Some traditional “high-tech” approaches to remediation can be cost-prohibitive for small, private owners and public housing agencies. Often, these hazards and their health sequelae are disproportionately concentrated in deteriorated older urban housing stock in low-income neighborhoods (Jacobs et al., 2002 Leaderer et al., 2002 Rauh et al., 2002 USCDC, 2001) and are found in concert with one another (e.g., asthma and childhood lead poisoning) (Environmental Health Watch, 2001 Johnson and Sobolewski, 2004). These include, e.g., lead-based paint hazards with elevated blood lead levels (Lanphear et al., 2002 Potula et al., 2001 Reissman et al., 2002) dampness and fungi (Brunekreef et al., 1989 Dales et al., 1991a, Dales et al., 1991b Gravesen, 1979 Jacob et al., 2002), cockroaches (Gold et al., 1999 Litonjua et al., 2001), rodents (Phipatanakul et al., 2000), and dust mite allergens with asthma and allergy (Kuehr et al., 1994 Lau et al., 1989 Sporik et al., 1993 Squillace et al., 1997), and fall, electrical, and fire hazards with injury and death (Dowd, 1999). Numerous residential hazards have been linked with adverse health outcomes, especially among children. Further research is needed to clarify the most effective sampling strategies, educational and behavioral interventions, and optimal intervention frequency. These results indicate that a comprehensive approach to hazard remediation can be highly effective and cost efficient and that overall improvements can be maintained. The greatest declines in dust lead and Bla g1 levels occurred in dwellings having the highest baseline levels and, for Bla g1, in dwellings in which occupants attended training sessions. Reductions in mold dust levels were of borderline statistical significance (50% decline, P = 0.07). 81.0 μg/ft 2, respectively, P < 0.0001) and Blatella germanica (Bla g1) levels among dwellings with elevated baseline levels (7.7 vs. Significant reductions were also observed in the geometric mean (GM) dust lead levels on floors and window sills (13.3 vs. 23%, P < 0.0001) high levels of dust lead on floors and window sills (67% and 46% declines, P < 0.01) evidence of cockroaches or rodents (43% and 36% declines, P < 0.01) and fire, electrical and/or fall hazards (between 67% and 88% declines, P < 0.01). Between the baseline and 5-month follow-up periods, significant reductions were achieved in the number of dwellings with multiple (i.e., three or four) problems (75% vs. Environmental conditions were evaluated prior to, immediately following, and an average of 5 months after remediation. The median remediation cost for labor and materials was $864.66 (range: $120.00–5235.33) per dwelling.
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Dwellings received paint stabilization, dust lead cleaning, integrated pest management (IPM), mold cleaning, and safety devices, as needed. To address this gap, a multihazard, multimethod intervention, addressing deteriorated lead-based paint and lead dust, vermin, mold, and safety hazards was pilot-tested in a sample of 70 pre-1940 dwellings. Comprehensive and affordable approaches to remediation are needed, but the feasibility and efficacy of such approaches has not been well documented. Many residential hazards are disproportionately concentrated in older, urban dwellings and share common underlying causes, such as uncorrected moisture problems and inadequate maintenance and cleaning.