A process evaluation of the childhood lead poisoning prevention program in Houston, Texas, 1992--1995

A process evaluation of the Houston Childhood Lead Poisoning Prevention Program, 1992-1995, was conducted. The Program's goal is to reduce lead poisoning prevalence. The study proposed to determine to what extent the Program was implemented as planned by measuring how well Program services were actually: (1) received by the intended target population; (2) delivered to children with elevated blood lead levels; (3) delivered in compliance with the Centers for Disease Control and Prevention and Program guidelines and timetables; and (4) able to reduce lead poisoning prevalence among those rescreened. Utilizing a program monitoring design, the Program's pre-collected computer records were reviewed. The study sample consisted of 820 children whose blood lead levels were above 15 micrograms per deciLiter, representing approximately 2.9% of the 28,406 screened over this period. Three blood lead levels from each participant were examined: the initial elevated result; the confirmatory result; and the next rescreen result, after the elevated confirmatory level. Results showed that the Program screened approximately 18% (28,406 of 161,569) of Houston's children under age 6 years for lead poisoning. Based on Chi-square tests of significance, results also showed that lead-poisoned participants were more likely to be younger than 3 years, male and Hispanic, compared to those not lead poisoned. The age, gender and ethnic differences observed were statistically significant (p =.01, p =.00, p =.00). Four of the six Program services: medical evaluations, rescreening, environmental inspections and confirmation, had satisfactory delivery completion rates of 71%-98%. Delivery timetable compliance rates for three of the six services examined: outreach contacts, home visits and environmental inspections were below 32%. However, dangerously elevated blood lead levels fell and lead poisoning prevalence dropped from 3.3% at initial screening to 1.2% among those rescreened, after intervention. From a public health perspective, reductions in lead poisoning prevalence are very meaningful. Based on these findings, the following are recommendations for future research: (1) integrate Program database files by utilizing a computer database management program; (2) target services at Hispanic male children under age 3 years living in the highest risk neighborhoods; (3) increase resources to: improve tracking and documentation of service delivery and provide more non-medical case management and environmental services; and (4) share the evaluation methodology/findings with the Centers for Disease Control and Prevention administrators; the implications may be relevant to other program managers conducting such assessments. ^

Comprehensive Greenhouse Gas Management for the Electric Generating Industry

Climate change is becoming more visible in the political arena. Electric generating companies will likely be impacted by future regulation of climate change related emissions. Even though few climate related programs are mandatory, electric generating companies should begin to implement greenhouse gas management systems. This report includes a review of issues facing the electric generating industry, an examination of current emission management programs, and recommendations for an effective greenhouse gas management framework. An effective greenhouse gas management program allows a company to continually improve their impact on climate change by reducing emissions using the plan, do, check, act process. To ease the reporting burden, companies should apply de minimis exemptions to sources that produce less than 5% of emissions.

Nutrient Load Reduction: Challenges facing the Chesapeake 2000 Agreement

The Chesapeake Bay is the largest estuary in the United States supporting a complex ecosystem that sustains many habitats and the organisms that depend on them. The bay also supports economic, recreational, and cultural activities to over 16 million people residing in the watershed. Changes within the watershed have caused excessive levels of nutrients, mainly nitrogen and phosphorous, to pollute the bay. The Chesapeake Bay Program, guided by a complex agreement, was created to address these and other issues and oversee the restoration of the bay. The most recent version of this agreement, the Chesapeake 2000, declares its continued commitment to restore the bay with over 100 goals to be met by the year 2010. Reports show that although intensive efforts have been made to promote nutrient reduction, very little reduction has actually resulted. This project described these efforts. The final results reveal obstacles affecting progress, shortcomings to current approaches and possible solutions for future implementation.

Transfer of interest on U.S. investment in the Panama Canal (GAO/AFMD-85-63).

Includes letter of April 8, 1985 from William R. Gianelli, Chairman, Board of Directors, Panama Canal Commission, to Frederick D. Wolf, Director, Accounting and Financial Management Division, U.S. General Accounting Office, Washington, D.C. (p. 12-17).

National accomplishments in pollution control, 1970-1980 : some case histories /

Mode of access: Internet.

Senior Companion Program : operations handbook.

"SCP handbook 4405.91."

Pharmaceutical industry : hazardous waste generation, treatment, and disposal.

Final report (SW-508) describing work performed for the Federal Solid waste management program under Contract no. 68-01-2684.

Wings of hope : the U.S. Air Force and humanitarian airlift operations /

Mode of access: Internet.

Evaluation of the Musculoskeletal Diseases Program.

Mode of access: Internet.

Delivering timely water quality information to your community : the lake access--Minneapolis project /

"EPA/625/R-00/013."

National Workshop on Bus-Wheelchair Accessibility, May 7-9, 1986.

"UMTA Technical Assistance Program"--Cover.

Landfill disposal of hazardous wastes : a review of literature and known approaches : a current report on solid waste management /

"U.S. Government Printing Office : 1977"--Page 36.