Effectiveness of interventions for the remediation of lead-contaminated soil to prevent or reduce lead exposure - A systematic review

• Published in: The Science of the total environment Vol. 806; no. Pt 1; p. 150480
• Main Authors: Dobrescu, Andreea-Iulia, Ebenberger, Agnes, Harlfinger, Julia, Griebler, Ursula, Klerings, Irma, Nußbaumer-Streit, Barbara, Chapman, Andrea, Affengruber, Lisa, Gartlehner, Gerald
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2022; Elsevier
• Subjects: Blood lead level; Child; Children; Cross-Sectional Studies; Environmental Exposure; Humans; Lead; Lead Poisoning; Soil; Soil remediation; SES; BLL; CG; NR; DLL; CI; ppm; Soil remediation; SE; SLL; Lead; Children; Blood lead level; vs; IG; US
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2021.150480

To summarize the evidence on the effectiveness of soil remediation to prevent or reduce lead exposure. We systematically searched MEDLINE, the Agricultural & Environmental Science Database, Web of Science, and Scopus from 1980 to February 15, 2021. We also performed reference list checking, hand-searched websites, and contacted experts. Eligible studies evaluated the effect of soil remediation to prevent or reduce lead exposure in humans of any age. We screened all records dually; one investigator performed the data extraction; a second checked for completeness and accuracy. Two investigators independently rated the risk of bias of included studies and graded the certainty of evidence. We synthesized findings narratively. We identified 6614 potentially relevant publications, all focused on children, of which five studies (six records) fulfilled our prespecified inclusion criteria. The number of evaluated participants ranged from 31 to 1425, with follow-up periods of 11 months to one year. The primary soil remediation method was the replacement of the upper layer with clean soil. Outcomes were limited to blood lead levels (BLL), dust lead levels, and soil lead levels. The largest study, a controlled before– after study (n = 1425) reported favorable effects of soil remediation compared to no intervention. This finding was consistent with results from two cross-sectional studies and one uncontrolled before–after study. One year post-remediation, the mean reduction in BLL was 2.1 μg/dL (p < 0.0001) greater in the intervention group than in the control group. Two randomized controlled trials with a total of 511 participants showed no statistically significant incremental effect of soil remediation when combined with paint and/or dust abatement. The certainty of evidence for all outcomes was low. Soil remediation appears to reduce BLL in children when used as a single intervention. The incremental benefit of soil remediation when part of other interventions is limited. [Display omitted] •Lead exposure from contaminated soil is an important public health issue, concerning both children and adults.•Soil remediation alone or in combination with other interventions appears to reduce the blood lead levels in children.•The effect of soil remediation on health outcomes, in high lead exposure areas or in low/middle-income countries is unclear.