Environmental Assessement for Childhood Lead Poisoning Prevention During the COVID-19 Pandemic

The Fall 2020 issue of the Childhood Lead Prevention Program Word on Lead Prevention provides information on how to remotely conduct environmental assessments and education during the COVID-19 pandemic. The multilingual, printable pdf is also available.

COVID-19 is complicating an already challenging story in our community! With the practice of sheltering-at-home and closure of childcare centers and schools, children may be spending more time around home lead hazards, like old peeling paint. Every child deserves to live in a safe and healthy home; and every parent deserves to have the confidence that their homes are maintained in a safe and healthy manner. If you are concerned about your child being at risk of lead exposure during the COVID-19 pandemic, contact San Francisco Children's Environmental Health Promotion (CEHP) to receive a remote lead hazard environmental assessment (Assessment) and education.

Before the COVID-19 pandemic, CEHP's routine procedure for reducing lead hazards involved investigators visiting families' homes to identify sources of lead. Home visits during the COVID-19 pandemic would put the investigation team at risk for infection because the virus causing COVID-19 is passed on mainly through close contact with infected individuals. In order to protect our investigators while also protecting San Francisco children, CEHP has been following guidelines from the California Department of Public Health Childhood Lead Poisoning Prevention Branch. Under the guidelines, CEHP has been conducting remote Assessment and education. Onsite visits are only performed for children meeting criteria including having a high blood lead level. For these onsite visits the investigator wears personal protective equipment and follows strict infection control procedures with family.

The Assessment and education involves interviewing families by phone, with questions guiding both the family and the investigator toward screening for potential sources of lead hazards. The questions cover the entire range of risk factors that are normally assessed on site. For example, the investigator asks questions to determine if there are potential lead-containing paint and dust hazards at a home's windows or other friction points (painted surfaces rubbing together), from bare soil, and lead dust contamination resulting from work clothes or recent remodeling in the building. The investigator also asks about the condition of the families' furniture, the children's toys, and whether the family uses imported spices, cosmetics, or home remedies that might contribute to lead poisoning. With the pandemic restricting home visits, investigators have fewer options to require property owners to correct lead hazards found on the property. Without a formal on-site inspection investigators can require correction of old buildings with deteriorated, legally presumed lead-based paint, but might not be able to verify other lead hazards.

When an Assessment reveals potential hazards in a unit, the investigator can identify interim actions that the family can take to prevent children from having access to the hazards, thereby reducing the risk of lead poisoning. Some simple actions include: repairing damaged paint, using furniture to block access to damaged paint or varnish until repairs are done by a lead-certified contractor, hiding phone, electrical, and computer cables behind furniture, keeping home clean and dust free by cleaning interior windowsills and hard surface floors at least twice a week with a wet microfiber cloth/mop or disposable cloths, washing children's toys, pacifiers and hands frequently, covering bare soil in the front or backyard with grass or mulch, hardscape, gravel, woodchip, etc.

The final part of the Assessment and education includes a letter to the family summarizing the potential lead hazards and guidelines for reducing lead exposures. In cases where a child has a high blood level, a public health nurse continues to check in with the family to provide guidance. For a FREE remote environmental assessment and education for lead hazards during the COVID-19 pandemic or for more information about childhood lead poisoning prevention, contact us at (415) 252 3956.