Fighting Lead Poisoning: Effective Conditions for Home-Based Education, Housing Remediation, and Relocation

Background—Against childhood lead poisoning, removing lead exposure is the main measure, but how to do it effectively has not been fully established. Our objective was to determine the impact of several interventions (education, housing remediation, and relocation) on children’s blood lead levels. Methods—A historical cohort of childhood lead poisoning was drawn in Marseille, France, from 2011 to 2018. A generalized mixed model was developed to study the kinetics of blood lead levels. Results—We included 151 children, with 56% living in legal substandard housing and others living in slums. Medical follow-up (median: 612 days) included 492 blood samples. In legal substandard housing, blood lead level decrease was significantly associated with every intervention. In slums, blood lead level decrease was significantly associated with housing relocation and education, although to a lesser extent. Conclusions—Every intervention contributed to reducing blood lead levels in substandard housing. Educational intervention is rapidly implemented. Housing remediation follows a long-lasting but effective legal procedure. Some families get housing relocation, depending on their financial resources or whether they are eligible for social housing. In slums, access to legal housing is the most effective against environmental exposure and education has a wider impact on health literacy.