A Randomized Controlled Trial to Reduce Childhood Lead Exposure and Lead-Associated Neurobehavioral Deficits: The HOME Study
Bibliographic record
Abstract
Background: Childhood lead exposure is associated with neurobehavioral impairments in children. No randomized trials have tested whether a comprehensive residential lead hazard intervention can prevent elevated blood lead concentrations and associated neurobehavioral outcomes.Objectives: We tested whether an intervention designed to reduce residential lead exposure completed during pregnancy could prevent elevated blood lead concentrations and improve neurobehavioral outcomes in children.Methods: We enrolled 355 pregnant women from the Cincinnati, OH metropolitan area in a randomized controlled trial. We randomly assigned women to receive either residential lead or injury hazards. The lead hazard intervention included elements designed to reduce or eliminate lead exposure from paint, drinking water, and soil. We assessed residential dust lead loadings at baseline and when children were ages 1 and 2 years. From ages 1-8 years, we measured blood lead concentrations and assessed cognition, behavior, and executive functions.Results: The intervention reduced floor, windowsill, and window trough dust lead loadings at ages 1 and 2 years by 24% (95% CI: -43, 1), 40% (95% CI: -60, -11), and 47% (95% CI: -68, -10), respectively. The intervention non-significantly reduced children’s blood lead concentrations (-6%; 95% CI:-17, 6). Race modified the intervention effect on children’s blood lead concentrations (intervention x race p-value=0.03); Black children had greater reductions in blood lead concentrations (-31%; 95% CI:-50, -5) than White children (-2%; 95% CI:-14, 12). Neurobehavioral test scores were subtly better among children in the intervention group than control group; all were statistically non-significant, except for a reduction in anxiety scores (-1.6; 95% CI:-3.2, -0.1).Conclusions: This intervention reduced residential lead exposures and, among Black children, blood lead concentrations, but did not result in substantive neurobehavioral improvements.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".