Letters to the editor.

Dear Editor:

In the October 2007 issue of the Journal of Environmental Health, Sharmer, Northrup-Snyder, and Juan contend that older, lead-containing paint covering furniture, toys, salvaged windows, and other used objects found in antique shops, secondhand shops, and similar settings represent a previously unrecognized source of lead in middle-and upper-income homes. They believe that residents of such homes are "not likely to ... fit into the officially recognized population most at risk for lead poisoning," i.e., the population "living in poor neighborhoods in older housing stock." The authors' concern originates with the vogue for the "shabby chic" style of decoration, a term ostensibly coined in 2000, although it is mentioned in one of their references published in 1993 (Sharmer, Northrup-Snyder, & Juan, 2007).

The study by Sharmer and co-authors was restricted to (1) content analysis of photos from four home decorating magazines in wide circulation and (2) clandestine swabbing with sodium rhodizonate solution of objects deemed likely to contain lead in 13 antique shops located in New York, Oregon, and Virginia. Thirty-six such items are tabulated. Going well beyond the scope of their very limited and subjective "data," Sharmer and co-authors offer four sweeping recommendations to counter what they perceive to be an impending environmental hazard.

Sharmer and co-authors provide no evidence that the items they identify are actually reaching middle- and upper-income homes (apart from their own). Also, from the non-representative numerator data presented, the reader is unable to estimate how prevalent the putatively leaded items are within the universe of used objects. Presumably, the authors' statement. "Within the first five minutes in each of the 13 stores, it was possible to find and purchase an object that tested positive ... "is intended to assure the reader that such items are legion. Further, the U.S. Environmental Protection Agency has concluded that sodium rhodizonate "test kits [swabs] should not be used for lead paint testing," because the user "cannot be confident that test kits will discriminate accurately between lead-based paint and non-lead-based paint (U.S. Environmental Protection Agency, 1995)." Although the authors state that the items they purchased were to be analyzed quantitatively (e.g., using x-ray fluorescence), this apparently wasn't done. Absent such analysis, it's unclear that these items actually contained lead.

If one assumes that shabby chic has the same appeal in Minnesota that it does in the states included in the Sharmer and co-authors study, it's possible to evaluate their hypothesis that lead levels should increase in residents of middle- and upper-income homes. Population-based income and lead surveillance data are required to do this. The census provides the former (U.S. Census, 2000). In Minnesota, the Minnesota Department of Health provides the latter in the form of the statewide Blood Lead Information System (BLIS) (Minnesota Department of Health, 2007).

The Hennepin County Human Services and Public Health Department receives county data from BLIS annually and has responsibility for its analysis. Hennepin is Minnesota's most populous county, with 1,116,200 residents in 2000; Minneapolis is the principal city. Twenty-five smaller cities make up Hennepin's far west suburbs. As a group, these suburbs are the most affluent in the county, with a median annual household income of $77,444 (city range: $36.071 to $153,881), compared with $51,711 for Hennepin County, $47,111 for Minnesota, and $41,994 for the U.S. (U.S. Census, 2000). If the hypothesis of Sharmer and co-authors is correct--whether originating in 1993 or 2000-stable or increasing proportions of elevated blood lead levels (BLLs) should be observable in children of the far west suburbs at some point between 1995 and 2006 (the most recent year available). The Centers for Disease Control and Prevention define an elevated BLL as 10 micrograms ([micro]g) or more of lead per deciliter (dl) of blood. They recommend that BLLs be monitored in children less than six years old, when the central nervous system is still developing (Centers for Disease Control and Prevention, 1997).

Figure 1 shows that the proportion of far west children less than six years old with elevated first BLLs dropped from 3.7% to 0.4% between 1995 and 2006. The median first BLL also dropped from 4.5[micro]g/dl to 2.2 [micro]g/dl (not shown). This trend is consistent with BLL trends in the remainder of Hennepin County, the state of Minnesota, and the U.S. (Centers for Disease Control and Prevention, 2007; Minnesota Department of Health, 2007). It provides no support for the Sharmer and co-authors hypothesis.

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References

Centers for Disease Control and Prevention. (1997). Screening young children for lead poisoning: Guidance for state and local public health officials. Atlanta, GA: Author.

Centers for Disease Control and Prevention, (2007). CDC surveillance data, 1997-2006. Retrieved April 9,2008, from www.health.state.mn,us/divs/eh/lead/reports/surveillance/profile2006.pdf

Minnesota Department of Health. (2007). Minnesota blood lead surveillance data report, 2006. Retrieved April 9, 2008, from www.health.state.mn.us/dives/eh/lead/reports/surveillance/prohle2006 .pdf.

Sharmer, L., Northrup-Snyder, K., & Juan, W.Y. (2007). Newly-recognized pathways of exposure to lead in middle-income homes. Journal of Environmental Health, 20(5), 15-19.

U.S. Census 2000. U.S. Census Bureau: American Factfinder. Retrieved April 8, 2008, from http://factfinder.census.gov/home/saff/main.html?_lang-en

U.S. Environmental Protection Agency. (1995, May). Afield test of lead-based paint testing technologies: Summary report (EPA Publication No. 747-R-95-002a). Retrieved April 8, 2008, from www.epa. gov/lead/pubs/summary.txt

Sincerely yours,

Jack Brondum, D.V.M., Ph.D.

Epidemiologist

Hennepin County Human Services and Public Health Department Hopkins, MN