As safe as houses; the risk of childhood lead exposure from housing in England

Abstract

Background and Aim: Exposure to lead can harm a child’s health, including damage to the nervous system. Lead exposure in children is still a concern and cases require public health management to find the exposure source. Housing characteristics can indicate the presence of lead-contaminated paint and leaded water supply pipes. We aimed to explore the relationship between housing characteristics and elevated blood lead concentration (BLC) in children in England. Methods: We used a retrospective cohort design and included all cases of lead exposure in children reported to the UK Health Security Agency between 2014 and 2020 via surveillance. A case was a child aged under 16 years, resident in England, BLC of ≥0.48μmol/L and referred for public health management. We collected case demographic details and housing characteristics (age and type). We explored associations between elevated BLC and risk factors, using generalised linear mixed effects models and compared cases’ housing type to that expected nationally. Results: 266 cases met the case definition. There was no difference in BLCs between genders, age groups, deprivation and housing type. After adjusting for reporting source, housing age and type, cases residing in housing built pre-1976 had a BLC of 0.32 (95%CI 0.02, 0.63) µmols/L higher than cases living in housing built after this time. Cases were 1.68 times more likely to be living in terraced housing than other children and less likely to live in apartments and detached properties. Conclusion: This study suggests an association between housing characteristics and BLC in children. Housing age and type may act as a proxy for lead exposure risk through exposure to leaded paint, lead water pipes and lead contaminated dust from outdoor sources. Public health action should consider targeting families more at risk in older housing raising awareness of lead pipes and paint. Keywords: Lead, children, housing