Improvements Are Needed to the U.S. Department of Urban Development’s Processes for Monitoring Elevated Blood Lead Levels and Lead-Based Paint Hazards in Public Housing

According to the Centers for Disease Control and Prevention (CDC), lead-based paint and lead-contaminated dust are some of the most widespread and hazardous sources of lead exposure for young children in the United States. There is no safe blood lead level in children, and there is no cure for lead poisoning. Therefore, it is important to prevent exposure to lead, especially among children. U.S. Department of Housing and Urban Development (HUD) officials reported that policies and guidance related to lead-based paint hazards and elevated blood lead levels (EBLL) were clear and well written. However, HUD did not align its EBLL value to CDC’s blood lead reference value (BLRV) for children under the age of 6. As of August 2022, HUD was using the EBLL value of 5 micrograms of lead per deciliter of blood (µg/dL), despite CDC lowering the BLRV to 3.5 µg/dL in October 2021. By aligning EBLL processes with CDC’s BLRV, HUD can help to ensure that cases of children with EBLLs between 3.5 µg/dL and 4.9 µg/dL are reported and monitored. HUD uses its EBLL tracker to monitor cases of children with identified EBLLs residing in public housing. However, the EBLL tracker’s data fields needed improvement. For example, the EBLL tracker did not enable field staff to reference historical EBLL cases; indicate how many children living in a housing unit had an EBLL; or specify whether the unit, building, or development previously had an EBLL case. Additionally, the EBLL tracker contained instances of unreliable data, which reduced its usefulness to HUD officials and hindered HUD’s ability to monitor EBLL cases and ensure that children residing in public housing with confirmed EBLLs were living in lead-safe units. Lastly, we compared the percentage of public housing development buildings constructed before 1978 to a snapshot of the EBLL tracker. We found it notable that New York and Pennsylvania together accounted for virtually all (94.1 percent) of EBLL tracker cases of children living in public housing with an EBLL resulting from a confirmed lead-based paint hazard. This result was despite other States’ having the same amount or more public housing development buildings built before 1978, when lead-based paint was banned. HUD uses its lead-based paint response (LBPR) tracker to monitor and resolve cases in which public housing agencies had missing or incomplete lead-related documentation. However, the COVID-19 pandemic halted HUD’s Real Estate Assessment Center inspection process, which determines whether HUD needs to create an LBPR tracker case for the inspected property. Additionally, there are no timeliness standards for the LBPR tracker, and we identified several cases in which there was no evidence of HUD action for long periods. Developing timeliness standards for the LBPR tracker would help HUD avoid delays in closing LBPR tracker cases. By improving its EBLL tracker and LBPR tracker, HUD could better ensure that it has accurate, complete, and useful data regarding where EBLLs and lead-based paint hazards are prevalent.