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Presents the findings of U.S. National Health and Nutrition Examination Surveys from the period 1976-1980 to 1991-1994, which focused on blood lead levels (BLL). Adverse health effects caused by lead exposure; Decline in the BLL percentage in children aged 1-5 years; Overall prevalence of elevated BLL for the U.S. population for 1999-2002; Cause of the decline in BLL in the U.S.

Toxocara malaysiensis n. sp. from the small intestine of the domestic cat (Felis catus L.) in Malaysia is described and illustrated. This ascaridoid nematode was previously assumed to be Toxocara canis, which it superficially resembles, or designated Toxocara sp. cf. canis. The new species differs from T. canis in the shape of the cervical alae in cross section, spicule length, and the lip structure. It is also distinct from other species assigned to Toxocara.

This article provides an overview of the ways in which the home environment can affect human health, describes how specific health hazards in housing are related, and considers implications of these concerns for research and programs to address the health-housing connection. The widespread availability of decent housing has contributed greatly to improvements in health status in developed countries through, for example, provision of safe drinking water, proper sewage disposal, and protection from the elements. However, a lack of decent housing and homelessness among a significant number of Americans remains a significant public health concern. In addition, a number of specific health hazards can be found even in housing that is in good condition and provides all basic amenities. Specific health hazards related to housing include unintentional injuries, exposure to lead, exposure to allergens that may cause or worsen asthma, moisture and fungi (mold), rodent and insect pests, pesticide residues, and indoor air pollution. A number of these specific hazards share underlying causes, such as excess moisture, and all may be influenced by factors in the community environment or by occupant behaviors. We make recommendations for developing programs and research efforts that address multiple housing problems in an integrated way, rather than categorically, and for closer collaboration between housing and public health programs.

In 1992, the U.S. Congress passed the Residential Lead-Based Paint Hazard Reduction Act, which requires the promulgation of health-based dust lead and soil lead standards for residential dwellings to prevent undue lead exposure in children. Unfortunately, the levels of lead in house dust and soil that are associated with elevated blood lead levels among U.S. children remain poorly defined. This pooled analysis was done to estimate the contributions of lead-contaminated house dust and soil to children's blood lead levels. The results of this pooled analysis, the most comprehensive existing epidemiologic analysis of childhood lead exposure, confirm that lead-contaminated house dust is the major source of lead exposure for children. These analyses further demonstrate that a strong relationship between interior dust lead loading and children's blood lead levels persists at dust lead levels considerably below the U.S. Department of Housing and Urban Development's current postabatement standards and the Environmental Protection Agency's guidance levels. Finally, these analyses demonstrate that a child's age, race, mouthing behaviors, and study-site specific factors influence the predicted blood lead level at a given level of exposure. These data can be used to estimate the potential health impact of alternative health-based lead standards for residential sources of lead exposure.

The Environmental Protection Agency is required to set a standard for lead-contaminated house dust, but whether dust lead loading (micrograms/ft2) or concentration (micrograms/g) is more predictive of children's blood lead levels, which dust collection method should be used, and which surfaces should be sampled are unknown. Using a random sample of sequential births, we enrolled 205 urban children, 12 to 30 months of age, who had lived in the same house since at least 6 months of age. Samples of dust were obtained from predetermined surfaces in each child's residence using a wipe method and two vacuum methods, the Baltimore repair and maintenance method (BRM) and the dust vacuum method (DVM). Other potential sources of environmental exposure also were analyzed for lead, including soil, water, and paint. In general, dust lead loading is more predictive of children's blood lead levels than is dust lead concentration. Dust lead loading as measured with the BRM sampler explained more of the variation in children's blood lead levels than did wipe loading and DVM loading (13.7, 10.1, and 5.9%, respectively, adjusted for other significant predictors). The partial correlation between BRM lead loading and children's blood lead was significantly different than that for DVM lead loading, but it was not significantly different than that for wipe lead loading. Of the four surfaces measured, noncarpeted floors and interior window sills or wells were significantly associated with children's blood lead levels in multiple regression models. These data indicate that dust lead loading is more predictive of children's blood lead levels than is dust lead concentration and that, to determine if a housing unit is safe for children, noncarpeted floors and interior window sills or window wells should be measured using either the BRM or wipe sampling method.

An experimental portable local exhaust ventilation system was installed in three dental operatories where nitrous oxide was used routinely. Standard methods of exhaust ventilation design used in industry to control exposures to toxic airborne substances were applied to the dental operatory setting. The concentration of nitrous oxide in the dentists' breathing zones was measured before and after installation to determine the efficiency of the system in reducing occupational exposures. Results indicate that placement of the exhaust opening and exhaust air flow rate are important in determining the degree of control achieved. After the system had been installed in one operatory, peak exposures declined from over 600 parts per million (ppm) to less than 70 ppm: the time-weighted average exposure was below the NIOSH recommended level of 25 ppm. A permanently installed local exhaust ventilation system modeled after the portable one used in this pilot study may be feasible for most operatories and should not interfere with dental procedures. The results suggest that nitrous oxide exposures can be greatly reduced if dental operatories are equipped with local exhaust ventilation.

Occupational exposures to nitrous oxide (N(2)0) were measured in numerous dental operatories. In all cases, the National Institute of Occupational Safety and Health (NIOSH) recommended time-weighted average (for one operation) of 25 ppm was exceeded by wide margins (NIOSH considers 50 ppm to be attainable in dental operatories). However, a new risk assessment is necessary to determine appropriate exposure limits. Many of the operatories were not equipped with scavenging systems and none of them used a scavenging device in combination with a local exhaust ventilation system. Scavenging devices and local exhaust ventilation should be used to control nitrous oxide exposures. Leaks in N(2)0 delivery systems, which were found to be commonplace, should also be controlled. Research and development efforts are needed to improve upon the already existing scavenging devices, and provision for local exhaust ventilation needs to be included in the design of dental operatories.