This study initiates and evaluates a primary prevention educational intervention targeted to pregnant women and their infants to reduce exposure to lead as measured by blood lead levels. The study is a collaborative effort between Saint Louis University School of Public Health and the Centers for Disease Control and Prevention. Pregnant women attending medical clinics and private physician offices in the inner-city of St. Louis, Missouri is the target population. The population is primarily poor Afro-American, Hispanic, Asian, and Caucasian women. All homes receive an environmental assessment that includes dust wipe sample for lead from all hard and carpeted surfaces and XRF measurements of lead paint. Prospective mothers complete a questionnaire that is used in tailoring educational interventions. The educational intervention is patterned on individualized health education techniques that include case management with hands on teaching of cleaning techniques, property maintenance, hygiene, and nutrition to reduce exposure of newborn children to lead and in addition, tailored computerized print material about how to deal with sources of lead exposure. One control group receives only the tailored print material without the case management and another control group receives only standard material distributed by the clinics. Case management follow-up visits will occur quarterly and print material will be sent monthly.

Specifically, we hypothesize that an educational intervention tailored to an individual mother's needs will reduce the probability that the infant of that mother will become lead poisoned (a blood lead levels greater than 10 mg/dl), as compared to infants of control mothers who receive only the standard lead educational material routinely distributed by local health clinics. We further hypothesis that newborns of women receiving both the case management and tailored print material will have lower blood lead levels than children of women receiving only tailored print material.