Number range CHAPTER

Slide 1-1: Module 1 Why Should I Be Concerned About Lead-Contaminated
Dust?

1.  This is the module title slide.

2.  Announce the module and move quickly to the next slide.

    **Overview of this module**: The table below summarizes the content
    and teaching methods for this module. This is for your reference. Do
    not cover this with the participants.

+-----------------------------------+-----------------------------------+
| ## Module 1: Why Should I Be      |                                   |
| Concerned About Lead Dust? 1 hour |                                   |
+-----------------------------------+-----------------------------------+
| -   [Activity]{.underline}: How   | [Key message]{.underline}: Dust   |
|     do we create dust             | is the problem and contractors    |
|                                   | make dust. By working lead safe,  |
| -   A little dust goes a long way | you can make a difference.        |
|                                   |                                   |
| -   [Activity]{.underline}: Dust  | [Notes]{.underline}: This module  |
|     wipe demonstration            | involves an upfront exercise and  |
|                                   | then slides.                      |
| -   Why is dust a problem?        |                                   |
|                                   | -   Exercise: Sweetener packet    |
| -   Health risks                  |     demo or paper-based exercise  |
|                                   |     (30 minutes).                 |
| -   What is lead-based paint?     |                                   |
|                                   | -   Slides (30 minutes)           |
| -   How widespread is LBP?        |                                   |
|                                   | [Preparing for this               |
| -   What is being done?           | module]{.underline}: Have         |
|                                   | materials ready for the exercise  |
| -   How do I work lead safe       | and demonstration.                |
|                                   |                                   |
|                                   | [Materials needed:]{.underline}   |
|                                   | -- sweetener packet, dustpan,     |
|                                   | broom, dust wipe kit.             |
|                                   |                                   |
|                                   | [Options]{.underline}: Trainer    |
|                                   | can replace the interactive       |
|                                   | sweetener packet exercise with a  |
|                                   | paper-based exercise in which     |
|                                   | participants rate different       |
|                                   | activities by how much dust they  |
|                                   | create. See Appendix 7 for        |
|                                   | Optional Exercise #1. Note:       |
|                                   | Instructor must use one of these  |
|                                   | two exercises.                    |
+-----------------------------------+-----------------------------------+

Slide 1-2: Module 1 Overview

3.  This module covers the bulleted list of topics on the slide. Review
    this list with the class participants.

4.  Module objective. The purpose of this module is to identify and
    describe the health effects of lead exposure and thereby establish
    the importance of protecting residents (and workers) from exposure
    to lead-contaminated dust.

5.  Upon completion of this module, participants will be able to
    explain:

    -   Why we are concerned with lead-contaminated dust;

    -   The health risks of lead to children and adults; and

    -   The Federal regulations that affect lead-based paint.

**Slide 1-3: How Do We Create Dust?**

Use this slide to launch a five-minute brainstorming exercise. The goal
of the exercise is for participants to make a connection between the
work they do and dust.

1)  Tell participants to think of activities they do that create dust.
    Ask them to write them down, individually or in groups. (Possible
    answers include: planning, sanding, scraping, drilling, sawing,
    demolition, etc.)

2)  After a couple minutes, stop them and ask them to share their
    answers.

3)  Write their answers on a flipchart or overhead slide. (Option --
    Participants can write answers on an overhead slide and then present
    the slide.)

4)  Highlight the fact that many common renovating, remodeling, and
    painting activities create dust.

**Optional Hands-On Activity:** Another way to achieve this training
objective is to have participants do some paint preparation work in
class.

1)  Select a small number of participants.

2)  Give them pieces of painted wood and assign them tasks such as
    sanding, planing, drilling, and sawing.

3)  When they are done, examine the area. Ask the large group -- Did
    these activities generate dust?

This activity helps reinforce the key message that dust is the big
concern, and the goals are to minimize it, contain it, and clean it up
effectively.

Slide 1-4: A Little Dust Goes a Long Way...

*For this slide you need a sweetener packet, broom and dust pan, and
dust-sampling supplies.*

Do the following demonstration to emphasize the points on this slide:

1)  Tear open a packet of artificial sweetener and sprinkle it on the
    floor. (Note: Use artificial sweetener rather than sugar. It is
    finer.)

2)  Ask a few participants to walk through it.

3)  Now give a participant a broom and tell him or her to sweep up all
    the sweetener.

4)  Question to the class \-- Do they think the sweetener is all gone?
    Ask them if there is any on the soles of the feet that walked
    through it. Where is that sweetener now? (probably all over the
    room).

5)  Explain that one way to test the amount of sweetener on the floor is
    to do a dust wipe.

6)  **Demonstrate the dust-wipe sampling process.** (For guidance on how
    to conduct dust wipe sampling, consult EPA's Lead Sampling Field
    Guide, which can be downloaded at
    [http://www.epa.gov/lead/Handbk-2A.pdf]{.underline}.)

7)  Question for the class: Do you think a lab analysis would show
    sweetener on the wipe?

8)  Now tell the class to imagine that packet was actually full of lead
    dust. The fact is that a packet of lead that size (one gram) could
    contaminate several family homes. The math that substantiates this
    assertion is provided below. You do not need to go into it in detail
    but use it if questioned.

    **\
    Option**: If this activity is not appropriate for your training,
    consider using Optional Exercise 1 in Appendix 7.

Sweetener Packet Math *(Use the information below only if asked by the
participants.)*

A packet of sweetener contains one gram of sweetener. Imagine that
one-gram packet contains 10,000 tiny pieces of sweetener. Each piece
would weigh a very small amount, 100 micrograms. (A microgram is a
millionth of a gram; a millionth of a packet of sweetener.)

If one of those tiny pieces were crushed and spread over a one square
foot area, that would be 100 micrograms per square foot. If the granule
were actually lead instead of sweetener, having it spread over a square
foot would exceed the EPA lead clearance standard of 40 micrograms per
square foot.

Those 10,000 granules in the package could be crushed and spread out
over 25,000 square feet and contaminate that entire area - that's the
floor space of twelve average houses!

Slide 1-5: Why Is Dust and Debris a Problem?

1.  Review the notes beneath the slide.

2.  Highlight the following points:

-   Tiny amounts of lead can be extremely harmful.

-   If dust contains lead, it can poison workers, residents, and
    children.

-   Workers may bring home lead-contaminated dust in their vehicles and
    on their clothes and shoes and expose children and other adults to
    lead-contaminated dust.

-   Lead particles are often so small that you cannot see them, and yet
    you can breathe or swallow them.

-   Children often inhale or swallow lead-contaminated dust during
    normal hand-to-mouth activities.

-   Adults can swallow or breathe dust during work activities.

3.  **Optional:** Pass around a laminated paint chip to show the amount
    of lead-based paint it takes to poison a child.

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1.  **Emphasize that if proper precautions are not taken prior to or
    during jobs that generate dust, workers, residents, and children may
    become lead-poisoned.**

Slide 1-6: Health Risks of Lead

-   This slide and the next cover similar points, so review both slides
    before presenting to the class to be sure you make the necessary
    points appropriate for each slide.

    [Health Effects in Children]{.underline}

-   Children, particularly children under age 6, are most at risk from
    small amounts of lead.

-   For children, the major route of entry of lead into the body is
    through ingestion of lead dust by normal hand-to-mouth contact as
    they swallow dust from their hands, toys, and other things they put
    in their mouths.

-   Children's bodies absorb a much greater percentage (50%) pf the lead
    that they ingest or breathe, compared to adults (10%).

-   In children, lead can cause:

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-   Nervous system and kidney damage.

-   Learning disabilities, attention deficit disorder, and decreased
    intelligence.

-   Speech, language, and behavior problems.

-   Poor muscle condition.

-   Decreased muscle and bone growth.

-   Hearing damage.

    While low-lead exposure is most common, exposure to high levels of
    lead can have devastating effects on children, including seizures,
    unconsciousness, and, in some cases, death.

    [Health Effects in Adults]{.underline}

    -   Emphasize that adults the major route of entry of lead into the
        bodies of adults is through inhalation (breathing) of leaded
        dust.

    -   In adults, lead can cause:

-   Increased chance of illness during pregnancy.

-   Harm to a fetus (unborn child), including brain damage or death.
    (Note: Lead does not get in breast milk.)

-   Fertility problems in men and women.

-   High blood pressure.

-   Digestive problems.

-   Nerve disorders.

-   Memory and concentration problems.

-   Muscle or joint pain.

Slide 1-7: Lead Poisoning

-   Lead poisoning often has no symptoms.

-   Testing a person's blood is the way we measure exposure to lead.

-   The most common way to measure the amount of lead in blood is the
    Blood Lead Level (BLL) test.

-   It is not necessary to describe the two tests listed below to
    participants. The information is provided for your purposes in case
    of questions.

-   The point to emphasize is that even small amounts of lead in the
    blood are cause for concern.

-   The BLL test:

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-   Measures the amount of lead that is circulating in your blood.

-   Tells you about your exposure to lead in the last 2-3 weeks.

-   Does not tell you the total amount of lead in your body.

-   Does not tell you if any long-term damage has occurred.

-   A blood lead level above 10 μg/dl is not safe for children or for
    women during pregnancy. A level of 39 μg/dl or less may mean that
    damage to your body is occurring, even if you have no symptoms. A
    level of 40 to 49 μg/dl means that serious health damage may occur.
    A level of 50 μg/dl or greater means that severe health damage is
    likely, may be permanent, and may occur quickly.

    -   A different, less common, test is the Zinc Protoporphyrin (ZPP)
        test. The ZPP test:

-   Indicates the effect of lead exposure over the previous 3-4 months.

-   The test can measure damage to a person's blood-forming system.

-   Does not tell you the total amount of lead in your body.

-   Does not tell you if any long-term damage has occurred.

-   

Slide 1-8: What Is Lead-Based Paint?

2.  The purpose of this slide is to provide the definition of
    "lead-based paint."

3.  Review the notes beneath the slide and emphasize that paint with
    lower concentrations of lead can cause health problems.

**Slide 1-9: How Widespread is Lead in Housing?**

**Key message of this slide:** Pre-1960 housing contains significant
amounts of lead-based paint. Homes built between 1960 and 1978 may
contain significant amounts of lead-based paint, but at a declining
rate.

-   Emphasize that pre-1978 housing should be assumed to contain
    lead-based paint. Additionally, note that lead-based paint under new
    paint is still a problem and will create lead-contaminated dust and
    debris.

-   Highlight that approximately 38 million homes contain some
    lead-based paint, according to the HUD Report on the National Survey
    of Lead-Based Paint in Housing, 2001.

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-   Homes built before 1950 may contain significant levels of lead-based
    paint. Explain that many homes built before 1978 may contain some
    lead-based paint. Participants should assume that any house built in
    1978 or earlier contains lead-based paint unless the house has been
    tested for lead by an EPA or State-certified risk assessor or
    inspector and the results indicate that the house does not contain
    lead-based paint.

-   Emphasize that pre-1950 housing is likely have lead-based paint on
    the exterior and interior. After 1950 and up through 1978, there was
    a decline in the use of lead-based paint in the interior of housing;
    however, it is likely that it will be present on the exterior of
    housing. Lead paint on the exterior of housing could result in soil
    contamination with lead, making it easy for dirt and dust from
    around the house to blow in or be tracked into the home. Children
    also are more likely to play in the dirt near the house and thus be
    exposed to lead contaminated soil, dirt, and dust. After 1978,
    lead-based paint is not likely to be found in the interior or
    exterior of housing.

Slide 1-10: What is Being Done About Lead?

*For this slide, have a copy of the blue "Protect Your Family Brochure"*
*on hand.*

-   Review the notes beneath the slide.

-   Highlight the following:

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-   Lead was banned from residential use in 1978. This is why 1978 is
    the critical cut-off date.

-   The Pre-Renovation Education Rule (PRE) requires contractors to
    distribute a pamphlet to clients in pre-1978 homes. This is the law.
    (See details in the notes under this slide and in Appendix 5.)

-   Show the "Protect Your Family" pamphlet. (Note that it is available
    in English, Spanish, and Vietnamese. Download these pamphlets on the
    Web at
    http://www.hud.gov/offices/lead/disclosurerule/index.cfm#forms or
    call 1-800-424-LEAD.)

    -   Some clients will have already seen this pamphlet. The
        disclosure rule requires that sellers and landlords give it to
        buyers and tenants.

Slide 1-11: What Is Being Done About Lead?

-   Review the notes at the bottom of this slide.

-   Highlight the following:

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-   Specialized training is required for abatement supervisors and
    workers. EPA and the States have training and accreditation
    programs.

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-   This training is also part of a national initiative to train people.
    While voluntary, it provides critical information to people who need
    it -- contractors and their personnel.

**Slide 1-12: How Do I Work Lead Safe?**

-   Use this slide to transition to the next modules. It shows
    participants what they must do in a renovation, remodeling, or
    maintenance job to work in a lead safe manner. The rest of this
    course will follow these steps in detail.

-   Remind them of 3 types of jobs discussed the Intro chapter (Slide 7)
    and refer them to Appendix 1. The flowchart in this appendix is a
    useful tool for determining if lead safe work practices are
    recommended or required in any given job.

-   Explain that if the property where the work will be performed
    receives housing assistance (Federal or State), contractors need to
    check whether there are specific lead safety requirements that must
    be met.

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-   Supervisors should make this determination and find out about the
    requirements.

-   Workers need to check with their supervisors to see if additional
    requirements apply. If work changes during the course of a job,
    workers need to check with their supervisor to make sure that the
    changes will meet the lead safety requirements. Remind them that if
    a job involves required abatement activities, this work must be done
    by a certified abatement contractor.

**Slide 1-13: Now You Know**

Reiterate the three key points from this module -- you may want to do
this as a discussion by asking the participants the following questions:

Q: Why are we concerned with lead-contaminated dust?

> A: We are concerned about lead-contaminated dust because standard work
> practices tend to create a lot of dust. If the painted surfaces being
> worked on contain lead-based paint, this work can generate dust that
> can poison workers and residents.

Q: How does lead get into children and adults, and what are the health
risks of lead?

> A: Adults tend to inhale lead-contaminated dust, while children tend
> to swallow lead-contaminated dust. Either way, lead-contaminated dust
> can cause significant health problems for both adults and children.
>
> A: Adults: loss of sex drive, high blood pressure, and damage to
> kidneys, reproductive organs, and the circulatory system. Pregnant
> women are susceptible to miscarriages, low birth- weight babies, and
> premature births.
>
> A: Children: Irreversible brain, nervous system, and organ damage that
> can cause reading and learning difficulties in school, behavioral
> problems, and difficulty paying attention and hyperactivity.

Q: What is being done about lead?

> A: It is no longer used in residential housing.
>
> A: Workers are being trained to work safely.
>
> A: Abatement workers are trained and certified by the State.

Emphasize that proper set-up and containment, work practices, and
clean-up techniques leave less lead-contaminated dust than standard work
practices and, therefore, are safer than standard work practices.