BL levels of 25
ug/dl or greater during 1983 were sent a special invitation to have their
children tested.  Only 25 children were tested during the 3 weeks that
free lead testing was available.  The average BL level was 22.4 ug/dl
(range 9 to 39 ug/dl).  All families with children who had a BL level of
25 ug/dl or greater have been contacted by PDHD and provided information
on ways to reduce childhood lead exposure.

Comparison of 1983 Idaho Blood Lead Data to National and Regional
Blood Lead Data

National BL data collected during the period 1976-1980 showed the mean BL
level of rural white children, aged 6 months through 5 years, to be 13.5
+ 0.6 ug/dl (14).  Given the decreasing trend in average BL levels seen
during this 4-year period (15), when mean BL levels of the population
aged 6 months to 74 years decreased by about 6 ug/dl, we estimate that
the mean national BL levels of white rural children in 1983 was
considerably less that 13.5 ug/dl.  Although no 1983 national data are
available, data on children's exposures in 1983 to smelter-associated
lead in East Helena, Montana, collected in a similar study involving
State and Federal agencies, do provide comparisons for the Idaho data
presented in this report (16).

The mean soil lead level in the local Montana comparison area, Area 3,
was 96.4 ppm, or about one-seventh that found in Idaho Area 3 (667 ppm).
Thus, the environment of Montana Area 3 had less lead contamination than
Idaho Area 3 and, thereby, provides a more accurate representation of
normal rural conditions than does Idaho Area 3.  Of interest is that the
mean BL level of children living in Montana Area 3 was 6 ug/dl, half the
mean BL level of children living in Area 3 in Idaho.

In Idaho, 1- and 2-year-old children within 1 mile of the smelter had a
mean BL level of 22 ug/dl.  Since these 11 children were born after the
smelter closed in 1981, they had not been exposed to high air lead
levels.  Unless they had been exposed to some unusual source of lead,
these children would be expected to have a mean BL level of about 6
ug/dl, the level found in Area 3 (the local comparison area) in Montana.
Since air lead levels in Idaho in 1983 were low and since very little
leaded paint was found in the homes studied, the main source of lead
exposure probably has been the contamination in the dust and soil.  This
hypothesis is supported by the multiple regression analyses discussed
above.
                                  39

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Comparison of 1983 Idaho Blood Lead Data to Earlier Idaho Data

The highest BL levels observed in Kellogg area children occurred in 1974.  The
mean BL levels of all area children are now about one-third the levels
observed in 1974.  The decline in the mean BL levels has been observed since
1974, when the IDHW began annual screening of Kellogg area children.  All Area
1 children (ages 1-12) were invited to participate in the voluntary BL
screenings conducted each August.  Selected Area 2 and a few Area 3 children
were also invited to the BL screenings.  No random selection of children for
testing, however, was done between 1976 and 1982.  As a result, the sampling
•may not accurately represent all children in the community.  The number of
Area 1, 2, and 3 children screened each year declined from 562 in 1974 to only
27 in 1979.  Although the sampling may have been nonrepresentative, the
results of the August 1979 screening suggested a rise in the mean BL levels;
therefore, a large community-wide survey was undertaken in April 1980 and
repeated in October 1980.  The mean BL levels of Area 1, 2, and 3 children in
1974, 1980 (October), and 1983 are compared in Table 80.  The percent of Area
1 children with BL levels of 30 ug/dl or greater dropped from 99% in 1974 to
21% in 1983 (Table 81).  Seventy-six percent of Area 2 children had BL levels
of 30 ug/dl or greater in 1974, whereas only 8% of Area 2 children had BL
levels of 30 ug/dl or greater in 1983.  These data confirm the significant
decline in the BL levels over the 10-year period.
Use of trade names is for identification only and does not constitute
endorsement by the Public Health Service or by the U.S. Department of Health
and Human Services.
                                          40

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REFERENCES

1.  Walter SD, Yankel AJ, vonLindern IH.  Age-specific risk factors for lead
    absorption in children.  Arch Environ Health 1980;30:53-8.

2.  Yankel AJ, vonLindern IH, Walter SD.  The Silver Valley lead study: the
    relationship between childhood blood lead levels and environmental
    exposure.  J Air Pollut Control Assoc 1977;27:763-7.

3.  Searle B, Chan W, Davidow B.  Determination of lead in blood and urine by
    anodic stripping voltametry.  Clin Chem 1973;19:76-80.

4.  Peter F, Growcock G, Strune G.  Fluorometric determination of erythrocyte
    protoporphyrin in blood, a comparison between direct (hematofluorometric)
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5.  Yankel AJ, vonLindern IH.  Procedures employed for a study of lead in
    dust, soil, and the ambient air.  In: Proceedings of the Pacific Northwest
    International Section Air Pollution Control Association.  Boise, Idaho:
    Air Pollution Control Association, 1974.

6.  Fairell RF.  A simple low-cost method for the dissolution of metal and
    mineral samples in plastic pressure vessels.  In: Report of investigation
    8480.  U.S. Department of Interior, 1982; DOI publication no. 128.

7.  Environmental Protection Agency (EPA).  Reference method of determination
    of lead and suspended particulate matter collected from ambient air.
    October 5, 1978.  Federal Register Vol. 43, No.  194,  Appendix G.

8.  Black SC, Brown KW, Flatman GT, Mullins JW, Richitt EP, Santolucito JA,
    Simon SJ.  Quality assurance project plan for the Kellogg, Idaho, study.
    Las Vegas: Environmental Protection Agency Environmental Monitoring
    Systems Laboratory, 1983.

9.  Centers for Disease Control (CDC).  Preventing lead poisoning in young
    children: a statement by the Centers for Disease Control-January 1985.
    Atlanta:  U.S. Department of Health and Human Services, 1985.  DHHS
    publication no. 99-2230.

10. Mielke HW, Anderson JC, Berry KJ, Mielke PW, Chaney RL, Leech M.  Lead
    concentrations in inner-city soils as a factor in the child lead problem.
    Am J Public Health 1983;73:1366-9.

11. Ure AM, Berrow ML.  The elemental constituents of soils.  In:  Bowen HJM,
    (senior reporter) Environmental chemistry. Vol.  2.  London: The Royal
    Society of Chemistry, 1982:70-205.
                                        41

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 2.   Milar CR,  Mushak P.   Lead contaminated house dust:  hazard,  measurement
     and decontamination.   In:  Chisolm JJ,  O'Hara DM,  eds.  Lead  absorption in
     children.   Baltimore,  Maryland:  Urban  and Schwarzenberg,  Inc.,
     1982:143-52.

13.   Committee  on Dietary Allowances,  Food  and Nutrition Board,  National
     Research Council.   Recommended dietary allowances,  9th ed.  Washington,
     D.C., National Academy of Science,  1980.

14.   Hahaffey KR,  Annest JL, Roberts J,  Murphy RS.   National estimates of
     blood lead levels:   United States,  1976-1980.   N  Engl  J Med
     1982;307:573-9.

15.   Annest JL, Mahaffey KR, Cox DH,  Roberts J.   Blood lead levels for persons
     6 months-74 years of age:   United States, 1976-1980.  Hyattsville,
     Maryland:  National Center for Health Statistics,  1982; DHHS publication
     no. (PHS)  82-1250.

16.   Final Report:  East Helena, Montana, Child Lead Study, Summer 1983.
     Issued by  the Lewis and Clark County Health Department; U.S.
     Environmental Protection Agency;  Montana Department of Health and
     Environmental Sciences; Center for Environmental  Health,  Centers for
     Disease Control, Public Health Service, U.S. Department of  Health and
     Human Services,  Atlanta, Georgia  30333,  July 1986.

17.   Mahaffey KR,  Corneliussen PE, Jelinek  CF, Fiorino JA.   Heavy metal
     exposure from foods.   Environ Health Perspect 1975;12:63-9.

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Table 1.  Mean and Range Blood Lead Levels of Smelterville (Area 1)
          Children Ages 1-9, 1974-1982
Date
August
August
August
August
August
August
April
October
August
August
Ranges
Ranges
Ranges
Ranges
Ranges
Ranges
Ranges
Ranges
Ranges
Ranges
Number of
Children 1
1974
1975
1976
1977
1978
1979
1980
1980
1981
1982
1974
1975
1976
1977
1978
1979
1980 (Apr)
1980 (Oct)
1981
1982
174
126
61
77
73
25
93
94
74
67
	 	
—
—
—
—
—
—
—
—
—
63.7
50.8
46.3
39.8
42.2
50.5
36.0
36.0
36.8
25.0
43-164
31-81
34-55
30-52
34-52
50-51
24-43
27-50
27-53
14-33
2
76.8
46.4
41.4
31.4
44.5
44.2
33.0
34.9
36.8
24.5
34-129
31-84
21-36
20-37
28-78
23-64
20-58
30-41
30-47
20-29
3
75.9
45.6
47.4
46.4
36.2
50.5
34.0
34.5
32.9
30.2
48-134
24-61
30-74
17-67
26-44
47-54
22-58
16-49
22-43
31-38
4
76.3
46.7
39.5
38.6
48.4
72.0
34.0
32.8
35.0
31.0
54-143
33-64
23-54
22-53
28-62
72
27-43
19-41
34-36
31
Age in
5
67.5
45.9
44.3
42.3
44.1
50.0
34.0
30.5
29.2
23.4
42-100
33-62
29-61
34-69
32-54
39-60
17-57
15-58
18-45
15-35
Years
6
67.8
46.8
41.2
31.7
44.0
52.4
32.0
30.5
31.0
24.3
42-97
26-77
22-58
14-50
32-60
41-72
18-50
14-44
18-54
18-36
7
64.5
49.4
42.3
34.0
40.7
53.0
35.0
31.2
33.5
22.8
43-98
35-77
28-56
25-42
31-50
47-59
20-57
18-49
26-43
15-29
8
61.3
46.0
46.3
35.0
39.0
-
30.0
30.0
27.6
21.4
39-95
30-60
36-62
28-52
39-45
33-45
15-42
12-43
16-38
16-28
9
58.6
38.4
39.0
35.3
37.3
39.0
28.0
26.0
25.7
24.6
44-73
26-49
22-52
22-50
27-51
39
20-40
19-32
1
1
                                             43

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Table 2.  Number of Kellogg Area Children Ages 1-12 Tested and Their Mean Blood
          Lead Levels in April 1980,  October 1980,  August 1981, and August 1982
Area^
1

2

1 & 2

Notes:

Month
April 1980
October 1980
August 1981
August 1982
April 1980
October 19803
August 1981
August 1982
April 1980
October 1980
August 1981
August 1982
Number
Children
93'
94
74
67
357
53
185
197
450
147
259
264
1. Area 1 = Smelterville; Area
2. April 1980 blood
lead levels
of Blood
Mean
31.0
30.5
29.1
22.9
26.0
31.0
26.0
20.7
27.0
30.7
27.1
21.2
2 = Kellogg, Wardner
were determined by
Lead (ug/dl)2
Range
12-58
12-58
15-54
9-38
7-63
13-54
7-50
5-46
7-63
12-58
7-54
5-46
, and Page.
Utah Biomedical
              Testing Laboratory,  and October 1980,  August 1981,  and August 1982
              blood lead levels were determined by ESA Laboratories, Inc.,
              Bedford, Massachusetts.

              October 1980 Area 2  results are biased,  since only children with
              blood lead levels of 40 ug/dl and greater during April 1980 were
              retested during October.  Only children with blood lead levels
              of 30 ug/dl or greater during 1980 or 1981 were encouraged to be
              retested during August 1982.
                                       44

-------
Table 3a.   ESA Laboratory Performance in the CDC Blood Lead Proficiency
            Testing Program, August-October, 1983



Month
August


September


October




Sample
Number*
1
2
3
1
2
3
1
2
3
Target
Lead
Level
(ug/dl)**
14
4
53
112
69
102
81
43
4

Target
Range***
(ug/dl)
8-20
0-10
45-61
95-129
59-79
87-117
69-93
37-49
0-10
Lead
Level
Detected by
ESA
13
2
53
117
70
107
84
43
3
    *Cow blood.

    **Arithmetic mean of values  reported by eight reference laboratories for
      the sample.

    ***15% below to 15% above  target value.  For target values below 40 ug/dl,
        the target  range is  6 ug/dl below to 6 ug/dl above the target value.

-------
fable  3b.     Mean  and  Range  Blood  Lead  Levels  of  Children Who  Participated
             in  the  August 1983  Kellogg Survey
Number of
Area Children Tested
Lowest
1 43 6
2 199 5
3 122 1
Blood Lead Level (ug/dl)
Arithmetic Geometric
Highest
35
45
40
Mean
21
199
122
Mean
20
16
11
       All  areas
364
45
16
14

-------
Table 4a.     ESA Laboratory Performance in the CDC Erythrocyte Protoporphyrin
              (EP) Proficiency Testing Program, August-October, 1983



Month
August


September


October




Sample
Number*
1
2
3
1
2
3
1
2
3
Target
EP
Level
(ug/dl)**
90
60
161
150
118
89
135
197
110

Target
Range
(ug/dl)
77-103
51-69
137-185
127-173
100-136
76-102
115-155
168-226
93-127
EP
Level
Detected by
ESA
96
67
174
156
123
91
130
194
107
*Spiked outdated human blood from a Blood Bank.

**Arithmetic mean of values reported by 9 reference laboratories for the
  samp le.

***is% below to 15% above target value.  For target values below 40 ug/dl, the
   target range is 6 ug/dl below to 6 ug/dl above the target value.
                                          47

-------
Table 4b.      Mean and Range Erythrocyte Protoporphyrin (EP) Levels of
              Children Who Participated in the August 1983 Kellogg Survey
          Area
   Number of
Children Tested
Erythrocyte Protoporphyrin (ug/dl)
  Mean     Lowest     Highest
1
2
3
43
199
121
35
27
22
13
11
12
77
153
77
      All areas
     363
   26
11
153

-------
Table 5.  Mean Blood Lead (BL) and Erythrocyte Protoporphyrin (EP)
          Levels of 1983 Survey Participants by Area and Age
Area
1


2


3


Number
BL
EP
(ug/dl)
(ug/dl)
Number
BL
EP
(ug/dl)
(ug/dl)
Number
BL
EP
(ug/dl)
(ug/dl)
1
6
23
37
13
14
30
12
12
34
2
5
21
43
15
18
25
14
12
20
Age
3
4
24
30
30
19
30
11
12
20
in Years
4 5
1
22
38
28
21
29
17
12
20
8
23
35
17
16
24
18
11
23
6
5
24
45
28
18
33
15
15
21
7
3
13
17
16
18
30
14
10
19
8
5
17
26
29
15
22
12
10
21
9
6
21
34
23
12
20
9
15
23
Table 6a.  Mean Blood Lead by Area for Children <2 Years and >2 Years
                    <2 Years of Age
               Arithmetic    Geometric
                  Mean         Mean
   >2 Years of Age
Arithmetic      Geometric
  Mean	Mean
Area
1 22
2 16
3 12

.0
.1
.2

19
14
10

.3
.6
.0

21
17
12

.1
.2
.1

19.
15.
11.

7
7
0
                                           49

-------
Table 6b.  Number of Children  Belonging to Two Different Age Categories  (<2
           Years and >6 Years)
Area
1
2
3
Total
Number of Children
Less than or Equal
to 2 Years
11
28
26
65
Number of Children
Aged 6-9
Years
19
96
50
165
Total
30
124
76
230
Table 6c.  Geometric Mean Blood  Lead Levels (ug/dl) According  to Children's
           Age Categories*  (<.2 Years and >6 Years)


Area
1
2
3
Age Less than
or Equal to
2 Years
19.1 (1.8)
14.6 (1.6)
10.0 (2.2)
Ages
6-9
Years t** p@
18.2 (1.5) 0.33 0.74
14.2 (1.5) 0.30 0.76
10.8 (1.6) -0.46// 0.65
* Standard deviations  appear  in parentheses.

** Student's t statistics.

@ Probability that the log-transformed mean blood lead levels  for  the  two
  groups within one area  are  essentially the same.  Statistically  significant
  differences are considered  to exist when p <0.05.

it Corrections made for unequal  variances.
                                                    rh'i belongs to:
                                                Office of TOX'.C S-.ib-L-tr.nces Library
                                                i] c c-.  .-.,[••': - i Protection Agency
                                      50

-------
Table 7.  Rank Order Listing of August 1983 Blood Lead Levels of 364
          Children by Area
Blood Lead
ug/dl
45
43
40
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
1
Area I
0
0
0
0
0
2
0
1
3
1
1
1
1
2
2
1
1
4
3
1
4
0
2
2
1
0
1
1
0
1
4
1
1
0
1
0
0
0
Area II
2
1
1
3
1
0
1
0
0
4
2
3
1
1
4
5
2
5
2
7
13
10
14
9
8
16
16
9
14
9
11
7
5
9
2
2
0
0
Area III
0
0
1
0
1
0
0
0
0
0
0
0
1
1
1
1
0
4
0
0
0
3
4
4
5
5
5
8
10
15
10
12
9
6
7
6
1
2
Combined
2
1
2
3
2
2
1
1
3
5
3
4
3
4
7
7
3
13
5
8
17
13
20
15
14
21
22
18
24
25
25
20
15
15
10
8
1
2
                                        51

-------
Table 8.   Proportion of Children Found To Be Lead Toxic*,  August 1983
Area
1
2
3
1-2
45
10
3
Years
.5%
.7%
.9%
(N)
(5)
(3)
(1)
3-9
18
8
1
Years
.8%
.8%
.1%
(N)
(6)
(15)
(1)
All Ages
Combined
25.6%
9.1%
1.7%
(N)
(11)
(18)
(2)
*Defined as blood lead 25 ug/dl or greater and EP 35 ug/dl or greater.

-------
Table 9.  Number of Household Premises From Which Composite Front and
          Back Yard Soil Samples Mere Collected

                           Composite Soil Lead Category (ppm)
Area
1
2
3
<500
2
2
43
501-1.000
1
13
26
1.001-2,500
5
42
8
2.501-5.000
9
49
1
5.001-10.000
7
16
0
>10.000
4
7
0
Number of
Samples
28
129
78
                                     53

-------
Table 10.  Lead Levels in Soil and Organic Litter Samples
           Collected During the 1983 Kellogg Survey
Sample Number
Area Type* Tested
1 Soil 1 28
Soil 2 29
Soil 3 11
Garden 2
Litter 3
2 Soil 1 129
Soil 2 121
Soil 3 59
Garden 17
Litter 15
3 Soil 1 78
Soil 2 74
Soil 3 29
Garden 20
Litter 11
Mean Lead (ppm)
Arithmetic Geometric
5,502 3,474
7,119 5,163
5,435 3,616
1,400 507
2,643 2,478
3,634 2,632
3,556 2,512
2,974 996
1,509 978
3,824 2,936
591 481
798 541
800 431
382 318
540 460
Range
(ppm)
322-18,400
83-17,550
258-15,585
95-2,705
1,720-3,945
53-20,700
108-41,200
80-34,475
141-5,160
997-11,310
151-2,915
97-4,375
37-6,370
98-1,065
118-1,102
* Soil 1 = Composite of front and back yard soil samples.
Soil 2 = Soil collected
Soil 3 = Soil collected
Garden = Soil collected
within 1.0 meter of house wall.
from play area.
from vegetable garden.
Litter = Grass and decaying vegetative matter found on top



of Soil 1 sample.
                                    54

-------
Table 11.  Cadmium Levels in Soil and Organic Litter Samples Collected
           During the 1983 Kellogg Survey
Sample
Area Type*
1 Soil 1
Soil 2
Soil 3
Garden
Litter
2 Soil 1
Soil 2
Soil 3
Garden
Litter
3 Soil 1
Soil 2
Soil 3
Garden
Litter
Number
Tested
27
29
11
2
3
128
121
59
17
15
77
74
20
20
11
Mean Cadmium (ppm)
Arithmetic Geometric
60.
67
48
24
225
34
31
24
14
65
12
12
11
7
17
52
56
43
10
126
30
26
14
12
56
10
10
9
7
15
Range
(ppm)
12-124
4-160
9-72
2-46
29-510
3-125
4-108
3-94
4-33
21-167
4-119
4-48
3-27
3-15
6-35
*Soil 1 = Composite of front and back yard soil samples.
 Soil 2 = Soil collected within 1.0 meter of house wall.
 Soil 3 = Soil collected from play area.
 Garden = Soil collected from vegetable garden.
 Litter = Grass and decaying vegetative matter found on top of Soil 1 sample.
                                  55

-------
Table 12.  Zinc Levels in Soil and Organic Litter Samples Collected
           During the 1983 Kellogg Survey
Sample
Area Type*
1 Soil 1
Soil 2
Soil 3
Garden
Litter
2 Soil 1
Soil 2
Soil 3
Garden
Litter
3 Soil 1
Soil 2
Soil 3
Garden
Litter
Number
Tested
27
29
11
2
3
128
121
59
17
15
77
74
29
20
11
Mean Zinc
Arithmetic
1,422
1,737
2,245
490
1,233
1,232
1,193
1,405
611
1,744
477
534
883
404
745
(ppm)
Geometric
1,177
1,436
1,537
315
1,160
1,017
954
659
489
1,626
416
441
439
345
645
Range
(ppm)
217-3,590
212-5,290
377-8,287
115-865
869-1,871
107-6,330
148-7,280
92-9,847
137-1,325
874-3,475
177-2,790
135-1,667
62-9,120
162-1,333
240-1,298
*Soil 1 = Composite of front and back yard soil samples.
 Soil 2 = Soil collected within 1.0 meter of house wall.
 Soil 3 = Soil collected from play area.
 Garden = Soil collected from vegetable garden.
 Litter = Grass and decaying vegetative matter found on top of Soil 1 sample.
                                  56

-------
Table 13.  Lead Levels in Special Soil and Organic Litter Samples Collected
           During the 1983 Kellogg Survey
Area
1
2
3
Sample
Type*
Special Soil
Special Litter
Special Soil
Special Litter
Special Soil
Special Litter
Number
Tested
3
3
15
15
12
11
Mean Lead
Arithmetic
4,830
3,776
5,197
4,186
632
1,128
(ppm)
Geometric
3,684
3,494
3,410
3,402
509
590
Range
(ppm)
2,045-10,000
1,992-5,280
985-21,050
1,256-9,450
116-1,281
158-6,565
^Special Soil = Sample collected with hand trowel as in 1974-75 survey.
 Special Litter = Grass and decaying vegetative matter found on top of the
                  Special Soil sample.
                              57

-------
Table 14.  Cadmium Levels in Special Soil and Organic Litter Samples
           Collected During the 1983 Kellogg Survey
Area
1
2
3
Sample
Type*
Special Soil
Special Litter
Special Soil
Special Litter
Special Soil
Special Litter
Number
Tested
3
3
15
15
12
11
Mean Cadmium (ppm)
Arithmetic Geometric
73
112
34
58
11
24
56
92
33
49
10
17
Range
(ppm)
23-142
36-173
16-50
10-109
5-17
7-111
^Special Soil = Sample collected with hand trowel as in 1974-75 survey.
 Special Litter = Grass and decaying vegetative matter found on top of the
                  Special Soil sample.
                              58

-------
Table 15.  Zinc Levels in Special Soil and Organic Litter Samples
           Collected During the 1983 Kellogg Survey
Area
1
2
3
Sample
Type*
Special Soil
Special Litter
Special Soil
Special Litter
Special Soil
Special Litter
Number
Tested
3
3
15
15
12
11
Mean Zinc (ppm)
Arithmetic Geometric
1,557
1,501
1,538
1,599
526
981
1,382
1,446
1,331
1,466
470
685
Range
(ppm)
900-2,675
1,004-1,974
607-4,915
563-3,089
188-916
274-3,490
*Special Soil = Sample collected with hand trowel as in 1974-75 survey.
 Special Litter = Grass and decaying vegetative matter found on top of the
                  Special Soil sample.
                                         59

-------
'able 16.   Number of Households From Which Vacuum Cleaner Bag Dust Samples
           Were Collected.
House Dust Lead Category (ppm)
Area
1
2
3
<500
-0-
1
1
501-1.000
-0-
8
20
1.001-2.500
1
30
4
2.501-5.000
17
48
4
5.001-10.000
5
2
1
>10.000
-0-
1
-0-
Number of
Samples
23
90
52
Table 17.  Lead Levels in Vacuum Cleaner Dust Samples Collected
           During the 1983 Kellogg Survey
Urea
1
2
3
Number
Tested
23
90
52
Mean Lead
Arithmetic
4,137
2,799
1,361
(ppm)
Geometric
3,933
2,489
1,138
Standard
Deviation
1,381
1,582
1,148
Range
(ppm)
1,910-8,193
221-10,395
412-7,865
Table 18.  Cadmium Levels in Vacuum Cleaner Dust Samples Collected
           During the 1983 Kellogg Survey
Number Mean Cadmium (ppm)
Area Tested Arithmetic Geometric
1 23 69 66
2 90 41 37
3 52 29 25
Range
(ppm)
37-137
6-104
10-125
                                       60

-------
Table 19.  Zinc Levels in Vacuum Cleaner Dust Samples Collected
           During the 1983 Kellogg Survey
             Number              Mean Zinc  (ppm)                    Range
Area         Tested          Arithmetic  Geometric                  (ppm)
  1            23              2,909      2,818                  1,220-4,570

  2            90              2,469      2,194                    293-9,620

  3            52              1,732      1,586                    804-5,245
                                          61

-------
Table 20.   Lead,  Cadmium,  and Zinc Levels in Filtered Dust Samples Collected
           From One Square Meter of Household Carpet, Kellogg Survey, 1983*
        Number      Lead (ppm)          Cadmium (ppm)       Zinc (ppm)
Area    Samples   Mean    Range      Mean   Range        Mean    Range
  1       1      3,111    	        35    	        3,848    	

  2       6      2,606  1,180-4,128   33    14-60       2,626  1,166-3,746

  3       3        864   787-972      15    12-18       1,394  1,109-1,620
*Pelleted samples analyzed by Montana Department of Health and Environmental
 Sciences Laboratory (MDHES), Helena, Montana.
                                          62

-------
Table 21a.  Lead Content (ppm) of Dust in 20 Homes:   Samples From Household
            Vacuum Cleaner Bags and From Special Vacuum Filters
Sample Origin
Mean
Standard
Deviation
Range
Grab Sample From
Vacuum Cleaner Bag           1,923

Filtered Dust Sample
Collected From One Square
Meter of Carpet*—

      Resuspended Coarse
      Particulates           2,56A
      (2.5 - 15 microns)

      Resuspended Fine
      Particulates           A,532
      (0 - 2.5 microns)
            79A
           1066
          2,672
               710-2,533
             1,217-5,A12
               835-12,082
^Samples resuspended from filters and analyzed by MDHES, Helena, Montana.
                                          63

-------
Table 21b.  Comparisons of Lead Contents in Household Dust Found by Different
            Sampling Methods:   Correlation Analyses
                   Resuspended         Resuspended         Pelleted
                   Coarse              Fine                Filter
                   Particulates        Particulates        Excess

Grab Sample        0.76*               0.30                0.98
From Vacuum        0.0001**            0.19                0.0005
Cleaner Bag        20@                 20                  6
* Pearson product moment correlation coefficient.
** Probability that the lead contents are uncorrelated.
@ Number of samples.
                                       64

-------
Table 21c.  Comparisons of Lead Contents in Household Dust Found by Different
            Sampling Methods:  A Series of Linear Regression Models for
            Predicting Vacuum Bag Grab Sample Dust Lead
Model Independent
Number Variable* r2
1 Lead-C 0 . 58
2 Lead-F 0 . 09
3 Lead-P 0 . 96
Significance
F value Level
25.2 0.0001
1.8 0.19
109.5 0.0005
   Lead-C = Lead content of resuspended coarse particulates from special
   vacuum filters.

   Lead-F = Lead content of resuspended fine particulates from special
   vacuum filters.

   Lead-P = Lead content of pelleted excess from special vacuum filters.
                                         65

-------
Table 22.   Lead Levels in Carrots,  Beets, Lettuce, and Garden Soil
            Samples Collected During the 1983 Kellogg Survey
Area
1



2



3



Sample
Type
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Number
Tested
2
0
1
2
14
9
14
17
19
7
10
20
Mean Lead
Arithmetic
22
. .
48
1,400
51
42
62
1,509
24
16
35
382
(ppm)
Geometric*
19
. .
48
507
32
33
50
978
18
15
28
318
Range
(ppm)
11-33
. .- . .
48-48
2,705-1,305
12-246
14-121
12-155
141-5,160
6-92
11-30
11-83
98-1,065
*Based on a national survey (17), expected mean lead levels are 0.11 ppm in
 root vegetables, such as carrots and beets, and 0.050 ppm in leafy
 vegetables, such as lettuce.
                                  66

-------
Table 23.  Cadmium Levels in Carrots, Beets, Lettuce, and Garden Soil
           Samples Collected During the 1983 Kellogg Survey
Ares'
1



2



3



Sample
Type
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Number
Tested
2
0
1
2
14
9
14
17
19
7
10
20
Mean Cadmium (ppm)
Arithmetic Geometric*
16
• •
5
24
14
17
19
14
4
6
12
7
13
. .
5
10
7
10
14
12
4
5
10
7
Range
(ppm)
6-26
. .-. .
5-5
2-46
2-26
2-42
2-66
4-33
1-11
2-13
4-28
3-15
*Based on a national survey (17), expected mean cadmium levels are 0.021 ppm
 in root vegetables, such as carrots and beets, and 0.051 in leafy vegetables,
 such as lettuce.
                                  67

-------
Table 24.   Zinc Levels in Carrots,  Beets, Lettuce, and Garden Soil
            Samples Collected During the 1983 Kellogg Survey
Area
1



2



3



Sample
Type
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Carrots
Beets
Lettuce
Garden Soil
Number
Tested
2
0
1
2
14
9
14

19
7
10
20
Mean Zinc
Arithmetic
194
. . •
78
490
142
547
289

97
281
277
404
(ppm)
Geometric*
119
• • .
78
315
108
423
251

83
233
216
345
Range
(ppm)
41-348
. .- . .
78-79
115-865
39-539
61-1,332
139-751

30-235
109-619
49-558
162-1,333
*Based on a national survey (17), expected mean zinc levels are 2.3 ppm in
 root vegetables, such as carrots and beets, and 2.2 ppm in leafy vegetables,
 such as lettuce.
                                   68

-------
Table 25.  Maximum Daily Lead Allowance and the Amount of Lead in a Single
           Serving of Garden Produce Needed To Exceed the Maximum Daily
           Allowance.
Person's Age
Less than 6 months
6-24 months
2-5 years
Greater than 5 years
Maximum Daily
Lead Allowance
100 ug
150 ug
300 ug
430 ug
Maximum Lead Level
in 4-Ounce Serving
10
15
30
43
ppm
ppm
ppm
ppm
                                    69

-------
Table 26.  Number of Surfaces Found To Contain Lead-Based Paint During August
          1983 Kellogg Survey
Lead Paint Value
(mg lead/sq cm)
Less Than
  0.7
Interpretation of  Below
Lead Paint Value   Detection
                   Limits
                            6 .0 or
0.7 to 2.9    3.0 to 5.9    Greater
            Low
              Moderate
            High
          Total
          Surfaces
          Measured
Area 1

Area 2

Area 3
  196

1,104

  501
 95

163

 39
 11

 91

 13
  8

 95

  3
  310

1,453

  556
Total
1,801
297
115
106
2,319
                                          70

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Table 27.  Lead, Zinc, and Total Suspended Particulates (TSP) in Air Samples Collected
           Five North Idaho Sites During August, September, and October, 1983.
Sampling Site
Number
24-Hour   Lead (ug/m3)
Samples   Mean   Range
Zinc (ug/m3)
Mean   Range
TSP    (ug/m3)
Mean     Range
Silver King School

Smelterville City Hall

Medical Arts Clinic

Pinehurst School

Osburn Radio Station
  29      0.17  0.05-0.26  0.06

  28      0.28  0.08-0.94  0.11

  30      0.13   ND*-0.39  0.05

  28      0.10   ND -0.19  0.05

  28      0.12  0.04-0.29  0.05
       0.12-0.05   39.5  11.0-122.0

       0.04-0.35  100.0  24.0-293.0

       0.02-0.20   43.9  13.0-122.0

       0.03-0.16   60.0   2.0-132.0

       0.03-0.13   56.7  21.0-178.0
*ND - Not detectable.
                                            71

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 'able 28.   Mean Blood Lead Levels (ug/dl)  According to Lead Content (ppm) of
           Front and Back Yard Composited  Soil Samples*

                               Composite Soil Lead Category (ppm)

Area	<500501-1.0001.001-2.500     2.501-5.000   5.001-10.000     >10.000
1
2
3
15
15
10
.2
.0
.9
(6)
(30
(68)
22.3
14.8
13.9
(3)
(20)
(40)
23.1
15.7
13.4
(7)
(69)
(12)
18.6
17.9
13.5
(10)
(74)
(2)
21.1 (11)
17.7 (19)
-0-
29.8 (6)
20.2 (13'
-0-
"Numbers of Children sampled appear in parentheses.
                                    72

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Table 29.  Mean Blood Lead Levels (ug/dl) According to Lead Content (ppm) of Side Yard
           Yard Soil Samples*
Area
1
2
3
Soil Lead Category (ppm)
<500 501-1.000 1.001-2.500 2.501-5.000 5.001-10.000 >10.000
13.5 (4) -0- 14.5 (2) 27.0 (10) 20.2 (21) 23.5 (6)
25.7 (7) 16.0 (16) 15.2 (70) 17.6 (74) 17.0 (14) 22.5 (40)
10.7 (50) 13.2 (23) 14.6 (27) 10.2 (6) -0- -0-
^Numbers of children sampled appear in parentheses.
                                       73

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Table 30.   Mean Blood Lead Levels (ug/dl)  According to Average Lead Content (ppm)  of Front,
           Back,  and Side Yard Soil  Samples*
Area
1
2
3
<500
10.3 (3)
24.0 (2)
11.2 (54)
Soil Lead Category (ppm)
501-1.000 1.001-2.500 2.501-5.000 5.001-10.000
23.0 (1)
15.5 (10)
13.1 (40)
30.0 (2)
15.5 (64)
14.5 (20)
19.4
17.5
8.3
(13) 22.6 (22)
(86) 15.4 (19)
(3) -0-
>10.000
27.5
22.5
-0-
(2)
(4)

^Numbers of children sampled appear in parentheses.
                                         74

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Table 31.  Mean Blood Lead Levels (ug/dl) According to Lead Content (ppm) of Play Area.
           Samples*
Area <500 501-1.000
1 -0- 10.3 (3)
2 15.6 (30) 16.6 (20)
3 9.9 (29) 15.0 (14)
Soil Lead Category (ppm)
1.001-2.500 2.501-5.000 5.001-10.000 >10.000
18.0 (3) 20.7 (3) 27.5 (4) 23.0 (1)
15.8 (20) 16.5 (13) 20.5 (12) 28.7 (3)
12.5 (6) 10.5 (2) -0-
^Numbers of children sampled appear in parentheses.
                                          75

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Table 32.  Mean Ages (Years) of Children Whose Mean Blood Lead Levels Are
           Displayed in Table 26*
Area
1
2
3
<500
5.8 (6)
3.7 (3)
4.9 (68)
Composite Soil Lead (ppm)
501-1,000 1,001-2,500 2,501-5,000 5,001-10,000
5.7 (3)
6.1 (20)
4.7 (40)
6.9
5.1
5.4
(7)
(69)
(12)
4.5 (10) 5.1 (11)
5.2 (69) 5.2 (74)
5.0 (2)
>10.000
2.7 (6)
4.8 (13)

^Numbers of children sampled appear in parentheses.
Table 33.  Mean Ages (Years) of All Children Interviewed According to Lead Content
           of Front and Back Yard Composited Soil Samples*
Area
1
2
3
<500
5.8 (6)
3.7 (3)
4.9 (71)
501-1.000
5.7 (3)
5.6 (22)
4.5 (46)
Composite Soil
1.001-2.500
6.9 (7)
5.1 (75)
5.4 (12)
Lead (ppm)
2.501-5.000
4.1 (12)
5.0 (80)
5.0 (2)
5.001-10.000
5.1 (11)
5.2 (15)

>10.000
2.7 (6)
4.6 (14)

^Numbers of children interviewed appear in parentheses.  These numbers include children froi
whom blood samples were not obtained.  Thus, for certain categories, Table 31 has more
children than Table 30.
                                      76

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Table 34.   Numbers of Households According to Yard
           Grass Coverage
Area
1
2
3
Percentage of Yard Covered by Grass
0 - 25% 25 - 50% 50 - 75% 75 - 100%
3 0
15 9
2 2
7
30
5
28
72
52
chi-square = 16.75, p = .01.
Table 35.  Mean Blood Lead Levels (ug/dl) According to
           Yard Grass Coverage*
Area
1
2
3
Percentage of Yard Covered by Grass
0 - 25% 25 - 50% 50 - 75% 75 - 100%
21.0
26.2
1A.3
(2) -0-
(18) 21.1 (18)
(3) 10.3 (3)
22.8 (13)
17.2 (48)
12.3 (81)
21.0 (2)
22.0 (10)
11.6 (29)
^Numbers of children sampled appear in parentheses.
                                       77

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   Le 36.   Mean Blood Lead Levels (ug/dl)  by Area and Dust Lead Content (ppm)*






                                    House Dust Lead  (ppm)




Area	<500    501-1.000     1.001-2.500     2.501-5.000	5.001-10.000	>10.000
1
2
3
-0-
20.0
8.0

(1)
(1)
-0-
12.9
9.8

(15)
(33)
22.3
16.5
13.9
(3)
(A8)
(44)
21.1
17.7
16.6
(22)
(73)
(7)
17.0
19.5
19.0
(5)
(4)
(1)
-0-
45.0
-0-

(1)

*Numbers of children sampled appear in parentheses.
                                           78

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Table 37.  Mean Blood Lead Levels (ug/dl) According to General Levels of
           Housekeeping*
Area
1
2
3
Poor
10
17
1A
.0
.8
.7
(3)
(15)
(11)
Fair
25.7
16.3
14.7
(13)
(AA)
(35)
Housekeeping
Average
20. A
17.7
10.8
(19)
(99)
(30)
Category
Excellent
21.2
1A.1
10.6
(5)
(33)
(31)
Hissing
10.0
2A.1
10. A
Data
(3)
(8)
(15)
^Numbers of children sampled appear in parentheses.
Table 38.  Mean Blood Lead Levels  (ug/dl) by Level of Housekeeping
           and Area*
Area
1
2
3
Level of Housekeeping
Fair/Poor Average/Excellent
2A
16
1A
.6
.7
.7
(6
(7
(6
.59)
.52)
.93
20
16
10
.5
.8
.7
(7
(7
(5
.98)
.35)
.17)
t
-1
0
-2
**
.76
.10
.86
P @
0.08
0.92
0.005
 ^Standard deviations appear  in parentheses.
**Student's t statistic based on geometric means.
@ Probability that the log-transformed mean blood lead levels for the two
  groups within one area are  essentially the same.  Statistically significant
  differences are considered  to exist when p <0.05.
                                          79

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  ale 39.   Mean Blood Lead Levels (ug/dl) According to the Absence or Presence of Lead Paint
           in the Household*
Area
1
2
3
Children in Households
Without Lead Paint
20
17
11
.9
.7
.4
(7)
(70)
(51)
Children in Households
With Lead Paint
22
16
14
.6
.3
.9
(32)
(108)
(40)
t **
-.29
1.44
-1.18
p
0
0
0

-------
Table 41.  Households With and Without Storm Windows
Area
1
2
3
Number of Households
With Storm Windows
20
100
57
Number of Households
Without Storm Windows
8
32
21
chi-square = 0.33, p = 0.84.
Table 42.  Mean Blood Lead Levels (ug/dl) According to Household Storm
           Window Usage*
Area
1
2
3
Children in Households
With Storm Windows
20.
16.
11.
5
3
5
(28)
(146)
(90)
Children in Households
Without Storm Windows
24
19
14
.4
.2
.1
(13)
(53)
(32)
t
-2
-2
-1
**
.40
.28
.80
P @
0
0
0
.C
.026
.074
 ^Numbers of children sampled appear in parentheses.
**Studenfs t statistic.
@ Probability that the two log-transformed mean blood lead levels are essentially
  the same.  Statistically significant differences are considered to exist when p <0.05.
                                           81

-------
 ible 43.   Mean House Dust Lead Levels (ppm) According to Household Storm Window Usage*
Area
1
2
3
Households With
Storm Windows
4,110 (15)
2,895 (77)
1,429 (39)
Households Without
Storm Windows
4,368 (7)
2,281 (14)
1,156 (13)
t **
0.72
-2.09
-0.37
P @
0.48
0.04
0.72
 ^Numbers of households sampled appear in parentheses.
**Student's t statistics.
@ Probability that the two log-transformed mean house dust lead levels are
  essentially the same. Statistically significant differences are considered to
  exist when p <0.05.

-------
Table 44.  Children in Households With or Without Active Lead Hobbyists




Area
1
2
3
Total
Number of
Children in Households
Where at Least One
Lead-Related Hobby Was
Practiced
6
55
32
93

Number of
Children in Households
Where No Lead-Related
Hobby Was Practiced
37
166
99
302




Total
43
221
131
395
                                            83

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Table 45.  Mean Blood Lead Levels (ug/dl) According to the Presence or Absence of
           Lead-Related Hobbies*
Area
 Children in Households
   Where at Least  One
 Lead-Related Hobby Was
	Practiced   	
Children in Households
Where No Lead-Related
 Hobby Was Practiced
 1

 2

 3
        15.2  (6.4)

        17.1  (7.2)

        13.8  (8.3
        23.4 (7.2)

        17.0 (7.7)

        11.6 (5.0)
"Standard deviations appear in parentheses.
Table 46.  Mean EP Levels (ug/dl) According to the Presence or Absence of Lead-Related
           Hobbies*
Area
1
2
3
Children in Households
Where at Least One
Lead-Related Hobby Was
Practiced
29.8 (23.4)
31.8 (22.7)
22.1 (9.0)
Children in Households
Where No Lead-Related
Hobby Was Practiced
37.0 (17.7)
25.2 (17.4)
22.3 (10.0)
"Standard deviations appear in parentheses.
                                           84

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Table 47.  Children's Frequencies of Eating Neighborhood-Grown Fruits
           or Vegetables
Area
1
2
3
Number of
Children Who Frequently
Ate Neighborhood Produce
7
72
56
Number of
Children Who Did Not
Frequently Eat
Neighborhood Produce
36
126
66
Table 48.  Mean Blood Lead Levels  (ug/dl) According to Frequency of Eating
           Neighborhood-Grown Fruits or Vegetables
Area
1
2
3
Children Who Frequently
Ate Neighborhood Produce
19.3 (11.2)
15.9 (5.9)
12.7 (7.5)
Children Who Did Not
Frequently Eat
Neighborhood Produce
21.8 (7.3)
17.7 (8.4)
11.7 (4.7)
t**
0.98
1.10
-0.23
P @
0.33
0.27
0.81
 ^Standard deviations appear  in parentheses.
**Student*s t statistics.
@ Probability that the  log-transformed mean blood lead 1; levels for the two
  groups within one area are  essentially the same.  Statistically significant
  differences are considered  to exist when p <0.05.
                                         85

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 able A9.  Mean EP Levels (ug/dl) According to Frequency of Eating
           Neighborhood-Grown Fruits or Vegetables.
Area
1
2
3
Children Who Frequently
Ate Neighborhood Produce
24.9 (11.3)
22.9 ( 9.9)
23.7 (11.1)
Children Who Did Not
Frequently Eat
Neighborhood Produce
36.5 (19.2)
29.6 (22.9)
21.0 (8.1)
t **
1.56
2.19
-1.70
P @
0.13
0.03
0.09
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant differences
  are considered to exist when p <0.05.
                                           86

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Table 50.  Children's Use of Vitamins, Minerals,  or Other Dietary Supplements
Area
1
2
3
Number of
Children Taking
Supplements
25 (54%)
119 (53%)
80 (61%)
Number of
Children Not Taking
Supplements
21
104
51
chi-square = 2.05, p = 0.36.
                                       87

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Fable 51.  Mean Blood Lead Levels (ug/dl) According to Use of Vitamins,
           Minerals, or Other Dietary Supplements*
Area
1
2
3
Children Taking
Supplements
19.7
16.6
10.6
(8
(7
(5
.6)
-1)
.0)
Children Not
Taking Supplements
23
17
14
.4
.5
.7
(6
(8
(6
.7)
.2)
.9)
t
1
0
3
**
.73
.59
.58
p
0
0
0

-------
Table 52.  Mean EP Levels (ug/dl) According to Use of Vitamins,
           Minerals, or Other Dietary Supplements*
Area
1
2
3
Children Taking
Supplements
31
26
21
.5 (17
.7 (19
.8 (10
.6)
.6)
.0)
Children Not
Taking Supplements
38
27
23
.5
.5
.0
(19
(19
(9.
.4)
.3)
3)
t
1.
0.
0.
**
22
51
89
P@
0
0
0
.22
.61
.37
 ^Standard deviations appear in parentheses.
**Studenfs t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant differences are
  considered to exist when p <0.05.
                                          89

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Table 53.  Children's Use of Grassy and Nongrassy Play Surfaces.
Area
1
2
3
Total
Number of Children
Using Grassy Play
Surfaces
12
76
50
138
Number of Children
Using Nongrassy Play
Surfaces
34
147
81
262
Total
46
223
131
400
                                 90

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Table 5A.  Mean Blood Lead Levels (ug/dl) According to Children's Use
           of Grassy and Nongrassy Play Surfaces*
Area
 Children Who
 Played on
Grassy Surfaces
Children Who
Played on
Nongrassy
Surfaces
t **
1
2
3
16
15
12
.9
.0
.0
(6
(6
(7
.9)
.A)
.0)
22
18
12
.9
.1
.3
(7
(8
(5
.8)
.0)
.5)
2.
2.
0.
21
82
648
0.0327
0.0053
0.5
 *Standard deviations appear in parentheses.
**Studenfs t statistic.
@ Probability that the log-transformed mean blood lead levels for the
  two groups within one area are essentially the same.  Statistically
  significant differences are considered to exist when p <0.05.
                                          91

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Table 55.  Mean EP Levels (ug/dl) According to Children's Use
           of Grassy and Nongrassy Play Surfaces*
                                         Children Who
                 Children Who            Played on
                 Played on               Nongrassy
Area             Grassy Surfaces         Surfaces           t **      p @
1
2
3
34
21
23
.9
.6
.6
(17
(9.
(12
.4)
7)
.0)
34
30
21
.5 (19
.0 (22
.4 (7.
.2)
.4)
9)
-0
3
-1
.284
.65
.06
0
0
0
.78
.0003
.29
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                         92

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Table 56.  Children in Households With and Without Household Members
           Who Smoked*
                 Number of               Number of
                 Children in             Children in
                 Households Where        Households Where
Area             Someone Smoked          Nobody Smoked               Total
1
2
3
Total
34
120
56
210
(1
(0
(1

.8)
.0)
.0)

9
70
46
125
(3
(0
(1

.1)
.0)
.7)

43
190
210
335
"Individual cell chi-square statistics appear in parentheses
                                           93

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Table 57.  Mean Blood Lead Levels (ug/dl) According to the Presence or
           Absence of a Household Member Who Smoked*
Area
Children in
Households Where
Someone Smoked
Children in
Households Where
Nobody Smoked
t **
1
2
3
23
18
12
.9
.8
.6
(6
(8
(5
.8)
.2)
.8)
11
13
11
.8
.9
.4
(3
(5
(6
.5)
.2)
.7)
-5
-4
-1
.34
.60
.72
0 . 0001
0.0001
0.09
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean blood lead levels for the
  two groups within one area are essentially the same.  Statistically
  significant differences are considered to exist when p <0.05.
                                         94

-------
Table 58.  Mean EP Levels (ug/dl) According to the Presence or Absence
           of a Household Member Who Smoked*
Area
Children in
Households Where
Someone Smoked
Children in
Households Where
Nobody Smoked
t **
P 9
1
2
3
38
30
22
.5
.0
.3
(18
(22
(19
.6)
.7)
.5)
20
22
22
.0
.0
.1
(8
(9
(8
.0)
.6)
.1)
-3
-3
0
.36
.17
.19
0.0017
0.0018
0.85
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                        95

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Table 59.  Households With and Without Smokers
Area
1
2
3
Total
Number of Households
With Smoker
24 (83%)
87 (66%)
52 (67%)
163
Number of Households
Without Smoker
5 (17%)
45 (34%)
26 (33%)
76
Total
29
132
78
236
                                        96

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Table 60.   Households With and Without Smokers According to Annual
            Family Income.
                  Households With
                     Smoker
Area
 Income
<$10,000
 Income
>$10,000
                                       Households Without
                                           Smoker
Income
<$10,000
Income -
>$10,000
Total
 1

 2

 3
 15 (56%)

 43 (38%)

 20 (31%)
  7 (26%)

 29 (26%)

 18 (28%)
 2 (7%)

13 (12%)

 6 (9%
 3 (11%)     27

27 (24%)    112

20 (31%)     64
                                         97

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Table 61.  Households With and Without Smokers According to Head of
           of Household's Education Level*

Area
1
2
3
Households
Head of
Household
Completed
High School
or More
15 (52%)
52 (39%)
33 (42%)
With Smoker
Head of
Household
Did Not
Complete
High School
9 (31%)
35 (26.5%)
19 (24%)
Households Without Smoker
Head of
Household
Completed
High School
or More
5 (17%)
35 (26.5%)
22 (28%)
Head of
Household
Did Not
Complete
High School
0 (0%)
10 (8%)
4 (5%)
Total
29
132
78
Cell percentages of total appear in parentheses.
                                        98

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Table 62.  Children's Habits of Taking Food Outside*
            Number of                     Number of
            Children Who                  Children Who Did
            Often Took                    Not Often Take
Area        Food Outside                  Food Outside                  Total
1
2
3
Total
26
99
99
209
(0.
(10
(13

5)
.1)
.8)

17
133
32
182
(0.
(8.
(12

A)
8)
.0)

43
217
131
391
Individual cell chi-square statistic appear in parentheses.
                                       99

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Table 63. Mean Blood Lead Levels (ug/dl) According to Children's Habits
          of Taking Food Outside*
                                          Children Mho Did
            Children Who Often            Not Often Take
Area        Took Food Outside             Food Outside           t **     p @
1
2
3
21
17
13
.8
.8
.0
(8
(7
(6
.2)
.4)
.4)
20
16
9
.2
.6
.8
(8
(7
(4
.1)
.9)
.5)
-0
-1
-2
.517
.56
.73
0.61
0.12
0.0072
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean blood lead levels for the two
  groups within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                         100

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Table 64. Mean EP Levels (ug/dl) According to Children's Habits of
          Taking Food Outside
                                          Children Who Did
            Children Who Often            Hot Often Take
Area        Took Food Outside             Food Outside          t **     p @
1
2
3
33
28
22
.-9
.5
.1
(18
(21
(8.
.9)
.5)
8)
33
26
22
.1
.3
.5
(16
(18
(12
.8)
.3)
.1)
-0
-1
-0
.060
.06
.074
0.95
0.29
0.94
 ^Standard deviations appear in parentheses.
**Studenfs t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                        101

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Table 65.  Children's Habits of Using a Pacifier,  Sucking a Thumb,  or
          Chewing Fingernails.
Area
Number of Children
Who Had These
Oral Habits
Number of Children
Who Did Not Have
These Oral Habits
Total
1
2
3
Total
21
92
49
162
25
131
82
238
A6
223
131
400
                                       102

-------
Table 66.  Mean Blood Lead Levels (ug/dl) According to Children's Habits of
           Using a Pacifier, Sucking a Thumb, or Chewing Fingernails*
                  Children Who            Children Who Did
                  Had These               Not Have These
Area              Oral Habits             Oral Habits          t **     p @
1
2
3
21
18
13
.7
.9
.4
(8
(9
(6
.5)
.0)
.8)
21
15
11
.0
.6
.4
(7
(6
(5
.7)
.0)
.5)
-0
-2
-1
.022
.49
.93
0.98
0.0136
0.056
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean blood lead levels for the two
  groups within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                        103

-------
Table 67. Mean EP Levels (ug/dl) According to Children's Habits of Using
          a Pacifier, Sucking a Thumb, or Chewing Fingernails*
Area
Children Who
Had These
Oral Habits
Children Who Did
Not Have These
Oral Habits
t **
1
2
3
39
32
21
.9
.4
.6
(21
(25
(9.
.0)
.4)
7)
33
23
22
.5
.0
.7
(16
(11
(9.
.5)
.7)
7)
-0
-3
-0
.009
.36
.869
0.99
0.0010
0.39
 ^Standard deviations appear in parentheses.
**Student's t statistic.
@ Probability that the log-transformed mean EP levels for the two groups
  within one area are essentially the same.  Statistically significant
  differences are considered to exist when p <0.05.
                                       104

-------
Table 68.   Correlations Among Log-Transformed Lead Levels in Soil and
            Dust Samples, All Areas

Composite


Side


Play


Dust


Garden


Front &
Back Yard
Composite
Soil Sample
(Composite)
1.000*
0 . 000**
235(3












Side Yard
Soil
Sample
(Side)
0.75
0.0001
222
1.000
0.000
224









Play
Area
Soil Sample
(Play)
0.22
0.027
97
0.34
0.0008
93
1.000
0.000
99






Vacuum
Bag Dust
Grab Sample
(Dust)
0.57
0.0001
163
0.56
0.0001
155
0.36
0.0013
77
1.000
0.000
165



Garden
Soil
Sample
(Garden)
0.59
0.0001
39
0.54
0.0005
38
0.45
0.082
16
0.34
0.079
28
1.000
0.000
39
 *Pearson correlation coefficient.
**The significance probability of the correlation.
@ The number of samples.
                                   105

-------
Table 69.   Correlations Among Log-Transformed Lead Levels in Vacuum
            Bag Dust Samples and Soil Samples



Area
1


2


3


Front &
Back Yard
Composite
Soil Sample
0.35*
0.10
22(3
0.28
0.007
89
0.06
0.65
52

Side Yard
Soil
Sample
0.006
0.98
23
0.35
0.001
83
0.12
0.41
49

Play
Area
Soil Sample
-0.48
0.16
10
0.18
0.24
45
0.22
0.33
22

Garden
Soil
Sample
ISN


0.21
0.50
13
0.20
0.51
13
 *Pearson correlation coefficient.
**The significance probability of the correlation.
@ The number of samples.
ISN = Insufficient sample number.
                                        106

-------
Table 70.  Correlations Among Log-Transformed Mean Blood Lead Levels
           of Siblings, All Areas
               Younger Siblings                Older Siblings
               Mean                            Mean
               Blood                           Blood
               Lead                            Lead
Difference
in Age
1
2
3
Year
Years
Years
Level
(ug/dl)
17.5
16.7
16.5
s
7
7
7
.d. *
.5
.2
.0
N **
26
77
117
Level
(ug/dl)
15.9
15.7
16.1
s
7
7
7
.d *
.1
.1
.9
N **
29
85
130
r @
0.87
0.81
0.72
P *
0.0001
0.0001
0.0001
 * Standard deviation.
**Sample size.
@ Pearson correlation coefficient.
# The significance probability of the correlation.
                                          107

-------
Table 71.  Principal Component Analysis of Child Behavior Variables
                  (342 observations, 8 variables)

MOUTH1
MOUTH2
MOUTH3
Eigenvalue
0.915418
0.290545
0.263364
Difference
0.624872
0.027181
Proportion
0.399469
0.126788
0.114926
                           EIGENVECTORS
                    MOUTH1
MOUTH2
EATSNOW
TOYS
ORAL
CPUFDT
CORIFU
CORIOT
CORIPA
CORISW
-0.03758
-0.02596
-0.10939
-0.03418
0.5208
0.79451
0.19726
0.20829
0.10368
0.26331
0.35534
0.52168
0.61462
-0.36031
0.07031
0.09478
Variables defined as follows:

     EATSNOW - does the child eat snow? (yes/no)
     ORAL - does the child suck thumb or fingers, suck a pacifier,
            or chew nails? (yes/no)
     TOYS - does the child have a favorite blanket or toy? (yes/no)
     CPUFDT - does the child often take some food or a bottle with
              him/her outside to play? (yes/no)
     CORIFU - does the child often put mouth on furniture or window
              sill?
     CORIOT - does the child put things other than food in mouth?
     CORIPA - have you ever seen child put paint chips in mouth?
     CORISW - does child swallow things other than food?

     (CORIFU, CORIOT, CORIPA, CORISW are coded:
        1 = a lot
        2 = just once in a while
        3 = almost never
        9 = don't know)
                                        108

-------
Table 72.  Principal Component Analysis of Outdoor Activity
Eigenvalue Proportion
OUTPLAY1 8.4510 0.526
Total Variance
16.0642

SUMMARY STATISTICS
COUTT CPOHR
Mean 0.864 6.296
Standard Deviation 2.043 2.638
CORIFL
3.279
2.219

EIGENVECTOR
OUTPLAY1
COUTT -0.14506
CPOHR 0.84367
CORIFL -0.51688
Variables are defined as follows:

     COUTT - average number of hours child spends away from home
             each day
     CPOHR - number of hours each day spent playing outdoors in
             the neighborhood
     CORIFL - number of hours during the day spent playing on the
              floor when indoors
                                      109

-------
Table 73.  Log Blood Lead Multiple Regression Results:  Soil Lead and
           Other Main Effects Only (Dust Lead Excluded)
Ln Blood Lead

Variable
ALPHA
LENV12
PBHOBBY
STRMWIND
AGE
AGE-SQ
AREA1
AREA2
MOUTH2
OUTPLAY1
SMOKET
VITAMINT
(n = 319; r2 = .355)
Unstandardized
Regression
Coefficient
1.8391
0.0769
0.1017
-0.1071
0.0832
-0.0125
0.4396
0.2938
0.0432
0.0943
0.1735
-0.0911


F Statistic

6.7
3.31
3.81
3.06
8.02
16.61
15.81
3.11
11.24
11.41
3.12


Significance
Level

0.01
0.069
0.05
0.08
0.005
0.0001
0.0001
0.078
0.0009
0.0008
0.078
                                        110

-------
Table 74. Main Effect Variables With Sufficient Data For Inclusion in
          Regression Models
Variable Name
Definition
LENV12
LENVA2
AREA1, AREA2

PBHOBBY
STRMWIND
AGE
AGE-SQ
INCOME
MOUTH1
MOUTH2
CPOHR
CORIFL
SMOKET
VITAMINT
WASH
VEGT
GRASSCOV
GENHOUSE
soil lead composite front/back yard
house dust vacuum grab sample
study area location - Areal=Smelterville
                    - Area2=Kellogg
indication of any lead-related hobby
stormwindows installed on house (coded yes/no)
child's age (coded as an integer)
child's age squared
family income (coded as <$10,000, >$10,000, refuse)
first principal component for behavior scale
second principal component for behavior scale
hours of outdoor play
hours on floor per day
does anyone in the house smoke?
does child use vitamins, minerals, or supplements?
is the child washed before meals, bed, or play?
does the child eat locally grown vegetables?
percent of yards grass cover
housekeeping scale
                                  111

-------
Table 75.  Log Blood Lead Multiple Regression Results: Including Main and
           Interaction Effects (All Children)
Ln Blood Lead
Variable
ALPHA
LENV12
PBHOBBY
AGE-SQ
INCOME
AREA1
AREA2
MOUTH2
OUTPLAY1
VITAMINT
INC-SMK
AGE-VIT
(n = 319; r2 = .36)
Unstandardized
Regression
Coefficient
2.2838
0.0726
0.1093
-0.0068
-0.1366
0.4281
0.3023
0.0559
0.0894
-0.3138
0.1099
0.0391

F Statistic

5.96
3.84
28.07
11.63
15.85
16.89
5.24
10.96
7.91
16.63
4.43

Significance
Level

0.015
0.05
0.0001
0.0007
0.0001
0.0001
0.022
0.001
0.005
0 . 0001
0.036
                                       112

-------
Table 76.  Log Blood Lead Multiple Regression Results: Including Main and
           Interaction Effects  (Children Who Remain Home All Day)
Ln Blood Lead
Variable
INTERCEPT
LENV12
PBHOBBY
AGE-SQ
INCOME
AREA1
AREA2
MOUTH2
OUTPLAY1
VITAMINT
INC-SMK
AGE-VIT
(n = 292; r2 = .362)
Unstandardized
Regression
Coefficient
2.3089
0.0687
0.1359
-0.0071
-0.1304
0.4527
0.3153
0.0534
0.0933
-0.3723
0.1076
0.0447

F Statistic

4.62
5.27
26.46
9.24
15.65
16.61
3.92
10.75
9.56
14.75
5.04

Significance
Level

0.032
0.022
0.0001
0.0026
0.0001
0.0001
0.048
0.0012
0.002
0.0002
0.255
                                        113

-------
Table 77.   Final Series of Regression Models for Assessing the
            Independent Significance of Soil Lead and Dust Lead in
            Predicting Blood Lead Levels
Backward Stepwise MAXR Stepwise
M
1
2
3
4

5
6

7

odel n r-square b p-value r-square b
.Soil 363 0.168
.Dust 258 0.188
.Air-HP 326 0.223
. (3)+soil 363 0.299

. (3)+dust 258 0.317
. (3)+soil, 258 0.331
dust

. (3)+soil, 258 0.3A2
dust,
areal
areaZ

0.1788 0.0001 0.168
0.3233 0.0001 0.188
2.519 0.0001 0.223
air 0.299
1.614 0.0003
soil
0.1388 0.0001
dust 0.317
0.3109 0.0001
soil 0.331
0.0616 0.0238
dust
0.2500 0.0001
dust 0.331
0.2269 0.0001
air
9.866 0.0034
areal
-1.525 0.0060
0.1788
0.3233
2.519
air
1.614
soil
0.1388
dust
0.3109
soil
0.0616
dust
0.2500
dust
0.2500
soil
0.0616

p-value
0.0001
0.0001
0.0001
0.0003
0.0001
0.0001
0.0238
0.0001
0.0001
0.0238

where b =   the unstandardized regression coefficient for air lead, for
            the natural log transformations of soil lead or dust lead, or
            for area, as identified in the table.

      @ =   PBHOBBY, STRMWIND, AGE, AGE-SQ, INCOME, MOUTH1*, MOUTH2*.
            CPOHR, CORIFL, SMOKET, VITAMINT, WASH.  (* Variables used to
            construct these principal component vectors were: EATSNOW,
            TOYS, ORAL, CPUFDT, CORIFU, CORIOT, CORIPA, CORISW.)

and (3)= the variables in the most predictive model from the preceding
         step, i.e., AIR, AGE, AGE-SQ, INCOME, SMOKET, and VITAMINT.
                                         114

-------
Table 78.   Testing for the Influence of Hand-to-Mouth Activity
Model
LN(SOIL)
LN(DUST)
AGE
AGE-SQ
SMOKET
VITAMINT
AGEHARK *
LN(SOIL)
LN(DUST)
AGE
AGE-SQ
SMOKET
VITAMINT
AGEMARK **
              n
   Backward Stepwise

r-sguare     b     p-value
            258   0.331
            258   0.331
           0.0616
           0.2500
           0.1139
           -.0152
           0.2045
           -.1401
0.0001
0.0238
0.0001
0.0199
0.0014
0.0003
0.0107
0.0616
0.2500
0.1139
-.0152
0.2045
-.1401
0.0001
0.0238
0 . 0001
0.0199
0.0014
0 . 0003
0.0107
     MAXR Stepwise

r-square    b      p-value

0.331
                              0.331
0.0606
0.2500
0.1139
-.0152
0.2045
-0.1401
0.0001
0.0238
0.0001
0.0199
0.0014
0.0003
0.0107

0.0616
0.2500
0.1139
-.0152
0.2045
-.1401
0.0001
0.0238
0.0001
0.0199
0.0014
0.0003
0.0107
* Where AGEMARK is an interaction- term between (1) a categorical variable
  whose value 1 denotes age less than or equal to 2 years and whose value
  2 denotes age greater than 2 years and (2) the natural log
  transformations of soil lead levels.  Although included in the model
  construction, AGEMARK failed to appear as a significant contributor to
  the dependent variable, i.e., the natural log transformation of blood
  lead.

** Where AGEMARK is an interaction term between (1) a categorical
   variable whose value 1 denotes age less than or equal to 2 years and
   whose value 2 denotes age greater than 2 years and (2) the natural log
   transformations of dust lead levels.  Although included in the model
   construction, AGEMARK failed to appear as a significant contributor to
   the dependent variable, i.e., the natural log transformation of blood
   lead.
                                       115

-------
Table 79.  Final Log Blood Lead Multiple Regression Model (All Children)
Ln Blood Lead (n = 258; r2 = .33)
Variable
Unstandardized
  Regression
 Coefficient
F Statistic
Significance
   Level
INTERCEPT

LENV12

LENV42

AGE

AGE-SQ

SMOKET

VITAMINT
    0.1559

    0.0616

    0.2500

    0.1139

   -0.0152

    0.2045

    -.1401
     5.17

    28.15

     5.49

    10.48

    13.72

     6.61
   0.0238

   0.0001

   0.0199

   0.0014

   0.0003

   0.0107
                                       116

-------
Table 80.  Comparison of the Average Blood Lead Levels of Children in Areas 1,
           2, and 3—1974, 1980, and 1983



Area
1
2
3



No.
172
199
191
1974
Mean
Blood Lead
(UR/dl)
68
49
35



No.
93
357
Not
1980
Mean
Blood Lead
(UB/dl)
31
26
tested



No.
43
199
122
1983
Mean
Blood Lead
(UR/dl)
21
17
12
Table 81.  Percent of Children in Areas 1, 2, and 3 With Blood Lead Levels
           of 30 ug/dl or Greater, 1974 and 1983
                                 Percent of Children With Blood Lead Level
                                      of 30 ug/dl or Greater

             Area                   1974                         1983

               1                      99                           19

               2                      76                            8

               3                      26                            2
                                        117

-------
Figure 1.  The Percentage  of Children With Lead Toxicity
           (Blood Lead Level =Ł 25  ug/dl and EP*35 ug/dl)
           in Each Study Area
        25 -
        29 -
        15 -

         5 -
         •
                                                     toxieit^
                           II
HI
                 toa .« X*Il»
-------
Mean  30-
Blood
Head
ftevel
      20-
      10-
            Figure 2.   Mean Blood  Lead Levels According
                       to the Lead Content  of Front and
                       Back Yard Soils            	
       T
       •
       1
     500   501-   1001-  2501-  5001-  10,000+
            1000   2500   5000    1 OK

            Soil  Lead  Level  (ppm)

95% confidence interval  of mean  value displayed
                             119

-------
                                                                         ATTACHMENT  I
                                PARTICIPANT CONSENT FORM
                                        August 1983


     ierstand that the Idaho Department of Health and Welfare with the assistance
     le Panhandle District Health Department is conducting a study to determine the
possible health effects of lead exposure on children ages 1-9 years living in the
Kellogg, Smelterville, and Pinehurst area.  I understand that there will be three
parts to the study and that my participation is voluntary:

A.  Interview — Collection of Information Concerning

    1.  health history, habits and activities of children in my home from
        1  thru 9 years of age;

    2.  Occupations and hobbies of adults in my home.


B.  Environmental Testing

    1.  Collection of dust samples from vacuum cleaners and/or surface within
        my home;

    2.  Collection of soil and vegetable samples from the yard and garden of
        my home;

    3.  Examination of walls at my home for presence of lead in paint.  (This
        will be done by placing an x-ray fluorescent instrument against the
        wall.  The procedure will  not damage nor alter the appearance of the
        wall.)


C.  Examination of Blood Samples

    1.  A blood sample, approximately 2-3 ml will  be taken from a vein in the
        arm of each child in my household ages 1 thru 9 years of age to be
        tested for blood lead and erythrocyte protophorphyrin.  (There should
        be no problems associated with collecting  the blood sample, other than
        slight, temporary discomfort and the possibility of a small bruise at
        the site where the needle enters the skin, which will disappear in a
        few days.)

I voluntarily agree to take part in this study and consent to having my child/children
participate.  I understand that my/our childrens'  participation involves:  1) Being
interviewed regarding the topics described-above;  2) Contributing a sample of blood;
3) Allowing soil, dust, and vegetable samples to be taken from my residence; and
4) Allowing examination of the paint in my home.  I have been assured that personal
identifying information will be kept in confidence by the Department of Health and
Welfare and neither I nor any member of my family  will be identified by name in
published reports of the results of this study.  I also understand that I may decline
to answer specific questions as I  see fit and that I am free to withdraw my/our child's
participation in the study at any time.  I  understand that I will be informed in
"""i^ing of the results of these tests at the completion of the study, unless additional
    3wup is indicated, in which case I will be notified immediately.  I understand that
     have further questions concerning the study,  information can be obtained by
contacting Dr. Charles Brokopp, or Jerry Cobb, or  Annabelle Rose at 784-5581.
Participant                                 Interviewer
Signature: 	   Signature: 	
           Parent/Guardian
                                            date:

-------
  STATE  OF   IDAHO
                                                              ATTACHMENT 2
BEZAXTMZNT OJF H2ALTH AND
 (  1—7)I.D. Number       /                                    Form approved
                 (BlocklTHouae)                           OMB No. 0920-0008


                             CHILD QUESTIONNAIRE
                           CHILDHOOD T.BAD EXPOSURE


        1.  Complete before interview:

          A. Address:
                      No.       Street                 Apt. it

 (  8-13)   B.  Date  of interview	/	/	
                              Mo.      Day     Yr.

 (14-15)   C. Interviewer No.	

 (16-19)   D. Tiae interview began:                (Convert to military tine

                           MILITANT TESTABLE

               0100 AH       0700 AM         1300 HI      1900 PM
               0200 AM       0800 AM         1400 FM      2000 PM
               0300 AM       0900 AM         1500 FM      2100 FM
               0400 AM       1000 AM         1600 FM      2200 FM
               0500 AM       1100 AM         1700 FM      2300 FM
               0600 AM       1200 N         1800 FM      2400 M
        2. I would 1*>* to talk to  the parent or legal guardian of  the
            children who live in this house, preferably the one who can
            tell us about how the younger children  spend their time.
            Is that person you?

 (20)                          1 -  Yes    2 - Jfa

           (If the answer is "no",  ask who that person is and if you can
           come back later to talk  to him/her.  Discontinue interview,
           until you are talking to the person wno  can cell you how the
           children spend their tiae.)



 This report is authorised by law (PL 96-510, Sect.  104 (b)).  While your
 response is voluntary, your cooperation is appreciated.

-------
         I.D. t	/	                            Page 2


        3.  What is your name?	
                                 First          Middle           Last

(21)    4.  How long has this family been living at this address:

                  1 - Less than 1 month
                  2 « 1 month or more but less than 2 months
                  3 » 2 to 3 months
                  4 - More than 3 months but less than 6 months
                  5 • 6 months to 1 year
                  6 - More than 1 year but less than 5 years
                  7*5 years or more
                  9 - Don't know or Unknown

                IF THREE MONTHS OR LESS, TERMINATE INTERVIEW

        5.  Total number of persons living in household including any baby,
            small children, and persons who usually live here but who are away
            now, traveling, on vacation, in a hospital, or somewhere else.
            (Include yourself)
              (ENTER ANSWER ONLY WHEN YOU ARE SURE OF THE TOTAL NUMBER)

(22-23) Total Number: 	


                            RESPONSES IN TABLE 1 ON NEXT PAGE

        6.  A. What is the full name of youngest person living in household? •

            B. Circle code for sex; ask if necessary

            C. On what date was he/she born?
               Who is the next youngest? (Proceed up in age.)

              (Repeat A,B,C for all members of the household.)

            D. Ask as appropriate for all persons 16 and older:
               What is (his/her/your) occupation—chat is, what
               does (he/she, do you) do?

-------
         I.D.
                                                             Page  3
                             HOUSEHOLD ROSTER
                                 TABLE 1
(24-25)
Person
  01
                       A
                     Name
(35-36)
Person
  02
(46-47)
Person
  03
(57-58)
Person
  04
(68-69)
Person
  05
                  F
                  M
                  L
                       A
                     Nane
                  F
                  M
                  L
                       A
                     Name
                  F
                  M
                  L
                       A
                     Name
                  F
                  M
                  L
                       A
                     Name
                  F
                  M
                  L
B
Sex
M 1
(26)
F 2
B
Sex
M 1
(37)
F 2
B
Sex
M 1
(48)
F 2
B
Sex
M 1
(59)
F 2
B
Sex
M 1
(70)
F 2
C
Dace of
Birch
MO.
DAY
YR.
AGE
^^^^^^^^H
C
Dace of
Birch
Mo. 	
Day
Yr.
Age
C
Dace of
Birch
Mo. 	
Day
Yr.
Age
C
Dace of
Birch
Mo.
Day
Yr.
Age
C
Dace of
Birch
Mo.
Day
Yr.
Age 	
(27-28)
(29-30)
(31-32)
__ (33-34)
(38-39)
(44-41)
(42-43)
(44-45)
(49-50)
" (51-52)
(53-54)
" (55-56)
(60-61)
(62-63)
" (64-65)
(66-67)

(71-72)
(73-74)
" (75-76)
(77-78)
D
Occupation
D
Occupation
D
Occupation
D
Occupation

-------
          I.D.
                                                             Page 4
(79-80)
Person
  06
(90-91)
Person
  07
(101-102)
Person
  08
          Person
(112-113)   09
(123-124)
Person
  10
A
Name
P
M
L
A
Name
P
M
L
A
Name
F
M
L
A
Name
F
M
L
A
Name
F
M
L

B
Sex
M 1
(81)
F 2
B
Sex
M 1
(92)
F 2
B
Sex
M 1
(103)
F 2
B
Sex
M 1
(114)
F 2
3
Sex
M 1
(125)
? 2

C
Dace of
Birth'
Mb.
Day
Yr.
Age 	
C
Dace of
Birch
Mo.
Day
Yr.
Age 	 (
C
Dace of
Birch
Mo.
Day
Yr.
Age
C
Dace of
Birch
Mo.
Day
Yr.
Age 	
C
Dace of
Birth
Mo.
Day
Yr.
Age
D
Occupacion
(82-83)
(84-85)
(86-87)
(88-89)
D
Occupation
(93-94)
(95-96)
(97-98)
99-100)
D
Occupacion
(104-105)
(106-107)
(108-109)
(110-111)
D
Occupacion
(115-116)
(117-118)
(119-120)
(121-122)
D
Occupacion
(126-127)
(128-129)
(130-131)
(132-133)

-------
         I.D.
                                                            Page 5
(134)   7.  Are you the head of the household?

                        1 - Yes (Bead)
                        2 • Yes (Co-Head)
                        3 - No

(135-136)8. A. Who is the head of the household?
               (PUT PERSON "NUMBER- ACCORDING TO TABLE 1.)
(137)
 B. What is the highest grade or year of regular school that
    (NAME OF HEAD) finished and got credit for?
             1 • Graduate work             5
             2 - 4 - year college degree   6
             3 - Some college              7
             4 » High School graduate      9
                                    Some High School
                                    7th or 8th grade
                                    Less than seventh grade
                                    Don't know or unknown
(138)
 C. Which of the statements in List 2 comes closest to the
     total family income for this family before taxes in 1982?
       1 - Under $5,000
       2 - $5,000 or more but less than 10,000
       3 » $10,000 or more but less than 15,000
       4 » $15,000 or more but less than 20,000
       5 - $20,000 or more but less than 25,000
                                         6 - $25,000 or more
                                         7 - Refused
                                         9 » Don' t know or unknown
(139)
(140-141)
(142-143)
(144-145)
(146-147)
(148-149)
(150-151)
 I'm going to read you a list of different kinds of jobs that
 expose people to lead dust or vapors.  Have you or any member of
 this household worked in one or more of these jobs during the
 last 3 months?
              1 - Yes   2 - No   9 - Unknown

 If yes, circle which ones —

         LEAD-ZINC RELATED OCCUPATION CODES
01 * Lead smelter worker
02 » Foundry Worker
03 - Oil Refinery Worker
04 =» Painter
05 - Battery Mfg. Plant Worker
06 * Chemical Plant Worker
(152-153)  07 -
(154-155)
(156-157)
(158-159)
08
09
10
Paint-pigment, zinc
 copper Worker
Plumber
Glass Worker
Other Lead-Related
 Industry Worker

-------
            I.D. #	/	                         Page  6
                Answer following questions in Table 2 for each person who has
                worked in a lead-zinc related occupation

           A.  What is the name of the place where (you/he/she) work(s)?

           B.  How long have you (has he/she) worked there?

           C.  Do(es) (you/he/she) change out of (your/his/her) work clothes
               and leave them at work?

           D.  Do(es) (you/he/she) shower at work before coming home?

           E.  What is (your/his/her) job title?

                            LEAD-RELATED JOBS
                                 TABLE 2
          A.
                             (Name of Workplace)

 Person No.                 B. Time at workplace         C.  Change Clothes
(160-161)                      Months:                          1 * Yes
                                      (152-164)        (165)    2 - No
                                                                9 - Don't know

          Occupation        D. Shower                  E.	
             Code               1 - Yes                      (Job Tide)
(166-167)	(168) 2 - No
                                9 » Don't know or Unknown
          A.
               (Name of Workplace)

Person No.                 B. Time at workplace          C.  Change Clothes
(169-170)                     Months:	               1 • Yes
                                     (171-173)       (174)      2 - No
                                                                9 • Don't know

          Occupation       D. Shower                     E.	
           Code                  1 - Yes                    (Job Tide)
(175-176)	(177)  2 - No
                                 9 - Don't know or Unknown

-------
                                                                        Page 7
        A.	 	__^_^	
                    (Name  or  Workplace)

Person No.                 B. Time at workplace       C.  Change Cloches
(178-179)	             Months:	            1 - Yes
                                     (180-182)        (183)    2 - No
                                                              9 - Don't know

          Occupation         D. Shower                 E.	
            -Code                  1 - Yes                      (Job Title)
(184-185)	(186)   2 - No
                                  9 - Don't know or Unknown
        A.
                      (Name of Workplace)

Person No.               B. Time at workplace      C.  Change clothes
(187-188)                   Months:                         1 - Yes
                                   (T89-T9T)(192)     2 - No
                                                            9 » Don't know

          Occupation        D. Shower                 E.	
            Code                 1 - Yes                      (Job Title
(193-194)	(195)  2 - No
                                 9 " Don't know or Unknown
                      (Name of Workplace)

Person No.                  B. Time at workplace      C.  Change clothes
(196-197)	              Months:	              1 - Yes
                                     (198-200)       (201)     2 - No
                                                               9 " Don'6» know

          Occupation        D. Shower                  E.
            Code                  1 - Yes                     (Job Tide)
(202-203)	(204)   2 - No
                                  9 » Don't know or Unknown

-------
I.D. if
                                                                       Page 3
      For questions 10-31 ask about each child under age 6.
       Start with the youngest.

        ENTER ANSWERS TO QUESTION 10 IN TABLE 3 BELOW

10.  Now I would like to talk to you about (CHILD NO.	 UNDER AGE 6)

     A.  Where does (CHILD'S NAME) spend most of his/her daytime hours?
         (ACCEPT MULTIPLE ANSWERS FOR 4 OR MORE HOURS AT ANY LOCATION)
         If not only at home, Ask:

     B.  About how many hours each day, on the average, does
         (he/she) spend away from home?

     C.  What Is the address where (he/she) spends
         most time away from home?

          1 - At home                 3 - At Day Care Center
          2 - At babysitters          4 - At relatives
                5 - At some other place (Specify)

                 CHILD'S DAILY ROUTINE
                        TABLE 3
(205)
             10A
Child    Where Spends
 No.    Time During Day
  1        12345
    10B
   Hours
   Away


(loT-Uco
                                                          IOC

                                                  Address away from home
                                         Number
                                                               Street
                                         City   State   Zip Code

                                    If away from home, environmental
                                    sample will be filled in lacer
(211)
             10A
Child    Where Spends
 No.    Time During Day
  2        12345
                                       10B
                                      Hours
                                      Away
                           (215-216)
                       IOC

               Address away from home
                                         Numoer
                                                               Street
                                         City
                                                            State   Zip Code
                                    If away from home, environmental
                                    sample will be filled in later

-------
             I.D.
                                                               Page  9
(217)
(223)
(229)
Child
 No.
  3
Child
 No.
  4
Child
 No.
  5
     10A
 Where Spends
Time During Day
   12345
     1QA
 Where Spends
Time During Day
   12345
     IDA
 Where Spends
Time During Day
   12345
   10B
  Hours
  Away


(227-222)
                                                           IOC

                                                  Address  away from home
                                                   Number
                                                       Screec
                                                   City
                                                    Scace    Zip  Code
                                        10B
                                       Hours
                                       Away
                                    (227-228)
                                              If away  from home,  environmental
                                              sample Co  be filled in later
                      IOC

              Address away from home
                                                   Number
                                                       Street
                                                   City
                                                    State    Zip  Code
                                        10B
                                      Hours
                                      Away
                                              If away  from home,  environmental
                                              sample to  be filled in  later
                      IOC

              Address away from home
                                                   Number
                                                       Street
                                     (233-234)
                                                   City
                                                    State    Zia  Code
                                              If away  from home,  environmental
                                              sample to  be filled in later
                        10A
         Child     Where  Spends
          No.     Time  During  Day
(235)      6          12345

                    "(136^231)""
                                10B
                              Hours
                              Away
                             (239-240)
                                           IOC
                                 Address  away  from  home
                                          Number
                                               Street
                                                   City
                                                    State    Zip  Coae
                                              If away  from home,  environmental
                                              sample to  be filled in later.

-------
    I.D.
                                     Page 10
 11.   Where does (he/she)  usually play when outdoors around this home?
        1 - In back yard
        2 » In front yard
         3 * Does not play outdoors
         8 - Other (specify)
                          TABLE 4
                  ACCEPT MULTIPLE ANSWERS
Child

(241)
(246)
(251)
(256)
(261)
(266)
No.
1
2
3
4
5
6

(242-245)
(247-250)
(252-255)
(257-260)
(262-265)
(267-270)

1
1
1
1
1
1

2
2
2
2
2
2

3
3
3
3
3
3

8
8
8
8
8
8
                                         Specify other
12.   Is the ground there mainly grassy, concrete/asphalt, plain  dirt
     or soil,  just a sandbox,  or what?
       1 » Grassy
       2 - Concrete/Asphalt
       3 - Dirt/Soil
         4 » Sandbox
         7 » Other (specify)
         8 - Mot applicable


(271)
(278)
(285)
(292)
(299)
(306)
CHILD
NO.
1
2
3
4
5
6
                       TABLE 5
                ACCEPT MUL'TIPLE ANSWERS
                   (Circle answers)
              (272-277)

              (279-234)

              (286-291)

              (293-298)

              (300-305)
1

1

1

1

1
GROUND MAINLY

2347
2

2

2

2
              (307-312)    1
3

3

3

3

3
4

4

4
7

7

7

7

7
8

8

8

3

8

8
                                                   Specify other

-------
  I.D.
                              Page 11
13.  About how many hours each day does (he/she) usually spend playiL
     outdoors in this neighborhood?

14.  Does (he/she) often take some food or a bottle with (him/her)
     outside to play?
      1 • Yes
      2 - No
8 - Not applicable
9 « Don't know or Unknown
                            TABLE 6

(313)
(317)
(321)
(325)
(329)
(333)
CHILD
NO.
1
2
3
4
5
6

(314-315)
(318-319)
(322-323)
(326-327)
(330-331)
(334-335)
13.
HOURS
^•MM^^B ^^BM
^•^•^•W ^^^H
^P^M^^B ^H^^
^^•^•V ^MB^H
^^^^ ^^

                                                    14.
                                                FOOD/BOTTLE
(316) 	
(320) 	
(324) 	
(328) 	
(332) 	
(336)
1289
1289
1289
1289
1289
1289
15.   Does (CHILD'S NAME) usually play alone, with other children,
     or mostly with adults?

                    1 - Alone
                    2 - Other children
                    3 - Adults

                      TABLE 7
             ACCEPT MULTIPLE ANSWERS

(337)
(341)
(345)
(349)
(353)
(357)
CHILD
NO.
1
2
3
4
5
6

(338-340)
(342-344)
(346-348)
(350-352)
(354-356)
(358-360)

1
1
1
1
1
1

2
2
2
2
2
2

3
3
3
3
3
3

-------
     z.o.  *
Page 12
          ENTER ANSWERS TO QUESTIONS 16 - 18 IN TABLE 8 BELOW

16.  Are (his/her)  hand or face usual 17 washed before eating?
17.  Are (his/her)  hands or face usually washed before going eo sleep?
18.  Are (his/her)  hands or face usually washed after making mud pies,
      or playing  with dirt or sand?

                     TABLE 8

    1 » lea, 2 -  Ho,  8 • Not applicable, 9 » Don't know or Unknown
CHILD
NO.
(361)
(365)
(369)
373)
377)
(381)
1
2
3
4
5
6
(362-364)
(366-368)
(370-372)
(374-376)
(378-380)
(382-384)
BEFORE
EATS
1289
1289
1289
1 2 8.9
1289
1289
BEFORE
SLEEP
1289
1289
1289
1289
1289
1289
AFTER
FLAY
1289
1289
1289
1289
1 2 8. 9
1289

-------
             I.D. #	/	                        Page 13



               ENTER ANSWERS TO QUESTIONS 19 - 22 IN TABLE 9 BELOW

        19.  Has (CHILD'S NAME) used a pacifier often in Che last 3 months?

        20.  Does (he/she) often suck (his/her) thumb or fingers?

        21.  Does (he/she) sometimes chew on (his/her) fingernails?

        22.  A.  Does  (he/she) have a favorite blanket or stuffed toy?

                 IF YES ASK B AND C.  OTHERWISE SKIP TO QUESTION 23.

             B.  Does (he/she) carry this around during the day?

             C.  Does (he/she) often put this in (hi's/her) mouth?


                                 TABLE 9

          1 - Yes, 2 - No, 8 - Not applicable, 9 - Don't know or Unknown
                            (Circle correct number)
         CHILD
          NO.
(385-391)  1

(392-398)  2

(399-405)  3

(406-412)  4

(413-419)  5

(420-426)  6
19
PACIFIER
1 2
1 2
1 2
1 2
1 2
1 2
9
9
9
9
9
9
20
SUCK
THTMB
1
1
1
1
1
1
2 8
2 8
2 8
2 8
2 8
2 8
9
9
9
9
9
9
21
CHEW
NAILS
1
1
1
1
1
1
2 8
2 8
2 8
2 3
2 8
2 8
9
9
9
9
9
9
22A
FAVORITE
1
1
1
1
1
1
2
2
2
2
2
2
9
9
9
9
9
9
22B
22C
TOY IN
CARRY
1
1
1
1
1
1
2 3
2 3
2 8
2 8
2 8
2 8
9
9
9
9
9
9
MOUTH
1
1
1
1
1
1
289
239
289-
289
289
239

-------
              I.D. #	/	     	                           Page 14
               ENTER ANSWERS TO QUESTIONS 23 - 27 IN TABLE 10 BELOW.

        23.  How many hours during Che day do you think (he/she) usually spend
              playing on the floor when indoors in this home.

        24.  Does (he/she) often put (his/her) mouth on furniture or on the
              window sill?

        25.  Many children put some things other than food into their mouths.
              Would you say that (CHILD'S NAME) does this a lot, just once in
              a while or almost never?

        26.  Have you ever seen (CHILD'S NAME) put paint chips in
              his/her mouth?

        27.  Sometimes children swallow things other than food.  Would you say
              that (CHILD'S NAME) swallows things other than food a lot, just
              once in a while, or almost never?   If a lot, or once in a while,
              please specify at bottom of page (27 a).

 27a. *
                                        TABLE 10

                   1 « A lot, 2 » Just once in a while,
                      3 - Almost never, 9 - Don't know or Unknown

(427-433)
(434-440) -
(441-447)
(448-454)
(455-461)
(462-468)
CHILD
NO.
1
2
3
4
5
6
23 24
HOURS FURNITURE
	 1
	 1
	 1
	 1
	 1
1
2
2
2
2
2
2
3 9
3 9
3 9
3 9
3 9
3 9
25
THINGS
IN MOUTH
1
1
1
1
1
1
2 3
2 3
2 3
2 3
2 3
2 3
9
9
9
9
9
9
26
PAINT
CHIPS
1 2
1 2
1 2
1 2
1 2
1 2
3 9
3 9
3 9
3 9
3 9
3 9
27
SWALLOW
1
1
1
1
1
1
239
239
239
239
239
239
*27a. Specify things swallowed:

Child No.      Icea(s) swallowed

-------
              1.0. #
                              Page 15
                     RECORD ANSWERS TO QUESTION 28 IN TABLE 11 BELOW

         28.  A. During Che last 3 months has (he/she) been taking any
                  vitamins?

              B. During the last 3 months has (he/she) been taking any
                  minerals?

              C. Has (he/she) taken any other kind of dietary supplement
                  in the last 3 months?

                                  TABLE 11
                    1 - Yes, 2 - No, 9 - Don't know or Unknown
(469)
(473)
(477)
(481)
(485)
(439)
GUILD
NO.
1
2
3
4
5
6
28A
VITAMINS
(470) 129
NAME
NAME
(474) 1 2-9
NAME
NAME
(478) 129
NAME
NAME
(482) 129
NAME
NAME
(486) 1 2 9
NAME
NAME
(490) 129
NAME
283
MINERALS
(471) 1 2 9
NAME
NAME
(475) 1 2 9
NAME
NAME
(479) 1 2 9
NAME
NAME
(483) 1 2 9
NAME
NAME
(487) 1 2 9
NAME
NAME
(491) 1 2 9
NAME
28C
SUPPLEMENT
(472) 1 2 9
NAME
NAME
(476)
NAME
NAME
(480)
NAME
NAME
(484)
NAME
NAME
(488)
NAME
NAME
(492)
NAME

1 2 9

1 2 9

129

1 2 9

1 2 9
                   NAME
NAME
NAME

-------
     I.D. 0           /                                       Page 16
     ENTER ANSWERS TO QUESTIONS 29 AND 30 IN TABLE 12 BELOW

29. A. Has (CHILD NO. 	) participated in any kind of lead poisoning
        screening program within the last 12 months?

         1 - Yes, 2 - No, 9 - Don't know or Unknown

        IT "YES" ASK 29B, IF "NO" SKIP TO QUESTION 30.

    B. What were the results of that screening; were they normal or
       high?

        1 - Normal, 2 * High, 9 - Don't Know or Unknown

30.  Circle code for race of child.  IP NECESSARY, ASK:  What race is
     (CHILD NO. 	)?

       1 » White, Non-Hispanic           5 - Asian or Pacific Islands:
       2 « White, Hispanic               6 - American Indian or
       3 - Black, Non-Hispanic                Native
       4 - Black, Hispanic               7 * Refused
                             9 » Unknown

                         TABLE 12
                  (Circle correct number)

(493-496)
(497-500)
(501-504)
(505-508)
(509-512)
(513-516)
CHILD
NO.
1
2
3
4
5
6
30A
SCREENED
1
1
1
1
1
1
2
2
2
2
2
2
9
9
9
9
9
9
30B
RESULTS
1
1
1
1
1
1
2
2
2
2
2
2
9
9
9
9
9
9
1
1
1
1
1
1
31
RACE
234
234
234
234
234
234
5 6
5 6
5 6
5 6
5 6
5 6
7 9
7 9
7 9
7 9
7 9
7 9
BE SURE QUESTIONS 11-30 HAVE BEEN ASKED FOR. EACH CHILD UNDER 6 IN
 THE HOUSEHOLD

-------
             I.D. it
                                                      Page  17
         31.   Thinking about  the kinds of hobbies  that people might have, or
               work or activities that people might do around the home,
               within the past 3 months has any member of  this household
               often:

                             BOBBIE CODES
  (1 - Yes, No - 2, 9 - Unknown)

                        Fainted pictures with artists paint?
                        Painted parts of the house or furniture in the house?
                        Worked with stained glass?
                        Cast lead into fishing sinkers, bullets or anything    ?
                         else?
                        Worked with soldering in electronics?
                        Worked on soldering pipes?
                     G. Made pottery at home?
(517)
(518)
(519)
(520)
(521)
(522)
(523)
1
1
1
1
1
1
1
2
2
2
2
2
2
2
9
9
9
9
9
9
9
A.
B.
C.
D.
E.
P.
G.
  1 - Yes, 2 - No, 9 - Don't know or Unknown

(524)  129    32
(525)  129    33.

(526)  129    34.

(527)  129    35.
(528)  1  2  9
(529)  1  2  9
(530)  1  2  9
(531)  1  2  9
(532)  1  2  9
36,
37,
38,
39.

40,
Does/do the child/children frequently eat fruits or
vegetables grown anywhere close by in this neighborhood?

Does your family have a garden?

Has soil been hauled in and placed on your garden?

When food is served, is it ever served in homemade or
imported clay pottery or ceramic dishes?

And when food is stored or put away for a while, is it
sometimes stored in the original can after being opened?
Give example if necessary: e.g. juice can.

Does/do the child/children sometimes eat snow in the
 wintertime?

Does anyone in this household smoke?
Does your home have storm windows?

What is the name of the medical doctor who generally
 examines or treats your child/children?
     1. 	
     2.  Have no family doctor
     9.  Don't know
                              (Name of Doctor)

-------
              I.D.
                                                                       Page 18
                  41.  A. Thank you very much for answering these questions.
                          There may be a few things we talked about that I need
                          to clarify.  May I telephone you if I need to?
(533)
                              1 - Yes, 2

                       IF YES, ASK:
                                           No, 3 - No Phone
                       B.  What is your telephone number? (or that of nearby
                           neighbor or relative?)
(534)
                  42.  Year house built -
                        1 - Before 1955
                        2 - After 1955
                        9 - Don't know
         II.  COMPLETE AFTER INTERVIEW:

              A.  Time Interview Ended
                     (Military Time)
(535-538)
         0100 AM        0700 AM        1300 PM
         0200 AM        0800 AM        1400 PM
         0300 AM        0900 AM        1500 PM
         0400 AM        1000 AM        1600 PM
         0500 AM        1100 AM        1700 PM
         0600 AM        1200 N         1800 PM
                                                      1900 PM
                                                      2000 PM
                                                      2100 PM
                                                      2200 PM
                                                      2300 PM
                                                      2400 M
(539)
              B.  Type of Housing Structure

                      Constructed of:
                       1 - Frame     3 » Concrete Block
                       2 - Brick     4 - Combination
                            5 - Other (Describe)
(540)

(541-542)
                      Structure is:
                          1 - Single, 2

                      Number of Units
                                          2-ranily, 3 - 3-or sore Family

-------
                                                                  ATTACHMENT 3
                 SOIL SAMPLING PROCEDURES - KELLOGG 1983
     Soil  samples will  be collected at each selected residence where children
ages 1-9 live.   Soil  Procedure 1  will  be followed at each selected residence
and Soil Procedure 2  will be followed  at every seventh selected residence.

Soil Procedure 1

     1. While facing  the selected residence from the street, select a
        site approximately directly in front of the residence.  The
        site must be  large enough to draw a circle 1 meter in diameter.
        Moving to the right or left of sidewalks, driveways or other
        nonmovable objects is permitted when necessary.

     2. Front yard sample

        a. Select a starting site as described in section 1 above, and l*s
           meters in  from the street,  curb, sidewalk or fence.  Place
           central pivot (nail) in the ground and draw an imaginary circle
           1 meter in diameter as shown below.  Select 4 equally spaced
           sampling sites on the  perimeter of the circle as indicated by
           the *.
           Curb
        b. Using a core sampler, extract a soil  sample at a selected site.

        c. Identify the upper organic layer and  the upper 1 inch of
           mineral soil.  Discard the organic layer and place the 1
           inch mineral soil  sample into a 27 oz.  whirlpak.
Top 1
                                                                Soil
                                                  \  soil

-------
Soil Sampling Procedures-Kellogg 1983
        d.  Repeat steps 2a and 2b at the other 3 selected sites.   Place
           the 1 inch mineral  soil  samples into the same 27 oz.  whirlpak.

     3. Back yard sample

        a.  Identify a site directly behind the residence and at least
           1*5 meters away from the house.

        b.  Draw an imaginary circle 1  meter in diameter and select 4
           equally spaced sampling sites as shown below.
                           •
        c.  Using the core sampler, extract a soil sample at each selected
           site.

        d.  Remove'the organic layer and place the top 1  inch of the mineral
           soil into the same 27 02 whirlpak containing  the front yard
           sample.   A total  of 8 subsamples (1  inch cores) will be included
           in the final  sample.
        e. Seal the whirlpak.

        f. Complete sample label  and affix it to the whirlpak.
           front-back sample will  be known as soil  sample 1.

     4. Side yard sample
                                                        The composite
        The second composite soil  sample (Soil  Sample 2) will be collected
        from the side yard.  While facing the residence from the street, the
        site for the side yard sample will  be selected from the left side of
        the residence whenever possible.  A site directly to the right of the
        residence may be selected if necessary.

        a. Select a side yard site approximately equal distance from the front
           and back of the residence.
b. Draw an imaginary circle with the center
   the residence.
                                                      m. from the side of

-------
Soil Sampling Procedures-Kellogg 1983
        c. Select soil sampling sites as shown below.
                                                    Side  01
        d. Using a core sampler, extract a soil sample at each selected
           site (*).
        e. Remove the organic layer, and place the top 1  inch mineral soil
           samples into a 27 oz. whirlpak.  The side yard soil sample will
           contain 4 sub samples (4- 1 inch soil cores) and be known as Soil
           Sample 2.
        f. Seal the whirlpak.
        g. Complete sample label and affix it to the whirlpak.
     5. Clean-Up
        a. Wash the core sampler and other equipment with water and detergent.
        b. Rinse with clean cold water.
        c. Air dry or dry with paper towels.
        d. Discard wash and rinse water.
        e. Place core sampler and other equipment in clean paper bag for
           transport to next site.
Soil Procedure 2
     1. Soil procedure 2 will be conducted at every 7th residence selected by
        each team.  Soil Procedure 2 is basically the same as Soil Procedure 1,
        except additional samples are required.
     2. Conduct Soil Procedure 1.

-------
Soil Sampling Procedures-Kellogg 1983
     3. Collect a second front-back soil  sample.   The 8 soil  cores should be
        taken within 2-3 inches of the original  cores.
     4. Save the organic layers from the second  front-back soil  sample.  The
        eight organic layers should be placed into a single 27 oz. whirlpak.
     5. Clearly label and seal  the duplicate soil  sample and sample of the
        organic layers.
     6. Visually divide the front, side,  and rear lawns into approximately 5
        equal area.   An example is given below.
     7. Select a site near the center of area 1  by tossing the trowel  into
        the area.   The site where the trowel  lands will  be sampled as  follows:
        a.  Carefully cut away all grass, weeds or other vegetation that is
           above ground, in a circular area approximately 3 inches in  diameter.
        b.  Using the trowel, expose a verticle soil surface showing at least
           1 inch  of mineral soil.
        c.  Using a scalpel or/and trowel, carefully remove the organic layer
           (approximately 1 inch square) and place it into a whirlpak.
        d.  Using a scalpel and/or trowel, carefully remove a soil  sample
           from the top 3/4 inch of mineral soil  and place it into a whirlpak.
        e.  Repeat  steps 7a-7d and place the organic layers into the same
           whirlpak containing the first organic layer.   Likewise, place the
           mineral soil subs into the same whirlpak as the first mineral soil
           sample.
        f.  Complete specimen label.  Seal whirlpaks and affix label to ap-
           propriate samples.
     8. Sampling Equipment Rinse - Field Blank
        Soil sampling equipment will be washed and rinsed as follows:

-------
Soil Sampling Procedures-Kellogg 1983
        a. Remove tips from core samples.
        b. Wash and rinse core sampler, scalpels, and^trowel as described
           in Soil Procedure 1, part 5.
        c. Carefully rinse and wash sampling equipment with 250-500 ml of
           distilled deionized water (DDI).  Save the DDI rinse in the
           designated container.
        d. Place rinse sample equipment into a clean paper or plastic bag
           for transport to the next sampling site.
        e. Complete sample label and affix to the field blank sample.
Soil Procedure 3 (Garden Soil Procedure)
     The garden soil sample will be collected from each garden that is sampled
     (See Vegetation Sampling Procedure) as described below.
     a. Select four sites near the center of the vegetation samples that
        were collected.
     b. Form each site, remove the top 1 inch core of mineral soil using
        the core sampler.
     c. Place all four subsamples into a single whirlpak.
     d. Complete a sample label and affix it to the composite garden soil
        sample.

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                     X-RAY FLUORESCENCE DATA SHEET - KELLOGG  1983
     ATTACHMENT 4
                                      PAINT



Instrument number     XRF  Standard     XRF  Reading  at  Start
XRF Reading at End
Area
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Bathroom
Kitchen
ining Room
Hallway
Exterior
Other (specify)
WALL TRIM XRF SITE XRF READING
Chipping or Peeling? Chipping or Peeling? 01 = wall
YES NO NA YES NO NA 02 = trim
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
01 02 03 01 02 03 01 02
Notes/Comments:
"\nalysis conducted by: (signature) ' datg _ time

-------
                                                                       ATTACHMENT 5
                     ENVIRONMENTAL DATA SHEET - KELLOGG 1983
I.D. #
'Sample •
Bank Noj Sample



i











1
i
Soil Sample 1 (front/back)
Soil Sample 2 (side)
Soil Sample 3 (play area)
Duplicate Soil 1
Duplicate Soil 2
Duplicate Soil 3
Special Soil Sample
Field Blank (rinse)
Household Dust 1 (vacuum bag)
Household Dust 2 (filter)
Vegetation Sample 1 (carrots)
Vegetation Sample 2 (beets)
Vegetation Sample 3 (lettuce)
Garden Soil Sample
Total Sample Collected
Yes-
1
1
1
1
1
1
1
1

1
1
1
1
1

No
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Comments


Collected by: (signature)
date - time    Rec'd by:  (signature)
date - time

-------
MASTER SAMPLE LOG - KELLOGG 1983
ATTACHMENT 6




   Page

Date




















Sample
Bank No




















ID Number





















[Relinquished by: (signature)
Sample





















date - time
Pb




















Cd




















Zn










































Received by: (signature) date - time

-------
                                                    ATTACHMENT 7
  STATE  OF  IDAHO
 DEPARTMENT OF HEALTH AND
DIVISION OF HEALTH, STATEHOUSE, BOISE, IDAHO  83720


(1) Date


                                  I.D. No. (2)
(3) Name
    Address
    City, State

Dear (4):

The results  of the analysis of the blood sample drawn on (5) in (6) have
been received by  the Department of Health and Welfare.  The blood lead
value was  (7)  micrograms  per  100 milliliters of blood, and the free
erythrocyte   protoporphyrin (FEP)   value  was (8)  micrograms  per
100 milliliters of blood.

(9) The blood lead and FEP values on your child are both above the normal
range  for  children.   The normal blood  lead  value is  less  than
30 micrograms/100 milliliters  of blood and the normal FEP value is less
than 50 micrograms/100 milliliters of blood. This represents undue-lead
absorption  even  in the absence  of clinical  symptoms.  We suggest you
discuss the  elevated blood lead and FEP level with your physician since
he can best evaluate your child.

If you have any further questions, we will  be  happy to try to answer
them.  A public  health nurse,  Annabelle Rose,  R.N. ,  who works for the
Lead Surveillance  Program  in  Kellogg may be contacted at 784-1351 to
obtain additional information or to answer questions that you may have.

Sincerely,
Fritz R. Dixon, M.D., Chief
Bureau of Preventive Medicine

FRD/CDB(10)

cc:  Annabelle Rose, R.N.
                    EQUAL OPPORTUNITY EMPLOYER

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                                                      ATTACHMENT 7
  STATE  OF IDAHO
DEPARTMENT OIF HEALTH AND
DIVISION OF HEALTH, STATEHOUSE, BOISE, IDAHO  83720
(1) Date
                                 I.D. No.  (2)
(3) Name
    Address
    City,  State

Dear (4):

The results  of  the analysis of the blood sample drawn on (5) in (6) have
been received by the Department of Health and Welfare.  The blood lead
value was (7) micrograms  per  100 milliliters of blood, and the free
erythrocyte   protoporphyrin (FEP)   value  was (8)  micrograms  per
100 milliliters of blood.

(9) Your child's blood lead  level was  above  the normal  range for
children.   However,  the FEP  level  was within the  normal  range  for
children.    A   normal  blood  lead   value  is   less   than
30 micrograms/100 milliliters  of blood and the normal FEP value is less
than 50 micrograms/100 milliliters of  blood.   We  suggest  that  you
discuss the  elevated blood lead level with your physician since he can
best determine the significance of the elevated blood lead level.

If you have any further questions, we will  be happy to try to answer
them.  A public health nurse,  Annabelle Rose, R.N., who works  for the
Lead Surveillance  Program  in  Kellogg may be  contacted at 784-1351 to
obtain additional information  or to answer questions that you may have.

Sincerely,
Fritz R. Dixon, M.D. , Chief
Bureau of Preventive Medicine

FRD/CDB(10)

cc:  Annabelle Rose, R.N.
                    EQUAL OPPORTUNITY EMPLOYER

-------
                                                      ATTACHMENT 7
  STATE  OF  IDAHO
 DEPARTMENT OF HEALTH AND WELFARE
DIVISION OF HEALTH, STATEHOUSE, BOISE, IDAHO 83720


 (1) Date


                                  I.D. No. (2)
(3) Name
    Address
    City, State

Dear (4):

The results  of the analysis of the blood sample drawn on (5) in (6) have
been received by the Department of Health and Welfare.  The blood lead
value was  (7)  micrograms  per  100 milliliters of blood, and the free
erythrocyte  protoporphyrin (FEP)   value  was (8)   micrograms  per
100 milliliters of blood.

(9) Your "child's  blood lead  level was  within  the  normal range for
children, but the FEP value was elevated.  The normal blood lead value is
less than 30 micrograms/100 milliliters of  blood and  the normal FEP
value is less than 50 micrograms/100 milliliters of blood and the normal
FEP value is less than 50  micrograms/100 milliliters of blood.  Children
with an elevated FEP  level may have  an iron deficiency  anemia.  We
suggest that you discuss the elevated FEP level with your physician since
he can best evaluate your child.

If you have any further  questions, we  will  be  happy to try to answer
them.  A public health nurse, Annabelle Rose, R.N.,  who works for the
Lead Surveillance  Program  in  Kellogg may be  contacted at 784-1351  to
obtain additional information or to answer questions that you may have.

Sincerely,
Fritz R. Dixoa, M.D. , Chief
Bureau of Preventive Medicine

FRD/CDBUO)

cc:  Annabelle Rose, R.N.
                    EQUAL OPPORTUNITY EMPLOYER

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                                                     ATTACHMENT 7
i| STATE  OF IDAHO
 DEPARTMENT OF HEALTH AND WE1TARE
DIVISION OF HEALTH, STATEHOUSE, BOISE, IDAHO 83720
 (1) Date
                                  I.D. No.  (2)
 (3) Name
    Address
    City, State

 Dear (4):

 The results of the  analysis of the blood sample drawn on (5)  in (6) have
 been received by the  Department of Health and Welfare.  The blood lead
 value was  (7) micrograms per 100 milliliters of blood,  and  the  free
 erythrocyte  protoporphyrin  (FEP)  value  was (8)   micrograms   per
 100 milliliters  of blood.

 (9) We  interpret these  results to be  within  the  normal  values  for
 children.    The   normal  blood   lead  value  is   less   than
 30 micrograms/100 railliliters of blood and the normal FEP  is less than
 50 micrograms/100 milliliters of blood.

 If you  have  any  further questions, we will  be happy to try to answer
 them.  A public health nurse,  Annabelle Rose, R.N., who works for the
 Lead Surveillance Program  in Kellogg  may be  contacted at 784-1351  to
 obtain additional information or to answer questions that you  may have.

 Sincerely,
 Fritz R. Dixon, M.D., Chief
 Bureau of Preventive Medicine

 FRD/CDB(10)

 cc:  Annabelle Rose, R.N.
                     EQUAL OPPORTUNITY EMPLOYER

-------
                                                        ATTACHMENT 7
PARAGRAPH A:

We interpret these results to be within the normal values for children.
The normal blood lead value is less than 30 micrograms/100 milliliters
of blood and the normal FEP is less than 50 micrograms/100 milliliters
of blood.
PARAGRAPH B:

The blood lead and FEP values on your child are both above the normal
range for children.  The normal blood lead value is less than 30 micrograms/
100 milliliters of blood and the normal FEP value is less than 50 micrograms/
100 milliliters of blood.  This represents undue lead absorption even in
the absence of clinical symptoms.  We suggest you discuss the elevated
blood lead and FEP level with your physician since he can best evaluate
your child.


PARAGRAPH C:

Your child's blood lead level was above the normal range for children.
However, the FEP level was within the normal range for children.  A
normal blood lead value is less than 30 micrograms/100 milliliters of
blood and the normal FEP value is less than 50 micrograms/100 milliliters
of blood.  We suggest that you discuss the elevated blood lead level
with your physician since he can best determine the significance of the
elevated blood lead level.
PARAGRAPH D:

Your child's blood lead level was within the normal range for children,
but the FEP value was elevated.  The normal blood lead value is less
than 30 micrograms/100 milliliters of blood and the normal FEP value is
less than 50 micrograms/100 milliliters of blood and the normal FEP value
is less than 50 micrograms/100 milliliters of blood.  Children with an
elevated FEP level may have an iron deficiency anemia.  We suggest that
you discuss the elevated FEP level with your physician since he can best
evaluate your  child.

-------
i STATE
                                                      ATTACHMENT 8
 DEPARTMENT OT HZAITH AND  WEUARE
                      LEAD SURVEILLANCE  PROGRAM


 Child's Name:                                 I.D. #
 Dear Doctor:

 The ,child named  above participated in  the  August 1983 blood lead  survey  •
 conducted in  the Kellogg area.  The blood  lead and/or free erythrocyte
 protoporphyrin  (FEP) level on this child was elevated.  The normal  blood
 lead level  is less  than 30 ug/dl  and the normal FEP level  is less  than
 50 ug/dl.

 We would appreciate it if you would review the results from our survey and
 obtain a CBC  (including red cell  indices)  on this child.  A follow up blood
 lead and FEP  may also be obtained through  our agreement with Silver Valley
 Medical  Arts  Clinic in Kellogg and with the ESA Laboratories in Massachu-
 setts.  After examining the child and  reviewing the laboratory data, we
 would appreciate you providing your interpretation to the  child's  parents
 and to our  office.  We are most interested in knowing if the child has
 lead poison,  undue  lead absorption, iron deficiency anemia, or other cause
 for the elevated FEP.

 Please submit your  bill for the single office visit .and the additional
 testing along with  a copy of the test  results and your interpretation to:

                      Bureau of Preventive Medicine
                      Attn:  Lead Surveillance Program
                      Statehouse
                      Boise, ID  83720

 If you have any  questions, or if you would like to discuss the child that
 has been referred to you, please contact the Bureau of Preventive  Medicine
 (334-4309)  or the Panhandle District Health Office (752-1235).

                                      Sincerely,
                                       Charles Brokopp, Dr.P.H,
                                       State Epidemiologist
 I authorize the  release of all test results obtained by our physician  to
 the Lead Surveillance Program, Idaho Department of Health and Welfare.
 Date                                  Parent or Guardian
                     EQUAL OPPORTUNITY EMPLOYER

-------
                                                           ATTACHMENT 9
                            IDAHO  HOUSEHULO  REPORT  FORM

                                FOH  1983  LEAD  STUDY
        ID   225R2UX


 IL  VALUES  fPPM)


                  SOIL  1  SOIL  d  SOIL  3    GARDEN
 AO                2193    5470    165       1475
CUUM BAG OUST  (PPM)



AD                1099


Ttt DUST SAMPLE" TAKEN FKOM  VACUUM BAR



4D PAINT VALUES (MG/SQ.CMJ
  LIVING ulNlNG RŁOKOUM  1 BEDKODM 2 BEDROOM  3  BEDROOM  U    BATnROOM
  0.3    .      0.2       0.4       0.1-       .            0.5
  KITCHEN  HALL EXTERNAL  OTHER
  0.3      0.2  0.1
GETATION VALUES  CPPH)


                 CAKRUTS   bEhTS     LETTUCE
AD               13        .         38
QUO VALUES (UG/ULJ         hOlE:    BLUUD LEAD HIGHER  THAN 30  UG/DL
	                  OW FEP GREATER THAN 50 UG/DL
                                    INDICATES NEED FOR MEDICAL  FOLLOW-UP


                               BLUOO
                 AGE   SEX     LEAO   FEP
ILD
                 9     MALE     13.0  18.0

-------
                                                             ATTACHMENT 10
  STATE  OF  IDAHO
DEPARTMENT OF HEALTH AND  WELFARE
DIVISION OF HEALTH, STATEHOUSE, BOISE,  IDAHO  83720
May 31,  1984
Dear Survey Participant:

The enclosed printout lists the results  of the tests performed on soil,
dust, painted surfaces, vegetation, and  blood samples obtained during
the lead survey conducted  last August.   This letter will briefly explain
the results obtained. A dot  (.) on the  printout indicates that no
sample was obtained.  You  may wish to compare your results with the
average of all results obtained by this  survey.

SOIL LEAD LEVELS

As many as four (4) different soil samples were collected at your residence.
Soil 1 contained soil from your front and back yard.  Soil 2 contained
soi'l from your side yard,  and soil 3 was obtained from a play area often
used by your children. Soil  samples were also obtained from some gardens.
The soil lead levels obtained are shown  below:
Area
1 Smelterville



2 Kellogg,
Wardner, Page


3 Pinehurst



Sample
Type1
Soil 1
Soil 2
Soil 3
Garden
Soil 1
Soil 2
Soil 3
Garden
Soil 1
Soil 2
Soil 3
Garden
Number of
Samples
44
46
17
3
216
207
105
29
130
126
55
35
Lead
Average
4,641
6,372
4,524
1,835
3,639
3,198
2,475
1,690
590
797
834
376
Level
Lowest
322
83
258
95
53
108
80
141
151
97
37
98
(ppra)
Highest
18,400
17,550
15,585
2,705
20,700
41,200
34,475
5,160
2,915
4,375
6,370
1,065
  1.  Soil  1 from front and back yard;  Soil 2 from side  yard; Soil 3 from
     play  area.

  2.  ppm = parts per million; 10,000 ppm =1.0 percent.

-------
                                                            ATTACHMENT 10
May 31,,. I9S4
Page 2
Hxgfas levels: of lead lit soil may be a significant, source of lead exposure
foe your: child-, Every timer a. child places their fingers or other* object.
fir thfffr- mouthy they may swallow small, amounts of lead.  'The more lead
iit the*-soil^ the-greater the possibility of a. child's blood lead*
becoming elevated.  Children* who* have been, playing: in the dirt should
wash, their hands thoroughly before eating^

VACUDK BAff DUST

Dust samples were collected from vacuum- bags at most, of the residences.
The amount of lead in. the dust sample collected at your residence is
shown-, in the printout;.  The results obtained from testing, the vacuum.
dust samples are summarized belovic

                                                      Lead! Level (ppnr)
Area	Number of Samples	Average    Lowest    Highest..
I Smelterville
2. Kellogg-, Wardner, Page
3 Pinehurst
33.
161
9Z
3,994
2,752
1,330
1,910
221
412.
5,19-2
10,395
7,S65
Household dust containing lead may contribute to> your child's exposure
t cn») indicate the presence of lead inv the tested
surface.  The higher the lead paint value,, the greater the amount of
lead! in the tested surface.  Painted surfaces that are not peeling: or
chipping; are not considered dangerous, unless your child chews on, the
surface.

Lead Faint Values
    (mg/sq- cm)	Interpretation	Number of Surfaces Tested
Less thvm Q.7
0.7 - 2.9-
1.0 - 5.9s
&.& or- greater
Negative
Low
Moderate
ffigb
1,133
186
75
66

-------
                                                        ATTACHMENT 10
May 31,.
Page 1
Y.OU should, be- aware oŁ the surfaces- in your home that have been painted-
with- a lead base* paint.  If these surfaces are peeling,, or if yourr
child? hast beem observed chewingr oa the surf ace or eating paint chips-
from the surfa.ce> we: care provide you witbi suggestions for reducing, this
hazard-

VEGSTATKM VALUES

Eating leafy and root vegetables grown locally can increase a person' s-
exposure to; lead.  Carrots^ beets,, and lettuce were sampled from  several!
gardens.  If? any ofr. these? produce samples were* obtained fromryoujr
garden-,, the lead levels- found in. thfr produce are shown ort your printout-
All produce samples were .thoroughly washed prior to analysis in an
effort to remove as. npn-fi soil or dust as possible-  Although: lead levels
in. carrots, beets, and. lettuce are about one-half those found in.
1974-75,. the current levels are unacceptably high.  The amount of lead
found in garden produce is summarized belowr

                                       Number- of        Lead LeveL (ppn):
Area
I Smelterville-


2 Kelloggy Wardner,
Page

3 Pinehurst


.Produce Sampled Samples Average Lowest Highest
Carrots-
Beets:
Lettuce?
Carrots
Beets
Lettuce
Carrots
Beets
Lettuce
i
or
i>.
22.
Ifc
25
32
?
2ft-
ia
a
4S
61
47
65
2S
I6V
32
11
a:
4$
12
14.
12
. 6
11
ir
33
- tt
43,
246V,
i2r
155
92
30
81
We- recommend that children not eat leafy vegetables (lettuce, chard,.
turnip greens,, etc.); or; root, vegetables Ccarrots, beets, potatoes,
onionar etc.)- growa locally.  Based on the average lead levels shown.
above-, a oner-half cap serving of these vegetables would be enough to-
exceed the n>ayfmnn» daily allowance of lead for children-  The maximum
daily allowance of lead for a child under two years old would be
exceeded by eating one-half cup of vegetables* containing; only 15 ppm
lead.

Fruits, suck as apples, pears, and plums, and vegetables, such as tomatoes,
peas, beans, and conr, were not tested; but other studies have shown that
these fruits and vegetables do* not take up lead as much, as the leafy or
root vegetables.  These locally grown, fruits, or vegetables may be eaten
after- carefully being washed or peeled.

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                                                            ATTACHMENT 10
May 31,,. 19S4
Page 4
BLOOD VALUES

Tha blood lead and free erythrocyte> protoporphyrin CFEF) values obtained'
oa. your- child were previously mailed to- you along with our interpretation:
of the- results.  Blood lead levels of 30 ug/dl. on greater require follow-up
to identify ways to> reduce the child1"s blood lead level.  The average
blood lead leveL of white rural children; between, the age of six- mantis,
and: 'five years; was- recently she wo. to> lyes 13.5 ug/dl.  Tie blood lead
level is a> -measurement: of: the- absorption, or, intake of. lead..
     Area
       number- of
    Children Tested
  Blood lead Levels (ug/dl)
-Average   Lowest:   Highest
     1 Smelterville          43
     2 Selloggy. Wardner,
       Page                 19*
     3: Pinehurst            122'

         AH Areas,          364-
                          21

                          17
                          12
             5
             I
35

45
4a

45
The- FEP also* indicates increased lead absorption? but. may also be elevated.
in-children? witk iron; deficiency.-.. A child with, FES' levels of, 50 ug/dl
or greater- should be. further evaluated" by a physician..
Area
    Number of    Free. Erythrocyte rrotoporphyrin; (ug/dl)
Children Tested        Average    lowest    Highest
I Smelterville 43?'
Z. Kellogg:, Wardner >
Page 15^
3 Pinehurst: I2L
35:

2r
22
' 12

11
12
77

153
77
    All Areas
      363-
              II.
 153
Thi& letter represents^ our initial summary of the results obtained from.
the August. 1983: studyy ^nd our recommendations' for decreasing lead
exposure in. the community.  Further- recommendation* may be necessary
after we evaluate the study results in- depth.  The Centers for Disease
Control currently is revising it* guidelines on- what blood lead level
will require follow-up- after screening.  Therefore, our final report may
use a definition, of elevated blood lead lower than 3Q ug/dl.
    are invited tor attend a public meeting!; to be held ia the Kellogg:
Junior- Higk Cafeteria on. June L3, at 7:00. p.m.-  Representatives from, the
Department aŁ Health and Welfare aad the Panhandle Bistrict Health.
Department will also- be avzilable on June 14 at the Panhandle District
Health Department office behind East Shoshone Hospital to. Silverton. to
discuss, your results. an
-------
                                                          ATTACHMENT 10
May 3T, 1984
PageS
After June* 14,. any questions that you. may have* can be* addressed, to?
Hr_ Charles Brokopp,. Bureau. oŁ Breventive Medicine,* Boiser  Idaho  83720
(toll free L-800-632-5927): or to> Mr. Jerry Cobb> Panliaiidle  District,
Healtk Department,. Silvertoir,, Idaho  83867 (752-1235) .
      yout for your participation^ in. this, important study.

Sincerely^
State Health Officer

FKD/CDB/dp/T?

Eiaclosura

-------
                                              ATTACHMENT 11
1983   KELLOGG    LEAD   SURVEY



                June  13,  1984

-------
                           AUGUST 1983 LEAD SURVEY
1.  Introduction.              Mr.  Larry  Belmont,  Director
                              Panhandle  District  Health  Department
2.   Background:               Fritz  R.  Dixon,  M.D.
                              State  Health  Officer'
                              Department  of Health  and  Welfare

        A)   Cooperation  of community
        B)   1974-75  Survey -  Shoshone' Project
        C)   Trends  in blood lead  levels 1976-1979
        D)   Trends  in blood lead  levels 1980-1983


3.   August  1983 Lead Survey:   Charles  Brokopp,  Dr.P.H.
                              State  Epidemiologist
                              Department  of Health  and  Welfare

        A)   Objectives and reasons of  1983  survey
        8)   Project  organization

              1)   Involvement  of  local  community
              2)   Panhandle District Health Department
              3)   Idaho  Department of  Health and Welfare
              4)   Centers  for  Disease  Control
              5)   Environmental Protection  Agency

        C)   Survey methods

              1)   Survey populations -  Area 1,  2, 3
              2)   Selection and training  of survey  team members
              3)   Door-to-door survey
              4)   Blood  drawing at local  clinic
              5)   Air monitoring
              6)   Laboratory analysis

        D)   Explanation  of results

              1)   Blood  lead and  FEP

                    a)   Area 1,2,3
                    b)   Age
                    c)   Percent of children by  area with elevated blood lead
                    d)   Comparison to  Idaho 1974 and 1980 data.
                    e)   Comparison to  national  (HANES) data and other surveys
                    f)   FEP by area
                    g)   CDC risk  classification --  improvements since 1979
                    h)   Follow-up of children with elevated blood leads

-------
2)  Soil  Results

      a)   Lead
            i)   Area  1,  2,  3
           ii)   Sample  location  -  lawns,  play areas,
                  gardens
          iii)   Comparison  to  1974-75  Idaho  data
           iv)   Comparison  to  other  smelter  environments
            v)   Comparison  to  urban  environments
           vi)   Significance of  soil with  high  lead levels
      b)   Cadmium
            i)   Area  1,2,3
           ii)   Sample  location
          iii)   Comparison  to  1974-75  Idaho  data
           iv)   Comparison  to  other  sites
            v)   Significance of  soil with  high  cadmium levels
      c)   Zinc

            i)  Area  1,2,3
           ii)  Sample location
          iii)  Comparison  to  1974  Idaho  data
           iv)  Significance of  soil  with  high  zinc  levels

3)  Household  Dust

      a)   Area 1,2,3
      b)   Comparison  to 1974-75  Idaho data
      c)   Comparison  to other  smelter sites  and  urban  environments
      d)   Significance of household dust

4)  Lead-Base  Paint

      a)   Interpretation of data  (negative,  low, moderate,  high)
      b)   Percent of  painted surfaces containing lead
      c)   Significance of lead in painted  surfaces

5)  Garden Produce

      a)   Lead

            i)  Areas 1,2,3
           ii)  Types of produce sampled
          iii)  Comparison  to  Idaho 1975  data
           iv)  Maximum daily  dietary allowance
            v)  Significance of  lead in  produce
           vi)  Leafy and root vegetables  vs fruits  and  non-root
                  vegetables

-------
                            -  3  -
            b)   Cadmium  and  Zinc

                  i)   Area  1,2,3
                 ii)   Type  of produce  samples
                iii)   Comparison  to  1975  Idaho  data
                 iv)   Maximum daily  dietary  allowance
                  v)   Significance of  cadmium and  zinc  in  produce

      6)   Ambient Air  Lead,  Cadmium, and  Zinc Levels

            a)   Lead
            b)   Cadmium
            c)   Zinc

E)  Recommendations

      1.   Goal  - To maintain childhood blood lead  levels at  the  lowest
            possible  level.   This can  be  achieved  by  reducing  exposure
            to  this toxic metal .

      2.   Specific Recommendations

            a)   Wash  your child's hands  frequently to  remove dirt  that
                  may  contain lead.
            b)   Reduce exposure  to dirt  containing high lead levels.
            c)   Try to keep  non-food items out  of  your  child's mouth.
            d)   Eat a  balanced diet.
            e)   Do not eat  locally grown  leafy  or  root  vegetables  that
                  contain high lead  levels.-
            f)   Thoroughly  wash  or peel  all  locally grown  fruits and
                  vegetables prior to  eating.
            g)   Don't  allow, children to  eat  snow or icicles.
            h)   Don't  allow children to  chew on painted surfaces or
                  printed materials.
            i)   Remove lead  base  paints  from peeling  surfaces.
            j)   Reduce household  dust  by  frequent  wet  mopping  or dusting
                  with a damp cloth.
            k)   Annual screening  of  all  1-5  year olds  to determine lead
                  absorption.

F)  Questions and Answers

-------
                                                                     PERCENT OF CHILDREN  WITH  31000  LEAD
                                                                        LEVELS ON 30 ug/dl  OR  GREATER
                                                                              1971,  1975,  1983
                                                                         Area
                                                                                19/3I97F
                                                                                  99

                                                                                  76

                                                                                  26
                                                                                         70
19

 3
                     B
:iJ.'iIFICAflCE  Or  /ARIOUS  3LOOD  LEAP LEVELS


              Observable effects
Blood Lead
  •jg/41
EO-'OO  Severe  neurologic  effects
    70  Anemia
    50  jl  effec'ts
    50  Mila  neurologic effects
    -0  Reduced  nemoglobin, kidney iys function
    30  Reduced  nerve  conduction
   '20  Increased E?
    10  ALA-innibi t:on
            SHOSHONE  PROJECT
                1974-1975
      WEP.AGc  3LOO:  LEAC  LEVELS OF AREA i
         :Smelterville' C:-iIL;p.E-!  "-3'ED
                 197-  - '983
'io . Mean Slood Lead
rear Chi
!97-i
197:
•975
1977
1 973
1979
1 920*
i960**
!981
!982
1933
* Aoril 1
'* Oc-soer
Idren
201
107
2i
]j
31
27
93
9-1
7^
57
-3
980
193C
;ug/dl ;
55
-7
iO
33
-11
:a
31
31
29
?2
21*


-•KM :.ncE3 .is:
:si :S!L;SEH 31
-16 ;
S'%














1 Ir

.•is :; 3LCOC .L;O
SUS: '.533 rjSVEY
i : >M :: ;r

4


Pi??:5:"

•

2 :* 4 20
2 3 4 IS
1 3 5 N
3 !5 i 21
1 16 5 22
153' =
3 :i 10 2«
I 9 IS 2!
» 11 '.0 2S
; • 12 2:
1 • 3 •'
3 ) 5 !«
S 12 '1C
5325:
4331
1332

-------
         CHILD IN THE LEADED ENVIRONMENT
                                                                            TRAINING  OF  SURVEY  *EAMS

                                                                          Conduct  interviews

                                                                          Collect  environmental  samples

                                                                          Test painted surfaces
                                                                                DOOR-TO-COOR SURVEY

                                                                        Explain aurpose ana obtain consent
                                                                        Administer questionnaire
                                                                        Collect soil, dust, garden produce
                                                                        "est painted surfaced
                                                                        Schedule olood drawing
           1983 LEAD SURVEY  --  OBJECTIVES

'.  determine current blood lead levels  of  children

2.  Compare blood lead levels  to national norms

"..  St..3y current relationship between  blood  lead
     md environmental  conditions

-.  !:entify current factors  associated  *ith  lead
     aoscrotion

    ocunlent improvements achieved  since 1974

a.  Jrsviae a aata base for future  public health
     and environmental  decisions
      ELOOO  :RAUING  AT  LOCAL  CLINIC

i'ocd samoie ootainec  from  arm
Sanp'es  snipoed  ta  private  'ao  *ir analysis
B'icoG lead ana  •?  netsr-ninec
In-": paid  SI5.00  casn
:esjl*.s  reported  in  Se
                   PROJECT ORGANIZATION
     1 .  Local  community
     2.  Panhandle District Health  department
     I.  !dano  Department of Health and  Welfare
     -.  Centers for Disease Control
     5.  Environmental  Protection Agency
                       SURVEY AREAS

                Area 1   Smelter/tie

                Area 2   
-------
                  n
                                                                                 15
     3LOOD lŁAO LEVELS  -   AUGUST 1983

        No.  Of
       Children  31ood Lead Levels (ug/dl)
  Area  Tested    Avg.   Lowest   Highest
'I
2
3

1$
199
122
364
21 6
17 5
12 1
16 1
35
as
40
45
                  U
 A'JE.'.AGE 3LOOC LEAC LEVELS - AUGUST 1933
Area
        Age in Years
     2   3   4   5   5
      23  21  24  22  23  24  13  17  21
12  IS  20  2!   15
                              13
          12  12  12  12  15  10  IP  15
                                                         COMPARISON DF 1983 SLQOO LEAC LEVELS TO
                                                                 OTHER PUBLISHED LEVELS

                                                              'lean/Median
                                              Location  Years Blood Lead   'lumber Ages     Description
Area 1
Area 2
Area 3
                                                                 53
                                                                 33
                                                                 33
                                                                  21
                                                                  17
                                                                  12
                                                              76-30
                                                              75-30
                                                              75-30
                                                              76-30
                                                              76-30
                                                                  16
                                                                  1 1
                                                                  21
                                                                  17
                                                                  H
    43   1-9  '.Ji'hiri 1 iTiile of sirreiser
   199   1-9  1 -c-i niles cf smelter
. J12_ _'Z9_ I'c^i1!5^! I"!1!8!
 2,272   -i-5  Al;  races, jroan i rural
   451    5-3  All  races, jrban i rural
   -1?   '-;-5  Slack, jrbart I rural
                            319
         >=-:  White,
Dallas, T:< 32
32
32
Helena, MT 33
33
33
15
15
15
13
10
7
45 1-5 .'lon-oiacK,
•withi n '--i nils o? smel tar
50
215
E;
250
59
1-5 Slack,
!-5 Slack,
;-: Jit.hin
1-5 :-2b. .-1
,.5 4-5 nil
witnin ^ mils
«-l .Tii'ie of ssiel '
1 riile from snel '
le rran smelts--
es from smel -er
                 II
   PSRCE'17 Or CHluGREN WITH 3LOOD L.EAC
-i *
31acc
•JC/
50
^5
-a
•35
30
25
20

i^i »i;j , . .m» rfrv^avjjj '..lu^-'
Lead Percent of Children
ctl Area i
100
100
100
95
31
55
35
14
Area 2 Area 3
100 100
99 100
98 99
96 98
92 98
35 95
50 92

COMPARISON OF AVERAGE 3LOOO LEAD
Area No .
1 '.72
: \ 39
• 191
31ooc Lead
53
^9
25
1930
:io. Slood Lead
93 21
257 ZS
'lot tesied









LEVELS
')o . Slood ;_aaa
43 21
199 17
122 12
                                                                         1§
                                                     -REE ESYTHROCTE P'.O'OPORPH'fRi;; LEVELS  - AUGUST  19S2

                                                           •"rnldrsn   ^ras  Irvtirrocy's  ?rci330r*pnyrin  'uo/cl,
                                                     Area   Tgstsc	Average    '.oxest    Hiqnest

~.
1

i3
1 so
:.2!
252
35
" ^
22
25
': 3
n. i
'2

.' /
' 5 J
77
152
                                                                               V7
                                                                  RISK CLASSIFICATION OF SMELTERVILLE CHI.DRE.';
Month/Year
Cctoter I 980
August 19B1
August 1932
August 1933
Sistr
i
58. 5
36.5
9€.5
90.7
Classi fica
il
31 .9
10.3
7 .5
9.3
•101
HI
3.5
2.7
o.e
3.0
2V
i .;
0.0
0.0
0.0

-------
               18
                                                                               22
FOLLOW-UP OF CHILDREN  WITH  ELE'/ATEO
 3LOOO LEAD AND/OR  EP,  AUGUST  1933

 Slood lead 30 ug/dl or greater 25

 EP 50 ug/dl  or greater        17
               12

 FOLLOW-UP OF CHIL3REN  - AUGUST  1983

   Home visit by  public health nurse
   Physician  referral
   Repeat  blood  tests
   COMPARISON  OF SOIL  LEAD  LEVELS

Location,  ^ear    '!o.  Lead  Level  (ppm;
Idano - 1
;
j
Dallas
Toronto
El Paso
Yugoslavia
E. Helena
3a! timore
33
33 21
33 1
32
75
72
75
33
30 4
a
5
:o


u


2
-641
3639
590
1130
15,000-20,000
3-157
5000 - 9000
2000 - 5000
i - 10,900

'.EAC LEVELS -
Sample
Area ">pe
1 Soil 1
Soil 2
Soil 3
Garden
2 Soil 1
Soil 2
Soil 3
Garden
! Soil 1
Soil 2
Soil 2
Garden
20
AUGUST
.'lumber
Tested
^i
-i6
17
j
216
207
105
29
120
126
5;
35

1583
.sad
Mean
•Wl
5372
i524
1335
3639
3133
2i75
1690
590
797
33i
376'


(ppra)
Ranqe
322-13400
33-17550
253-15535
35- 2705
53-20700
1Q8--M200
30-2^75
,H1- 5160
151- 2915
97- ^275
37- 637C
93- 1065
                                                                               11
                                                           SOIL CADMIUM LEVELS  -   AUGUST  1983
Area
1



;



2




Sampl e
Type
Soil 1
Soil 2
Soil 3
Garden
soii 1
Soil 2
Soil 3
.Garden
Soil 1

sol i '-
Soil I
Garden
Number
Tested
44
46
17
3
215
207
105
29
I2C

-. _ -
55
35
Cacmium
Mean
55 1
53
i2
31
2-1
'30
22
15
!2

• i
' r*~
" "
(ppm)
2-12*
4-160
9- 72
2- -16
3-125
--1C8
2- 34
-- '2
--119'
^.- -Q

" 1 "*
2- 15
              11
       SPECIAL  SOIL  LEAD  LEVELS
             1974  and  1933
COMPARISON OF SOIL CADMIUM LEVELS  *
         1974 and 1983
Mean Soi
Area 1974
i 7224
2 3809
3 1073
Lead Levei (ppm
1983'
3504
-1994
561
     Samplea  jsing same techniques
     both years
                                                                   Mean Soil Cadmium Levels (ppm)
                                                               Area      1974     1983
1
2
3
53
23
11
54
32
i "i
i O
* Sampled using same technique  both
  years

-------
                  25

SOIL CADMIUM LEVELS (ppm)

  Background levels         < 1.0

  Baltimore (urban)     .56

  Michigan (residential).41

  Michigan (rural)       .57

  Michigan (industrial)  .66

  Japan (rice fields)    1-69

  Sweden (-sludge)        .25
.02-U

OIL ZINC LEVEL -
Sample
Area Type
1 Soil 1
Soil 2
Soil 3 ,
Garden
2 Soil 1
Soil 2
Soil 3
Garden
3 Soil 1
Soil 2
Soil 3
Garden
26
AUGUST,
Number
Tested
44
45
17
3
216
207
105
29
' 130
125
55 .
25

1933
Zinc
Mean
1312
1562
1373
515
1209
1124
1244
• 574
473
530
920
436


(ppm)
Range
217-3590
212-5290
377-3237
115- 365
107-5080
143-7280
92-9347
137-1325
177-2790
135-1667
62-9120
162-1333
                  27_

   COMPARISON OF  SOIL  ZINC LEVELS
           1974 and 1983

       Mean Soil  Zinc Levels  (ppm)
   Area      1974      1983
1
2
3
2340
1512
941
1261
1502
476
   *  Sampled using same technique
     both years
                   28

    LEAD LEVELS  IN HOUSEHOLD OUS
            August 1983
Area
1
•}
3
.'lumber
Samples
33
161
92
Leaa
Mean
3994
2752
1330
( ppm )
Range
1910-3193
221-10395
-112-7865
                                              29

                                  LEAD  LEVELS  IN  HOUSEHOLD  OUS"
                                          1974 and  1983
Area
.1
2
3
Mean Lead
1974
11920
11149
2253
Levels (ppm)
1983
3994
2752
1330
                                                                                30


                                                              COMPARISON OF LEAD LEVELS IN DUST
Location
Idaho - 1
Idaho - 2
Idaho - 3
El Paso (72).
El Paso (74)
Philadelpnia
Portland (73)
Lead Leve
Mean
3994
2752
1330
22191
1479
(72) 3855
325
Is (ppm)
Range
1910-3193
221-10395
412-7365
929-15630
100-2700
                                                            ;DMIUM ADO zi;:c LEVELS
                                                                          August '
                                                    -CUSEHOLD j'JST
                            '  'lumber  Cadmium ;-ppm.i  ^-inc    , pom;
                         Area  Samples Mean   Range   Mean    Range

                           1      33    57   37-137   23*0  1220-^5:0

                           2    161    47    5-1Q4   2535   239-9620

                           3     92    29   10-12S   1673   304-5245
                                                                                 32
                                                        NUMBER OF SURFACES FOUND
                                                                           August
                                               70 CONTAIN LEAO-SASE PAINT
                                                1983
Lead Paint Value
(,nq lead/sq cm)
Less than 0.7
0.7 to 2.9
3.0 to 5.9
6.0 or greater
Interpretation
Negative
Low
Moderate
Hi ah
'lumoer of
Surfaces
1133
136
75
OD

-------
                      33
                 37
         LEAD LEVELS  IN  GARDEN  "ROOUCE
                 August  1982
Area
1


2


3


Produce
Samples
Carrots
3eets
Lettuce
Carrots
3eets
Lettuce
Carrots
Beets
Lettuce
'lumber
Tested
3
:iS
1
23
14
25
32
o
20
Lead
•lean
13

18
61
17
55
25
15
2 2
(ppm)
Range
11- 33


12-246
U-121
12-155
6- 92
11-30
11- 33
       .'iS   Not sampled
                                                                      CADMIUM  LEVELS  EM  GARDEN PRODUCE
                                                                               1975 and  1933
Area
1


2


3


/Produce
Carrots
Beets
Lettuce
Carrots
Seets
Lettuce
Carrots
Beets
Lettuce
1975
Mean Ranqe Me a
_
.
28
5
23
24
4
13
12
19
-
21-34 5
2-9 3
18-34 15
2-61 13
2-6 i
11-15 5
2-25 10
933
i Range
6-26
-
-
2-26
2--2
2-66
1-11
2-13
1-23
                      34

      '• EAO LEVELS IN GARDEN PRODUCE
             1975 and 1983
-rea/



i


~.


Produce
Carrots
3eets
Lattuce
Carrots
3eets
Lettuce
Carrots
Seets .
Lettuce
19?
Mean
.
.
231
20
1G8
161
37
12
10
3
Ranae
.
-
171-287
5-36
27-130
19-303
5-111
9-15
5-29
1983
Mean
13
-
-13
51
17
55
25
15
32
Range
n-33
-
-
12-216
14-121
12-155
5-92
11-30
11-33
                      35
   '•'AXIMUM 3AILY  DIETARY  ALLOWANCE  FOR  LEAD
                 38


  MAXIMUM DIETARY ALLOWANCE FOR CADMIUM


Maximum Daily Intake              -  "0  j

Maximum Cadmium in ^ cuo serving  -   >  j
                                                                                     39

                                                             AND  II.'IC  i:: AIR  SAMPLES COLLECTED .AT FIVE :iORTH IDAHO SITES"
                                                                  Il'RIi'JG AUGJS*,  SEPTEMBER,  AHC  OCTCSER, 1983
Maximum Dai iy
:srson's Ace Lead Allowance
<6


>5
•nonths
6-24 months
2-5 years
/ears
100
150
3CO
130
ug
•jg
ug
•ja
:'.axiuium Lead Leave1.
in 4-ounce serving
10
15
30
13
ppm
ppm
ppm
aom
Samo'iina Site
•Si 1 ver 
-------
              12

"o •naintain childhood blood  lead
  levels at the lowest possible  level
       child's hands frequently to
    remove dirt tnat ma/ contain
         exoosure to dirt and dust
    containing high lead levels.

  iarougnly wasl or pee)  all  local!/ ;rown
   fruits ana vegetables  prior to eating.
              43

   Con't allow children to eat snow
     or  fcicJes.

   Con't allow children to chew on
     painted  surfaces or sainted material.

           lead aase saint  from peeling
     surfaces.
              44
           nousenola dust  5y  frequent wet
      •nopping  or  dusting with  a  aamp cloth.

    Annual  screening of  all children 1-5 years
      of age to ieteraine  if  lead  absorption
      h.as occurred.-

-------