Household interventions for preventing domestic lead exposure in children
Appendices
Appendix 1. Search strategies used in previous version of the review
MEDLINE search strategy
1. Lead Poisoning, Nervous System, Childhood/ or Lead Poisoning/ or Lead/ or lead.mp. or Lead Poisoning, Nervous System/ or Lead Radioisotopes/
2. lead poisoning.mp.
3. lead exposure.mp.
4. lead blood level.mp.
5. lead reduction.mp.
6. 1 or 2 or 3 or 4 or 5
7. randomized controlled trial.pt.
8. controlled clinical trial.pt.
9. randomized controlled trials/
10. random allocation/
11. double blind method/
12. single blind method/
13. or/7‐12
14. animal/ not (animal/ and human/)
15. 13 not 14
16. clinical trial.pt.
17. exp clinical trials/
18. (clinic$ adj25 trial$).ti,ab.
19. cross‐over studies/
20. (crossover or cross‐over or cross over).tw.
21. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.
22. placebos/
23. placebo$.ti,ab.
24. random$.ti,ab.
25. research design/
26. or/16‐25
27. 26 not 14
28. 15 or 27
29. adolescent/ or child/ or infant.mp. [mp=title, original title, abstract, name of substance word, subject heading word]
30. (child$ or boy$ or girl$ or baby or babies or infant$ or toddler$ or teen$ or adolescen$).tw.
31. 29 or 30
32. 28 and 31
33. limit 28 to ("newborn infant (birth to 1 month)" or "infant (1 to 23 months)" or "preschool child (2 to 5 years)" or "child (6 to 12 years)" or "adolescent (13 to 18 years)")
34. 32 or 33
35. 6 and 34
CENTRAL search strategy
#1 LEAD POISONING NERVOUS SYSTEM CHILDHOOD
#2 LEAD POISONING
#3LEAD
#4 (lead near poison*)
#5 (#1 or #2 or #3 or #4)
#6 CHILD
#7 INFANT
#8 (child* or baby or babies or infant* or preschool* or (pre next school*)
or boy* or girl*)
#9 (#6 or #7 or #8)
#10 (#5 and #9)
EMBASE search strategy
1. LEAD 203/ or LEAD 212/ or LEAD/ or LEAD POISONING/ or lead.mp. or LEAD 210/ or LEAD BLOOD LEVEL/
2. lead poisoning.mp.
3. lead exposure.mp.
4. lead reduction.mp.
5. lead control.mp.
6. 1 or 2 or 3 or 4 or 5
7. exp clinical trial/
8. comparative study/
9. drug comparison/
10. major clinical study/
11. randomization/
12. crossover procedure/
13. double blind procedure/
14. single blind procedure/
15. placebo/
16. prospective study/
17. ((clinical or controlled or comparative or placebo or prospective or randomi#ed) adj3 (trial or study)).ti,ab.
18. (random$ adj7 (allocat$ or allot$ or assign$ or basis$ or divid$ or order$)).ti,ab.
19. ((singl$ or doubl$ or trebl$ or tripl$) adj7 (blind$ or mask$)).ti,ab.
20. (cross?over$ or (cross adj1 over$)).ti,ab.
21. ((allocat$ or allot$ or assign$ or divid$) adj3 (condition$ or experiment$ or intervention$ or treatment$ or therap$ or control$ or group$)).ti,ab.
22. or/7‐16
23. or/17‐21
24. 22 or 23
25. (baby or babies).mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
26. youth.mp.
27. child$.mp.
28. adolescen$.mp.
29. teenage$.mp.
30. or/25‐29
31. limit 24 to (infant or child or preschool child <1 to 6 years> or school child <7 to 12 years> or adolescent <13 to 17 years>)
32. 24 and 30
33. 31 or 32
34. 6 and 33
PsycINFO search strategy
1. exp LEAD POISONING/ or exp "LEAD (METAL)"/ or lead.mp.
2. lead poisoning.mp.
3. lead control.mp.
4. lead reduction.mp.
5. lead exposure.mp.
6. lead blood level.mp.
7. 1 or 2 or 3 or 4 or 5 or 6
8. random$.af.
9. (random$ adj25 (alloc$ or assign$ or divid$)).mp.
10. (random$ adj25 (trial$ or study or studies)).mp.
11. ((control$ or clinic$ or prospectiv$) adj25 (trial$ or stud$)).mp.
12. ((alloc$ or assign$ or divi$) adj25 (condition$ or experiment$ or treatment$ or control$ or group$)).mp.
13. ((singl$ or doubl$) adj (blind$ or mask$)).mp.
14. "CROSS?OVER".mp.
15. exp placebo/
16. (compar$ adj25 (trial$ or stud$)).mp.
17. or/8‐16
18. child$.af.
19. adolesc$.af.
20. teenage$.af.
21. or/18‐20
22. limit 17 to (100 childhood or 120 neonatal or 140 infancy or 160 preschool age or 180 school age or 200 adolescence )
23. 17 and 21
24. 22 or 23
25. 7 and 24
5 CINAHL search strategy
CINAHL searched 1982 to March 2006
1. LEAD POISONING/ or LEAD/ or lead.mp.
2. lead poisoning.mp.
3. lead reduction.mp.
4. lead control.mp.
5. lead exposure.mp.
6. lead blood level.mp.
7. 1 or 2 or 3 or 4 or 5 or 6
8. experimental studies/
9. exp clinical trials/
10. ((control$ or clinic$ or prospectiv$) adj25 (trial$ or study or studies)).tw.
11. ((allocat$ or assign$ or divid$) adj25 (condition$ or experiment$ or treatment$ or control$ or group$)).tw.
12. cross?over$.tw.
13. placebo$.tw.
14. (comp$ adj25 (trial$ or study or studies)).mp.
15. exp clinical research/
16. exp Comparative Studies/
17. exp evaluation research/
18. exp "control (research)"/
19. exp Random Assignment/
20. exp prospective studies/
21. random$.tw.
22. or/8‐21
23. child$.tw.
24. adolescenc$.tw.
25. teenage$.tw.
26. exp child/
27. or/23‐26
28. 22 and 27
29. limit 22 to (newborn infant or infant <1 to 23 months> or preschool child <2 to 5 years> or child <6 to 12 years> or adolescence <13 to 18 years>)
30. 28 or 29
31. 7 and 30
6 Sociofile search strategy
Sociofile searched 1963 to March 2006
Lead (KY) or lead (De) or lead poisoning (De)
7 ERIC search strategy
Lead poisoning.mp and Lead poisoning (subject heading)
8 Science Citation Index search strategy
TS=(lead same poison*) AND TS=(child* or baby or babies or infant* or
preschool* or boy* or girl*)
9 ZETOC search strategy
This was searched using the term "childhood lead poisoning prevention"
10 LILACS search strategy
lead poison$ and (child$ or baby or babies or infant$ or preschool$ or
girl$ or boy$)
11 Dissertation Abstracts search strategy
Searched using the term "childhood lead poisoning prevention"
12 Terms used for search other databases and websites
Terms used for searching ClinicalTrials.gov, Current Controlled Trials, Australian Clinical Trials Registry and National Research Register (all searched 22/03/06)
These four titles were searched using the terms "lead" and "children".
Appendix 2. MEDLINE search strategy
1 Lead Poisoning, Nervous System, Childhood/ or Lead Poisoning/ or Lead/ or Lead Poisoning, Nervous System/ or Lead Radioisotopes/
2 lead.rn. or Pb.tw.
3 (lead adj5 poison$).tw.
4 (lead adj5 expos$).tw.
5 (lead adj5 blood$).tw.
6 (lead adj5 reduc$).tw.
7 (lead adj5 toxic$).tw.
8 (lead adj5 environ$).tw.
9 (lead adj5 hazard$).tw.
10 (lead adj5 control$).tw.
11 (lead adj5 (domestic$ or home$ or hous$)).tw.
12 (lead adj5 contamin$).tw.
13 (lead adj5 pollut$).tw.
14 or/1‐13
15 exp Infant/
16 Adolescent/
17 exp Child/
18 15 or 16 or 17
19 (child$ or baby or babies or toddler$ or boy$ or girl$ or preschool$ or pre‐school$ or pre school$ or teen$ or adolescen$).tw.
20 18 or 19
21 randomized controlled trial.pt.
22 controlled clinical trial.pt.
23 randomized.ab.
24 placebo.ab.
25 drug therapy.fs.
26 randomly.ab.
27 trial.ab.
28 groups.ab.
29 or/21‐28
30 exp animals/ not humans.sh.
31 29 not 30
32 14 and 20 and 31
Appendix 3. CENTRAL search strategy
#1 MeSH descriptor Lead, this term only
#2 MeSH descriptor Lead Poisoning, Nervous System, Childhood, this term only
#3 MeSH descriptor Lead Poisoning, this term only
#4 lead near poison*
#5 lead near expos*
#6 lead near blood*
#7 lead near toxic*
#8 lead near environ*
#9 lead near reduc*
#10 lead near hazard*
#11 lead near control*
#12 lead near pollut*
#13 lead near contamin*
#14 lead near (domestic* or home* or hous*)
#15 (#1or#2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14)
#16 MeSH descriptor Infant explode all trees
#17 MeSH descriptor Child explode all trees
#18 MeSH descriptor Adolescent, this term only
#19 child* or baby or babies or toddler* or boy* or girl* or preschool* or pre‐school* or (pre next school*) or teen* or adolescen*
#20 (#16 OR #17 OR #18 OR #19)
#21 (#15 AND #20)
Appendix 4. EMBASE search strategy
1 lead chloride/ or lead sulfide/ or lead 212/ or lead chromate/ or lead oxide/ or lead 210/ or lead nitrate/ or lead acetate/ or lead 203/ or lead/ or "pb".tw.
2 lead poisoning/
3 lead blood level/
4 (lead adj5 poison$).tw.
5 (lead adj5 expos$).tw.
6 (lead adj5 blood$).tw.
7 (lead adj5 reduc$).tw.
8 (lead adj5 toxic$).tw.
9 (lead adj5 environ$).tw.
10 (lead adj5 hazard$).tw.
11 (lead adj5 control$).tw.
12 (lead adj5 (domestic$ or home$ or hous$)).tw.
13 (lead adj5 contamin$).tw.
14 (lead adj5 pollut$).tw.
15 or/1‐14
16 exp child/
17 exp adolescent/
18 (child$ or baby or babies or toddler$ or boy$ or girl$ or preschool$ or pre‐school$ or pre school$ or teen$ or adolescen$).tw.
19 or/16‐18)
20 crossover procedure/
21 exp double blind procedure/
22 single blind procedure/
23 random$.tw.
24 randomized controlled trial/
25 factorial$.tw.
26 (crossover$ or cross over$ or cross‐over$).tw.
27 placebo$.tw.
28 doubl$ blind$.tw.
29 singl$ blind$.tw.
30 assign$.tw.
31 allocat$.tw.
32 volunteer$.tw.
33 or/20‐32
34 15 and 19 and 33
35 limit 34 to yr="2006 ‐Current"
Appendix 5. PsycINFO search strategy
PsycINFO (EBSCOhost) searched 2006 to 2010
S34 S16 and S20 and S30
S33 S16 and S20 and S30
S32 S16 and S20 and S30
S31 S16 and S20 and S30
S30 S21 or S22 or S23 or S24 or S25 or S26 or S27 or S28 or S29
S29 AB (placebo*) or TI (placebo*)
S28 AB (randomly) or TI (randomly)
S27 AB (randomi?ed) or TI (randomi?ed)
S26 AB (trebl* blind* or trebl* mask* or tripl* blind* or tripl* mask*) or TI (trebl* blind* or trebl* mask* or tripl* blind* or tripl* mask*)
S25 AB (double* blind* or doubl* mask*) or TI (double* blind* or doubl* mask*)
S24 AB (singl* blind* or singl* mask*) or TI (singl* blind* or singl* mask*)
S23 AB (clinic* trial*) or TI (clinic* trial*)
S22 MR Quantitative Study
S21 MR Treatment Outcome/Clinical Trial
S20 S17 or S18 or S19
S19 TI (baby or babies or infant* or toddler* or child* or pre school* or preschool* or pre‐school* or teen* or adolescen* or boy* or girl*)
S18 AB (baby or babies or infant* or toddler* or child* or pre school* or preschool* or pre‐school* or teen* or adolescen* or boy* or girl*)
S17 AG (100 or 120 or 140 or 160 or 180 or 200)
S16 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15
S15 DE "Lead (Metal)" or DE "Lead Poisoning"
S14 AB ("Pb") or TI ("Pb")
S13 AB (lead N5 poison*) or TI (lead N5 poison*)
S12 AB (lead N5 pollut*) or TI (lead N5 pollut*)
S11 AB (lead N5 contamin*) or TI (lead N5 contamin*)
S10 AB (lead N5 hous*) or TI (lead N5 hous*)
S9 AB (lead N5 home*) or TI (lead N5 home*)
S8 AB (lead N5 domestic*) or TI (lead N5 domestic*)
S7 AB (lead N5 control*) or TI (lead N5 control*)
S6 AB (lead N5 hazard*) or TI (lead N5 hazard*)
S5 AB (lead N5 environ*) or TI (lead N5 environ*)
S4 AB (lead N5 toxic*) or TI (lead N5 toxic*)
S3 AB (lead N5 reduc*) or TI (lead N5 reduc*)
S2 AB (lead N5 blood*) or TI (lead N5 blood*)
S1 AB (lead N5 expos*) or TI (lead N5 expos*)
PsycINFO (OVID) searched 2010 to 2012
1 "Lead (Metal)"/
2 Lead Poisoning/
3 Pb.tw.
4 (lead adj5 poison$).tw.
5 (lead adj5 expos$).tw.
6 (lead adj5 blood$).tw.
7 (lead adj5 reduc$).tw.
8 (lead adj5 toxic$).tw.
9 (lead adj5 environ$).tw.
10 (lead adj5 hazard$).tw.
11 (lead adj5 control$).tw.
12 (lead adj5 (domestic$ or home$ or hous$)).tw.
13 (lead adj5 contamin$).tw.
14 (lead adj5 pollut$).tw.
15 or/1‐14
16 ("100" or "120" or "140" or "160" or "180" or "200").ag.
17 (child$ or baby or babies or toddler$ or boy$ or girl$ or preschool$ or pre‐school$ or pre school$ or teen$ or adolescen$).tw.
18 16 or 17
19 clinical trials/
20 (randomis* or randomiz*).tw.
21 (random$ adj3 (allocat$ or assign$)).tw.
22 ((clinic$ or control$) adj trial$).tw.
23 ((singl$ or doubl$ or trebl$ or tripl$) adj3 (blind$ or mask$)).tw.
24 (crossover$ or "cross over$").tw.
25 random sampling/
26 Experiment Controls/
27 Placebo/
28 placebo$.tw.
29 exp program evaluation/
30 treatment effectiveness evaluation/
31 ((effectiveness or evaluat$) adj3 (stud$ or research$)).tw.
32 or/19‐31
33 15 and 18 and 32
34 limit 33 to yr="2010 ‐Current"
Appendix 6. CINAHL search strategy
S40 S20 and S37 and S38
S39 S20 and S37 and S38
S38 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15
S37 S21 or S22 or S23 or S24 or S25 or S26 or S27 or S28 or S29 or S30 or S31 or S32 or S33 or S34 or S35 or S36
S36 AB (placebo*) or TI (placebo*)
S35 (MH "Placebos")
S34 (MH "Quantitative Studies")
S33 TI (random* N5 assign* or random* N5 allocat*)
S32 AB (random* N5 assign* or random* N5 allocat*)
S31 (MH "Random Assignment")
S30 AB (randomi?ed control* trial*) or TI (randomi?ed control* trial*)
S29 TI (trebl* blind* or trebl* mask* or tripl* blind* or tripl* mask*)
S28 AB (trebl* blind* or trebl* mask* or tripl* blind* or tripl* mask*)
S27 TI (double* blind* or doubl* mask*)
S26 AB (double* blind* or doubl* mask*)
S25 TI (singl* blind* or singl* mask*)
S24 AB (singl* blind* or singl* mask*)
S23 AB (clinic* trial*) or TI (clinic* trial*)
S22 PT clinical trial
S21 (MH "Clinical Trials+")
S20 S16 or S17 or S18 or S19
S19 (MH "Adolescence+")
S18 (MH "Child+")
S17 TI (baby or babies or infant* or toddler* or child* or pre school* or preschool* or pre‐school* or teen* or adolescen* or boy* or girl*)
S16 AB (baby or babies or infant* or toddler* or child* or pre school* or preschool* or pre‐school* or teen* or adolescen* or boy* or girl*)
S15 AB ("Pb") or TI ("Pb")
S14 AB (lead N5 pollut*) or TI (lead N5 pollut*)
S13 AB (lead N5 contamin*) or TI (lead N5 contamin*)
S12 AB (lead N5 hous*) or TI (lead N5 hous*)
S11 AB (lead N5 home*) or TI (lead N5 home*)
S10 AB (lead N5 domestic*) or TI (lead N5 domestic*)
S9 AB (lead N5 control*) or TI (lead N5 control*)
S8 AB (lead N5 hazard*) or TI (lead N5 hazard*)
S7 AB (lead N5 environ*) or TI (lead N5 environ*)
S6 AB (lead N5 toxic*) or TI (lead N5 toxic*)
S5 AB (lead N5 reduc*) or TI (lead N5 reduc*)
S4 AB (lead N5 blood*) or TI (lead N5 blood*)
S3 AB (lead N5 expos*) or TI (lead N5 expos*)
S2 AB (lead N5 poison*) or TI (lead N5 poison*)
S1 (MH "Lead") or (MH "Lead Poisoning")
Appendix 7. Sociological Abstracts search strategy
((DE="lead poisoning") or(KW= ((lead within 5 poison*) or (lead
within 5 expos*) or (lead within 5 blood*) or (lead within 5 reduc*) or (lead
within 5 toxic*) or (lead within 5 environ*) or (lead within 5
hazard*) or (lead within 5 control*) or (lead within 5 domestic*) or (lead
within 5 home*) or (lead within 5 house*) or (lead within 5 contamin*) or (lead
within 5 pollut*) or "pb")))
AND
((DE=("children" or "adolescents" or
"infants")) or(KW=(baby or babies or infant* or child* or toddler* or
pre‐school* or "pre school*" or pre‐school* or boy* or girl* or teen* or
adolescen*)))
Appendix 8. ERIC search strategy
((DE="lead poisoning") or(KW=(lead within 5 poison*)or (lead within 5 expos*)
or (lead within 5 blood*)or (lead within 5 reduc*)or (lead within 5 toxic*)or (lead within 5 environ*) or (lead within 5 hazard*)or(lead within 5 control*)or (lead within 5 domestic*)or (lead within 5 home*) or (lead within 5 hous*) or (lead within 5 contamin*) or (lead within 5 pollut)or ("Pb")))
AND
((DE=("adolescents" or "children" or "infants" or "toddlers" or "young children")) Or (KW= (baby or babies or infant* or toddler* or child* or preschool* or pre‐school* or pre school* or teen* or adolescen* or boy* or girl*)))
Appendix 9. Science Citation Index search strategy
#5 #4 AND #3
#4 TS=(baby or babies or infant* or child* or toddler* or boy* or girl* or preschool* or preschool* or teen* or adolescen*)
#3 #2 OR #1
#2 TS= ("Pb" same (poison* or expos* or blood* or reduc* or toxic* or environ* or hazard* or control* or pollut* or contamin* or domestic* or home* or hous*))
#1 TS= (lead same (poison* or expos* or blood* or reduc* or toxic* or environ* or hazard* or control* or pollut* or contamin* or domestic* or home* or hous*))
Appendix 10. ZETOC search strategy
Lead and child*
Appendix 11. LILACS search strategy
Mh lead or Mh lead poison$ or TW lead and poison$ or TW lead and expos$ or TW lead and toxic$ or TW lead and contamin$ or TW lead and blood$ or tw lead and reduc$ or TW lead and control$ orTW lead and pollut$ or TW lead and hazard$ or TW lead and hous$ or TW lead and home$ or TW lead and domestic$ or TW lead and environ$ or tw Pb [Words] and (Mh infant or Mh child or Mh child,preschool or Mh adolescent or tw baby or tw babies or tw infant$ or tw child$ or tw preschool or tw pre‐school or Tw adolescen$ or Tw teen$) AND (PD 2006 or PD 2007 or PD 2008 or PD 2009 or PD 2010) [Words] and ((Pt randomized controlled trial OR Pt controlled clinical trial OR Mh randomized controlled trials OR Mh random allocation OR Mh double‐blind method OR Mh single‐blind method) AND NOT (Ct animal AND NOT (Ct human and Ct animal)) OR (Pt clinical trial OR Ex E05.318.760.535$ OR (Tw clin$ AND (Tw trial$ OR Tw ensa$ OR Tw estud$ OR Tw experim$ OR Tw investiga$)) OR ((Tw singl$ OR Tw simple$ OR Tw doubl$ OR Tw doble$ OR Tw duplo$ OR Tw trebl$ OR Tw trip$) AND (Tw blind$ OR Tw cego$ OR Tw ciego$ OR Tw mask$ OR Tw mascar$)) OR Mh placebos OR Tw placebo$ OR (Tw random$ OR Tw randon$ OR Tw casual$ OR Tw acaso$ OR Tw azar OR Tw aleator$) OR Mh research design) AND NOT (Ct animal AND NOT (Ct human and Ct animal)) OR (Ct comparative study OR Ex E05.337$ OR Mh follow‐up studies OR Mh prospective studies OR Tw control$ OR Tw prospectiv$ OR Tw volunt$ OR Tw volunteer$) AND NOT (Ct animal AND NOT (Ct human and Ct animal))) [Words]
Appendix 12. Dissertation Abstracts search strategy
This was searched using the term "childhood lead poisoning prevention"
Appendix 13. Terms used for search other databases and websites
Terms used for searching ClinicalTrials.gov, Current Controlled Trials, Australian New Zealand Clinical Trials Registry and National Research Register Archive
"lead" AND "children".
Study flow diagram
Comparison 1 Education, Outcome 1 Blood lead level (continuous).
Comparison 1 Education, Outcome 2 Blood lead level (dichotomous) ≥10 µg/dL.
Comparison 1 Education, Outcome 3 Blood lead level (dichotomous) ≥15 µg/dL.
Comparison 1 Education, Outcome 4 Floor dust ‐ hard floor.
Comparison 2 Environmental ‐ Dust control, Outcome 1 Blood lead level (continuous).
Comparison 2 Environmental ‐ Dust control, Outcome 2 Blood lead level (dichotomous ≥10 µg/dL).
Comparison 2 Environmental ‐ Dust control, Outcome 3 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.01.
Comparison 2 Environmental ‐ Dust control, Outcome 4 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.1.
Comparison 2 Environmental ‐ Dust control, Outcome 5 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.2.
Comparison 2 Environmental ‐ Dust control, Outcome 6 Blood lead level (dichotomous ≥15 µg/dL).
Comparison 2 Environmental ‐ Dust control, Outcome 7 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.01.
Comparison 2 Environmental ‐ Dust control, Outcome 8 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.1.
Comparison 2 Environmental ‐ Dust control, Outcome 9 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.2.
| Education strategies for preventing domestic lead exposure in children | ||||||
| Patient or population: Children | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Regular environment | Education strategies for prevention of domestic lead exposure | |||||
| Blood lead level (continuous) | The mean blood lead level (continuous) ranged across control groups from | The mean blood lead level (continuous) in the intervention groups was | 814 | ⊕⊕⊕⊕ | ||
| Blood lead level (dichotomous) ≥ 10 µg/dL | Medium risk population3 | RR 1.02 | 520 | ⊕⊕⊕⊝ | ||
| 238 per 10004 | 243 per 1000 | |||||
| Blood lead level (dichotomous) ≥ 15 µg/dL | Medium risk population3 | RR 0.6 | 520 | ⊕⊕⊕⊝ | ||
| 110 per 10004 | 66 per 1000 | |||||
| Floor dust ‐ hard floor (continuous) Scale from: 0 to 40 | The mean floor dust level ‐ hard floor ‐ ranged across control groups from | The mean floor dust level ‐ hard floor ‐ in the intervention groups was | 318 | ⊕⊕⊕⊝ | ||
| Cognitive and neurobehavioural outcomes ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Change in blood lead level | ||||||
| Environmental strategies (dust control) for preventing domestic lead exposure in children | ||||||
| Patient or population: Children | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Environmental strategies (Dust Control) | |||||
| Blood lead level (continuous) | The mean blood lead level (continuous) ranged across control groups from | The mean blood lead level (continuous) in the intervention groups was | 298 | ⊕⊕⊕⊝ | ||
| Blood lead level (dichotomous ≥ 10 µg/dL) | Medium risk population3 | RR 0.93 | 210 | ⊕⊕⊕⊝ | ||
| 573 per 10004 | 533 per 1000 | |||||
| Blood lead level (dichotomous ≥ 15 µg/dL) | Medium risk population3 | RR 0.86 | 210 | ⊕⊕⊕⊝ | ||
| 205 per 10004 | 176 per 1000 | |||||
| Cognitive and neurobehavioural outcomes ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Change in blood lead level | ||||||
| Study ID | Aschengrau 1998 | Boreland 2009 | Brown 2006 | Campbell 2011 | Charney 1983 | Farrell 1998 | Hilts 1995 | Jordan 2003 | Lanphear 1996 | Lanphear 1999 | Rhoads 1999 | Sterling 2004 | Wasserman 2002 | Weitzman 1993 |
| Mean blood lead level at baseline (µg/dL) | 15‐19 | 15‐19 | 15‐19 | 2.6‐2.7 | >20 | 10‐14 | 10‐14 | <10
| <10 | <10 | 10‐14 | 10‐14 | <10 | 10‐14 |
| Mean age at baseline (months) | 24‐36 | > 36 | 12‐24 | 8‐14 | > 36 | 6‐72 | 24‐36 | <12 | 12‐24 | <12 | 12‐24 | > 36 | 12‐24 | 24‐36 |
| Study ID | Education | Dust control | Soil abatement | Combination |
| Aschengrau 1998 | Yes | |||
| Boreland 2009 | Yes | |||
| Brown 2006 | Yes | |||
| Campbell 2011 | Yes | |||
| Charney 1983 | Yes | |||
| Farrell 1998 | Yes | |||
| Hilts 1995 | Yes | |||
| Jordan 2003 | Yes | |||
| Lanphear 1996 | Yes | |||
| Lanphear 1999 | Yes | |||
| Rhoads 1999 | Yes | |||
| Sterling 2004 | Yes | |||
| Wasserman 2002 | Yes | |||
| Weitzman 1993 | Yes |
| Study ID | Blood lead ‐ continuous | Blood lead ‐ dichotomous | Hard floor lead | Carpet lead | Other |
| Aschengrau 1998 | Yes | Yes | |||
| Boreland 2009 | Yes | ||||
| Brown 2006 | Yes | Yes | Parent‐Child Interaction scale | ||
| Campbell 2011 | Yes | Yes | Chicago Parents Knowledge Test | ||
| Charney 1983 | Yes | Yes | |||
| Farrell 1998 | Total effect (blood lead levels) | ||||
| Hilts 1995 | Yes | Yes | Yes | ||
| Jordan 2003 | Yes | ||||
| Lanphear 1996 | Yes | Yes | Yes | Yes | |
| Lanphear 1999 | Yes | Yes | Yes | Yes | |
| Rhoads 1999 | Yes | Yes | Maternal knowledge lead poisoning | ||
| Sterling 2004 | Yes | ||||
| Wasserman 2002 | Yes | Yes | Chicago Parents Knowledge Test | ||
| Weitzman 1993 | Yes |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Blood lead level (continuous) Show forest plot | 5 | 815 | Mean Difference (IV, Random, 95% CI) | 0.02 [‐0.09, 0.12] |
| 2 Blood lead level (dichotomous) ≥10 µg/dL Show forest plot | 4 | 520 | Risk Ratio (M‐H, Random, 95% CI) | 1.02 [0.79, 1.30] |
| 3 Blood lead level (dichotomous) ≥15 µg/dL Show forest plot | 4 | 520 | Risk Ratio (M‐H, Random, 95% CI) | 0.60 [0.33, 1.09] |
| 4 Floor dust ‐ hard floor Show forest plot | 2 | 318 | Mean Difference (IV, Random, 95% CI) | ‐0.07 [‐0.37, 0.24] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Blood lead level (continuous) Show forest plot | 3 | 298 | Mean Difference (IV, Random, 95% CI) | ‐0.15 [‐0.42, 0.11] |
| 2 Blood lead level (dichotomous ≥10 µg/dL) Show forest plot | 2 | 210 | Risk Ratio (M‐H, Random, 95% CI) | 0.93 [0.73, 1.18] |
| 3 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.01 Show forest plot | 2 | 204 | Risk Ratio (M‐H, Random, 95% CI) | 0.93 [0.73, 1.18] |
| 4 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.1 Show forest plot | 2 | 173 | Risk Ratio (M‐H, Random, 95% CI) | 0.95 [0.72, 1.24] |
| 5 Blood lead level (dichotomous ≥10 µg/dL) ICC 0.2 Show forest plot | 2 | 155 | Risk Ratio (M‐H, Random, 95% CI) | 0.97 [0.72, 1.29] |
| 6 Blood lead level (dichotomous ≥15 µg/dL) Show forest plot | 2 | 210 | Risk Ratio (M‐H, Random, 95% CI) | 0.86 [0.35, 2.07] |
| 7 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.01 Show forest plot | 2 | 204 | Risk Ratio (M‐H, Random, 95% CI) | 0.82 [0.37, 1.81] |
| 8 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.1 Show forest plot | 2 | 173 | Risk Ratio (M‐H, Random, 95% CI) | 0.83 [0.34, 2.03] |
| 9 Blood lead level (dichotomous ≥15 µg/dL) ICC 0.2 Show forest plot | 2 | 155 | Risk Ratio (M‐H, Random, 95% CI) | 0.75 [0.34, 1.66] |
