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Replacing Windows Reduces Childhood Lead Exposure: Results From a State-Funded Program

Jacobs, David E. PhD, CIH; Tobin, Matthew MS; Targos, Loreen MS; Clarkson, Dale BS; Dixon, Sherry L. PhD; Breysse, Jill MHS, CIH; Pratap, Preethi PhD; Cali, Salvatore MPH, CIH

Journal of Public Health Management and Practice: September/October 2016 - Volume 22 - Issue 5 - p 482–491
doi: 10.1097/PHH.0000000000000389
Original Articles

Context: Despite considerable evidence that window replacement reduces childhood lead exposure and improves energy conservation and market value, federal policies in childhood lead poisoning, home improvement, and weatherization programs all tend to discourage it.

Objective and Intervention: To evaluate a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones.

Design and Setting: Pre-/post evaluation in 1 urban and 1 rural jurisdiction.

Participants: Low-income households (n = 96).

Main Outcome Measures: Dust wipe sampling, visual assessment, and physical and mental self-reported health at baseline and 1 year.

Results: Geometric mean lead dust (PbD) from baseline to 1 year for interior floors, interior sills, and exterior troughs declined by 44%, 88%, and 98%, respectively (P < .001); 1 year later, levels remained well below baseline but rose slightly compared with clearance sampling just after intervention. PbD declined significantly on both sills and troughs in both the urban and rural jurisdictions from baseline to 1 year. On interior floors, PbD significantly declined by 58% (P = .003) in the rural area and 25% (P = .38) in the urban area, where the decline did not reach statistical significance. Households reported improvements in uncomfortable indoor temperatures (P < .001) and certain health outcomes. Economic benefits were estimated at $5 912 219 compared with a cost of $3 451 841, resulting in a net monetary benefit of $2 460 378. Residents reported that they were “very satisfied” with the window replacement work (87%).

Conclusion: Local and state governments should fund and operate window replacement programs to eliminate a major source of childhood lead exposure, improve energy bills, increase home market value, and create local construction and industrial jobs. Federal agencies should encourage (not discourage) replacement of old windows contaminated with lead. In budget climates such as Illinois with reduced public expenditures, making wise investments such as lead-safe window replacement is more important than ever.

Supplemental Digital Content is Available in the Text.This study evaluates a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones.

The University of Illinois at Chicago, Chicago (Drs Jacobs and Pratap, Messrs Tobin, and Cali, and Ms Targos); Peoria City/County Health Department, Peoria, Illinois (Mr Clarkson); and National Center for Healthy Housing, Columbia, Maryland (Drs Jacobs and Dixon and Ms Breysse).

Correspondence: David E. Jacobs, PhD, CIH, Environmental and Occupational Health Sciences Division, School of Public Health, The University of Illinois at Chicago, MC922, 2121 W. Taylor St, Chicago, IL 60612 (

Jacobs is principal investigator; Tobin, Targos, and Clarkson are data collectors/analysts; Pratap is project manager; Dixon is statistician; Breysse is quality control officer, and Cali is environmental sampling supervisor; all participated in writing and reviewing the manuscript.

The authors thank the residents who welcomed them into their homes, and Quincy Coleman, Will Villalona, Ralph Murphy, Maria Rosa, Paul Diaz, Amanda Escobar Gramigna, ChaNell Marshall, Anne Evens, Anita Weinberg, Kert MacAfee, Rick Nevin, and Jeff Gordon. This project was funded with HUD grant ILLHH0169-10. The opinions expressed in this paper are those of the authors, not the US or local governments.

The authors declare no conflicts of interest, except Jacobs, who is research director at NCHH and an unpaid adjunct associate professor at UIC; he has a conflict of interest management plan in place with UIC.

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