***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background . Dust control is recommended as one of the primary strategies to prevent or control children 's exposure to residential lead hazards , but the effect of dust control on children 's blood lead levels is poorly understood . Objective . To determine the effectiveness of dust control in preventing children 's exposure to lead , as measured by blood lead levels , during their peak age of susceptibility . Design . A r and omized , controlled trial . Setting . Rochester , NY . Participants . A total of 275 urban children were r and omized at 6 months of age , of whom 246 ( 90 % ) were available for the 24-month-old follow-up visit . Interventions . Children and their families were r and omly assigned to an intervention group ( n = 140 ) , which received cleaning equipment and up to eight visits by a dust control advisor , or a control group ( n = 135 ) . Outcome Measures . Geometric mean blood lead levels and prevalence of elevated blood lead levels ( ie , > 10 μg/dL , 15 μg/dL , and 20 μg/dL ) . Results . At baseline , children 's geometric mean blood lead levels were 2.9 μg/dL ( 95 % confidence interval [ CI ] = 2.7 , 3.1 ) ; there were no significant differences in characteristics or lead exposure by group assignment , with the exception of water lead levels . For children in the intervention group , the mean number of visits by a dust control advisor during the 18-month study period was 6.2 ; 51 ( 36 % ) had 4 to 7 visits , and 69 ( 49 % ) had 8 visits . At 24 months of age , the geometric mean blood lead was 7.3 μg/dL ( 95 % CI = 6.6 , 8.2 ) for the intervention group and 7.8 μg/dL ( 95 % CI = 6.9 , 8.7 ) for the control group . The percentage of children with a 24-month blood lead ≥10 μg/dL , ≥15 μg/dL , and ≥20 μg/dL was 31 % versus 36 % , 12 % versus 14 % , and 5 % versus 7 % in the intervention and control groups , respectively . Conclusions . We conclude that dust control , as performed by families and in the absence of lead hazard controls to reduce ongoing contamination from lead-based paint , is not effective in the primary prevention of childhood lead exposure . blood lead , lead-contaminated house dust , r and omized trial , children , environmental exposure , lead poisoning , primary prevention , prevention BACKGROUND Contaminated household dust is believed to be a major source of exposure for most children with elevated blood lead levels . To determine if a vigorous dust clean-up effort would reduce this exposure we conducted a r and omized controlled field trial . METHODS We r and omized 113 urban children between the ages of 6 and 36 months : 56 children to a lead dust intervention composed of maternal education and biweekly assistance with household cleaning and 57 children to a control group . Household cleaning was done by two trained lay workers who focused their efforts on wet mopping of floors , damp-sponging of walls and horizontal surfaces , and vacuuming with a high-efficiency particle accumulating vacuum . Household dust lead levels , child blood lead levels , and maternal knowledge of lead poisoning and sources of exposure were measured before and after the intervention . RESULTS Ninety-nine children were successfully followed for 12 + /- 3 months : 46 children in the lead group and 53 children in the control group .  Age and blood lead were similar in the two groups at baseline and averaged 20 months and 12.0 micrograms/dL , respectively . Blood lead fell 17 % in the intervention group and did not change among controls . Household dust and dust lead measures also fell significantly in the intervention group . Children in homes cleaned 20 or more times throughout the year had an average blood lead reduction of 34 % . CONCLUSIONS Regular home cleaning , accompanied by maternal education , is a safe and partially effective intervention that should be recommended for the large majority of lead-exposed children for whom , unfortunately , removal to lead-safe housing is not an option In this article we report on the effectiveness of a community-based , culture-specific , controlled trial of intensive peer education aim ed at preventing lead burden in children 0 - 36 months of age within a neighborhood with high risk for lead exposure . Mothers ( n = 594 ) were r and omly assigned to control or intervention groups . Offspring blood lead levels were assessed every 4 months . All participants received brochures on basic lead prevention strategies . Intervention participants were offered 20 bi-weekly educational sessions by same-ethnicity peer educators over the course of 1 year , and quarterly booster sessions for 2 years afterward . The intervention group 's educational curriculum included information on lead sources ( e.g. , paint , dust , water , soil , and risks from home repairs and remodeling ) , health consequences of lead burden , and strategies to reduce lead exposure , including household cleaning , hygiene , safe use of water , and nutritional recommendations . Results indicated that of the 378 children contributing sufficient blood data for analysis , 23 % had blood lead levels > 10 micro g/dL before 3 years of age . Intervention participants were more likely to maintain blood lead levels < 10 micro g/dL than were controls ( 81 % vs. 73 % ; p = 0.08 ) . Multivariate analyses demonstrated that the intervention reduced the risk of blood lead levels > 10 micro g/dL by approximately 34 % . We conclude that although intensive education result ed in a lower proportion of children with elevated lead levels , education alone can not be relied upon to prevent lead burden OBJECTIVES The aim of this study was to quantify the relative contributions to surface lead contamination of boat-caulkers ' houses of three contamination modes , namely " take-home " lead from the caulker , " natural " spatial dispersal from boatyard to household and " redistribution " of accumulated lead-laden dust within the house . METHODS Boat-caulkers ' houses situated in areas surrounding boat repair yards were recruited . Caulkers ' houses that were located close together were divided into location-matched pairs , within which one was r and omly assigned to be given a cleaning and design ated a CL house , and the other was to be left uncleaned and design ated a NCL house . Geographically isolated caulker 's houses were r and omly assigned to one of the two categories . The nearest non-boatyard worker 's house ( NB ) was additionally recruited for each set . The surface lead loading rate ( SLLR ) , defined as the mass of lead deposited in dust per unit area of surface per unit time , was measured over a period of 3 mo in all houses , and the data were modeled using linear mixed effects regression . RESULTS Adjusted values of SLLR differed only slightly between CL and NCL houses ( 0.96 to 1.02 times ) but were between 1.65 and 2.03 times higher in CL and NCL houses than in NB houses depending on proximity to the boatyard and between 2.12 and 2.61 times higher in houses within one km of a boatyard than in more distant houses depending on category of house . CONCLUSIONS Newly deposited dust lead likely result ed from the take-home and spatial dispersion modes . The contribution of redistribution is very small OBJECTIVES This study assessed the relationship between lead-contaminated house dust and urban children 's blood lead levels .  METHODS A r and om- sample survey was used to identify and enroll 205 children , 12 to 31 months of age , who had resided in the same house since at least 6 months of age . Children 's blood and household dust , water , soil , and paint were analyzed for lead , and interviews were conducted to ascertain risk factors for elevated blood lead ( > or = 10 micrograms/dL ) . RESULTS Children 's mean blood lead level was 7.7 micrograms/dL. In addition to dust lead loading ( micrograms of lead per square foot ) , independent predictors of children 's blood lead were Black race , soil lead levels , ingestion of soil or dirt , lead content and condition of painted surfaces , and water lead levels . For dust lead st and ards of 5 micrograms/sq ft , 20 micrograms/sq ft , and 40 micrograms/sq ft on noncarpeted floors , the estimated percentages of children having blood lead levels at or above 10 micrograms/dL were 4 % , 15 % , and 20 % , respectively , after adjusting for other significant covariates . CONCLUSIONS Lead-contaminated house dust is a significant contributor to lead intake among urban children who have low-level elevations in blood lead . A substantial proportion of children may have blood lead levels of at least 10 micrograms/dL at dust lead levels considerably lower than current st and ards Background . Dust control is recommended to prevent children 's exposure to residential lead hazards , but the long-term effect of dust control on children 's exposure to environmental lead is unknown . Objective . To determine the effect of dust control on children 's exposure to lead , as measured by blood lead concentration at 48 months of age . Design . A r and omized , controlled trial . Setting . Rochester , New York . Participants . A total of 275 urban children were r and omized at 6 months of age ; 189 ( 69 % ) were available for the 48-month follow-up blood test . Intervention . Children and their families were r and omly assigned to an intervention group that received cleaning equipment and up to 8 visits by a trained lead hazard control advisor or to a control group . The intervention was terminated when the children were 24 months of age . Outcome Measures . Geometric mean blood lead concentration and prevalence of elevated blood lead concentration ( ie , ≥10 μg/dL , ≥15 μg/dL , and ≥20 μg/dL ) , by group assignment . Results . For children with 48-month blood tests , baseline geometric mean blood lead concentrations were 2.8 μg/dL ( 95 % confidence interval [ CI ] : 2.6,3.0 ) ; there were no significant differences in baseline characteristics or lead exposure by group assignment . At 48 months of age , the geometric mean blood lead was 5.9 μg/dL ( 95 % CI : 5.3,6.7 ) for the intervention group and 6.1 μg/dL ( 95 % CI : 5.5,6.9 ) for the control group . The percentage of children with a 48-month blood lead ≥10 μg/dL , ≥15 μg/dL , and ≥20 μg/dL was 19 % versus 19 % , 2 % versus 9 % , and 1 % versus 2 % in the intervention and control groups , respectively . Conclusions . We conclude that dust control , as performed by families and in the absence of lead hazard controls to reduce ongoing contamination from lead-based paint , was not effective in preventing children 's exposure to residential lead hazards OBJECTIVE Some children in the United States continue to be exposed to levels of lead that increase their risk for lowered intellectual functioning and behavior problems . It is unclear whether chelation therapy can prevent or reverse the neurodevelopmental sequelae of lead toxicity . The objective of this study was to determine whether chelation therapy with succimer ( dimercaptosuccinic acid ) in children with referral blood lead levels between 20 and 44 microg/dL ( 0.96 - 2.12 micromol/L ) at 12 to 33 months of age has neurodevelopmental benefits at age 7 years . METHODS The Treatment of Lead-Exposed Children ( TLC ) study is a r and omized , double-blind , placebo-controlled trial that was conducted between September 1994 and June 2003 in Philadelphia , PA ; Newark , NJ ; Cincinnati , OH ; and Baltimore , MD . Of 1854 referred children who were between the ages of 12 to 33 months and screened for eligibility , 780 were r and omized to the active drug and placebo groups stratified by clinical center , body surface area , blood lead level , and language spoken at home . At 7 years of age , 647 subjects remained in the study . Participants were r and omly assigned to receive oral succimer or placebo . Up to 3 26-day courses of succimer or placebo therapy were administered depending on response to treatment in those who were given active drug . Eighty-nine percent had finished treatment by 6 months , with all children finishing by 13 months after r and omization . All participants received residential lead hazard control measures before treatment . TLC subjects also received a daily multivitamin supplement before and after treatment(s ) with succimer or placebo . Scores on st and ardized neuropsychological measures that tap cognition , behavior , learning and memory , attention , and neuromotor skills were measured . RESULTS Chelation therapy with succimer lowered average blood lead levels for approximately 6 months but result ed in no benefit in cognitive , behavioral , and neuromotor endpoints . CONCLUSION These new follow-up data confirm our previous finding that the TLC regimen of chelation therapy is not associated with neurodevelopmental benefits in children with blood lead levels between 20 and 44 microg/dL ( 0.96 - 2.17 micromol/L ) . These results emphasize the importance of taking environmental measures to prevent exposure to lead . Chelation therapy with succimer can not be recommended for children with blood lead levels between 20 and 44 microg/dL ( 0.96 - 2.12 micromol/L ) OBJECTIVE Dust control is recommended as one of the cornerstones of controlling childhood lead exposure ; however , the effectiveness of dust control has not been demonstrated for children who have low to mild elevations in blood lead ( ie , less than 25 micrograms 
    Output:
    
Therefore , there is currently insufficient evidence to clarify whether soil abatement or a combination of interventions reduces blood lead levels .
Based on current knowledge , household educational interventions are ineffective in reducing blood lead levels  in children as a population health measure .
Dust control interventions may lead to little or no difference in blood lead levels ( the quality of evidence was moderate to low , meaning that future research is likely to change these results ) .
There is currently insufficient evidence to draw conclusions about the effectiveness of soil abatement or combination interventions .