Environmental lead levels after Hurricane Katrina conducted after Hurricane Katrina (Walsh et al. 2006; Zahran et al. 2010). The U.S. EPA Louisiana Department of Environmental Quality survey found no change in the dis­ tribution of soil lead levels, and Zahran et al. (2010) reported a 46% decrease in median soil lead from pre­Katrina levels. Both of these studies were conducted in the immedi­ ate aftermath of Hurricane Katrina and before most reconstruction activity. Furthermore, the reduction in soil lead observed immediately after the storm may have reflected relatively low levels in soil sediment from surround­ ing water bodies, which was deposited dur­ ing widespread flooding of the city (Zahran et al. 2010). Natural and anthropogenic activities can redistribute soil lead, and it was predicted by Potera (2010) that the cleaner soil sediment brought by Hurricane Katrina may not persist. The ATSDR (2007) specifi­ cally warned of the risk of lead dispersion as a result of home renovation and demolition and predicted that if lead­safe practices were not employed, the level and the extent of soil and interior contamination would increase. As a result of Hurricane Katrina’s wide­ spread destruction, homes previously in good condition required renovation, and the sub­ sequent disturbance of lead in old homes makes the risk of lead exposure universal. In this population, 64.2% of the homes were built before 1946, a period when lead paint was in widespread use. Lead paint can be released directly into the soil via air resuspension during renovation activities. Power sanding, a popular method of exterior paint removal, can release a large amount of lead dust into the environment. HUD (1995) estimated that 1 ft2 of pulverized lead paint produces a settled dust lead level of 9,300 µg/ft2. Although power sanding is prohibited in New Orleans by city ordinance (New Orleans, Louisiana, Code of Ordinances 2001), lack of oversight in the postdisaster environment resulted in widespread sanding of homes undergoing renovation. Therefore, it seems plausible that subsequent soil contamination may have occurred. If renovation/demolition activities are contributing to the high lead levels, the lack of association with commonly known sociodemographic factors is not surprising given the extent of housing damage. There is abundant evidence that soil lead exposure is a significant contributor to blood lead levels in children (Clark et al. 2004; Dixon et al. 2007; Lanphear et al. 2005; Ren et al. 2006). Estimates of the contribution of exterior soil to indoor dust range from 20–30% (Culbard et al. 1988; Davies et al. 1985; Rutz et al. 1997) to as high as 85% (Fergusson and Kim 1991; Roberts et al. 1991; Trowbridge and Burmaster 1997). Urban soils can integrate lead from numerous sources, including paint on the exterior of homes, leaded gasoline emissions, and incinerator or industrial lead emissions that have accumulated in the environment (Mielke 1999; Mielke et al. 2005). Because regulations are in place to limit industrial emissions and because leaded gasoline and paint have been banned, of particular concern is new contamination as a result of renovation and demolition of old structures. According to a 1998–2000 national survey (Jacobs et al. 2002), 24 million housing units contain leadb­ased paint hazards; these housing units serve as a reservoir of lead hazards that can pose a risk to children via dust and soil for years to come. The preponderance of old homes coupled with extensive renovation/ demolition activities and high dust and soil lead suggests that children in New Orleans are at substantial risk of environmental lead exposure in and around their homes. An alternate explanation is that soils contaminated with heavy metals may have been carried by flood water and redeposited to new locations post­Katrina (Presley et al. 2010). However, regardless of the actual source of contamination and the findings from the pre­ and post­ Katrina comparative analysis, our findings indicate that lead contamination— particularly soil contamination—is prevalent and has significant public health implications for residents, especially children. The current targeted screening and public health intervention efforts to prevent childhood lead poisoning may need to be expanded to capture a population that previously was not considered at risk of environmental lead exposure. Regulatory action is an effective tool for reducing lead exposure. The key, however, is the extent to which regulations are enforced and their degree of coverage. A U.S. EPA rule governing renovation on child­ occupied structures built before 1978 was adopted in April 2008 (U.S. EPA 2008b). Although the rule provides a formal framework for lead­ safe work practices, it has several limitations. First, it includes work performed by contractors and exempts work performed by homeowners, tenants, and day laborers. In a study of home renovation among children with lead levels ≥ 20 µg/dL in New York, 14% of elevated levels were attributed to renovation, and owners or tenants performed 66% of that work (CDC 2009). The rule also exempts homes without children. Although a child may not currently reside in the home, there can be no prediction for future occupancy. Furthermore, children residing near homes where lead dust is dispersed are put at risk from resuspension of lead, particularly in high­ density areas, such as urban cores, where the vast amount of old housing exists. Testing urban soils should be a priority, and policy officials should support efforts to halt power sanding and other work practices that result in resuspension of lead into the environment. Environmental Health Perspectives • volume 120 | number 2 | February 2012 This study has several limitations. Although households were selected by strati­ fied random sample, the overall response rate was low at 32.5%. Although likely an underestimation because of the conservative approach taken to define occupancy, there were no reliable population estimates because occupancy was a dynamic and fluid process postK­atrina. The possibility of selection bias due to differential participation by households concerned about lead hazards should be con­ sidered; however, the primary goal of the proj­ ect was measurement of allergens and mold in homes, and mold exposure was the princi­ pal health concerns for residents returning to New Orleans after the storm. Furthermore, media extensively reported the U.S. EPA find­ ing of no new lead exposure in the wake of the storm; therefore, we feel it is unlikely that participation was motivated by concern for lead hazards. A further limitation of the study is the lack of information on renovation activi­ ties for participating households and structures nearby to support the ad hoc hypothesis that renovation activities are contributing to the high residential lead levels. Although > 86% of households in this study reported that they had completed renovations, were in the pro­ cess of renovating, or still needed renovation, no data were collected as to the extent of dam­ age or what type of renovations had taken place; therefore, renovation status could not be included in the multivariate model, and the role that renovation and demolition may have played remains unknown. Finally, our com­ parison of soil lead data pre­ and postK­atrina has some limitations. Although our approach was similar to that of other studies, it is likely that differences in sampling methodology may explain some of the observed differences in census­tract–specific soil lead levels. In the present study, samples were collected exclu­ sively from soil around participating houses. In the 2000 soil survey (Mielke et al. 2000), although data were collected primarily from around the house, some samples were collected near streets in residential neighborhoods. Moreover, the number of soil samples taken per census tract varied between the surveys. Conclusion To our knowledge, this is the first study of residential lead hazards in New Orleans in the aftermath of Hurricane Katrina. Survey results indicate that 61% of homes had lead levels that exceed the U.S. EPA standards, indepen­ dent of race, income, and ownership status. New Orleans children are at risk for elevated blood lead levels, including children who were not considered at high risk previously and for whom lead reduction has been considered a public health success. Enhanced surveillance and lead hazard mitigation efforts are needed to safeguard the health of New Orleans residents. 183