# Presentation: 683788

## First National Environmental Health Survey of Child Care Centers: Lead Results

**Presenter: ****Warren Friedman, Ph.D., CIH;****at CDC ACCLPP meeting March 23, 2004.**
**Research Team: ****J.Y. Zhou****1****, W. Friedman****1****, ****D.E. Jacobs****1****, N.S. Tulve****2****, P.A. Jones****2****, ****C.W. Croghan****2****, C.J. Cave****3****, J. Rogers****4****, ****S.M. Viet****4****, D. Marker****4****, A. Fraser****4**
**1****HUD, ****2****EPA, ****3****CPSC, ****4****Westat**

## Survey Rationale and Target Population

**Survey was recommended in ****2000 Federal Strategy**
**100,000 institutional (licensed) child care centers in continental US serving children under 6 years**
**4.6 million children under 6 years in those child care centers**

## Survey Sample

**Nationally (CONUS) representative sample**
**Random population-weighted selection from 30 primary sampling units (Metropolitan Statistical Areas or portions, or non-metropolitan groups of counties)**
**Appx. 11 institutional (state-licensed) centers/PSU; of 334 sampled centers, ****68 were not eligible for the survey**
**Of 266 eligible centers remaining, ****168 (63%) agreed to participate and completed the survey**

## Questionnaire, Sampling and Analysis

**Center Director (usually) recruited by and answered survey questions asked by CPSC staff**
**Two classrooms, 1 multi-purpose room, exterior bare soil; randomly selected**
**Paint tested by XRF; dust and soil samples collected**
**Samples analyzed for lead, selected allergens and selected pesticide residues**

## Lead Measurements

**Paint (XRF measurement)**
**Painted building components, ****bookshelves and cabinets**** in sampled rooms**
**Exterior painted components, including play equipment**
**Dust Wipe: Floor and window sill in sampled rooms**
**Soil:  Composite soil core in play area**

## Data Limitations

**Classification may be biased from:**
**Sampling and measurement variation**
**Incomplete sampling of rooms resulting in missing a room with a LBP hazard**
**Comparison with National Survey of Lead and Allergens in Housing (HUD and NIEHS, 1999-2000) indicates bias is small**

## Significant LBP Hazard per HUD Lead Safe Housing Rule

_**Significant**_** deterioration of LBP**
**Large surfaces: 2 ft****2**** interior, or 20 ft****2**** exterior;**
**Small surfaces: 10% total area of a component type**
**Lead-contaminated dust**
**40 ****μ****g/ft****2**** on floor; or**
**250 ****μ****g/ ft****2 ****on window sill**
**Bare, lead-contaminated soil**
**400 ****μ****g/g in play area; or**
**1200 ****μ****g/g in > 9 ft****2**** of bare soil in rest of yard**

## Results: Significant LBP Hazards

**Of 100,000 institutional child care centers nationally:**
**14% (9% to 22%) have significant LBP hazards**

## Factors Related to Significant LBP Hazards

**p < 0.05:**
**Construction Year****: Centers in older buildings more likely**
**Race****: Centers where majority of children are African-American as reported by Center Director more likely than those where majority of children are white**
**0.05 < p < 0.10:**
**Region****:  Northeast/Midwest somewhat more likely than South/West**** **
**Note: No urban/rural difference (both 14%)**

## Number of Centers with Significant LBP Hazards

**Notes:**
309 centers (0.3%) have significant paint-lead hazards and also dust lead hazards.
All centers with soil lead hazards have paint lead hazards.

## Centers with Significant LBP Hazards by Construction Year

## Results: Lead-Based Paint

**Of 100,000 institutional centers nationally:**** **
**28% (22% to 35%):****	****some LBP**
**16% (10% to 24%):****	****deteriorated LBP**
**11% (6% to 20%):****	****significantly ****	****	****	****	****	****deteriorated LBP**

## Location of LBP

## Painted Components with LBP

**Components most likely to have LBP:**
- Interior trim, Exterior surfaces
**Components with largest area of LBP:**
- Interior walls, Exterior walls
**Components with highest lead loading:**
- Doors, Walls, Windows, Trim

## LBP Deterioration vs. Construction Year

## Results: Dust Lead Loading

**In 100,000 centers nationally:**
**No floor samples had a dust lead loading ******** 40 ****μ****g/ft****2**
**Window sill dust lead loading is higher than floor lead loading**
**3% (1% to 7%) have window sill lead loading ******** 250 ****μ****g/ft****2**
**Indicates a lead dust hazard in about 2,800 child care centers**

## Window Sill Dust Lead Loading by Construction Year

## Results: Play Area Soil Lead

**Of 100,000 institutional centers nationally:**
**  ****4%****	****(2 - 9%):****	****	****no play area**
**23%****	****(15 - 34%):****	****no play area soil**
**38%****	****(26 - 51%):****	****no bare play area soil**
**33%****	****(23 – 45%):****	****bare play area soil****	****	****	****	****	****	****lead < 400 ****μ****g/g**
**  ****1%****	****(0 - 6%):****	****	****soil lead hazards****	****	****	****	****	****(bare play area soil ****	****	****	****	****	****lead **_**>**_** 400 ****μ****g/g)**

## Summary: First National Environmental Health Survey of Child Care Centers: Lead Results

**Survey of 168 institutional child care centers representing 100,000 centers nationally serving 4.6 M children < 6 yr old**
**28% have some LBP**
**14% have a significant LBP hazard:**
**11% have significantly deteriorated LBP**
**3% have a dust lead hazard**
**1% have a soil lead hazard (and significantly deteriorated LBP)**
**0.3% have significantly deteriorated LBP and ****a dust lead hazard**

**Notes:**
309 centers (0.3%) have signficant paint-lead hazards and also dust lead hazards.
All centers with soil lead hazards have paint lead hazards.