A community-based participatory research program to identify lead exposure risks and community priorities

Background: Lead is an environmental health hazard that disproportionately impacts communities of color across the United States (U.S.). Recent incidents of widespread lead exposure have been linked to aging infrastructure, historical land use, and challenges in lead remediation. Objective: To understand community-identified concerns, needs, and priorities related to lead exposure. Methods: Four focus groups with a total of 73 community members, were conducted in Norristown, Pennsylvania, U.S. from Fall 2022 to Spring 2023. Using a community-based participatory research (CBPR) framework and a semi-structured interview guide, participants were asked questions regarding their perceived exposure to lead and current exposure prevention methods. Open coding was used to conduct a thematic analysis of the transcript data. Results: Four themes were identified: (1) community reportesources of concern, including water, soil, and paint; (2) lack of information surrounding lead, particularly in Spanish; (3) systemic neglect, from workplaces, healthcare systems, and landlords; and (4) financial implications, from high costs and fear of displacement. Participants expressed a desire for lead testing of household water, paint, and soil, as well as personal blood lead level screening. Conclusions & implications: : There was broad community support for a lead exposure risk assessment that investigated soil, tap water, and paint sources of lead, as well as the prevalence of elevated blood lead levels in adults and children. The study also highlighted the lack of information about lead exposure in non-English speaking communities, the need for providing language-appropriate information, and the necessity for multiple lead exposure assessment methods.