Health and housing collaboration at LAST: the Philadelphia Lead Abatement Strike Team.

The Lead Abatement Strike Team (LAST) was developed in 2002 by the Philadelphia Department of Public Health (PDPH) in response to community concern about management of children with elevated blood lead levels (EBLLs). Fourteen hundred backlog properties (housing at least one child with EBLLs) were identified through inspection as having housing-based lead hazards for which no satisfactory environmental remediation (control of lead hazards) had been achieved. In the first two years of LAST, 834 new housing cases also were identified. The heightened awareness of this problem, sparked in part by community advocacy efforts, led to the appropriation of 1.5 million dollars for environmental remediation. A collaborative group of health, housing, and other officials was convened. Enforcement for remediation of properties with lead hazards was strengthened with the development of the Lead Court, a special judicial court devoted exclusively to hearing cases where owners had violated local lead poisoning prevention laws. Identifying a group of Pennsylvania-certified lead abatement contractors, expanding the health department's abatement team, creating temporary relocation capacity, and providing funding for basic housing system repair work were crucial to obtaining rapid remediation of homes. In the first two years of the LAST program, 1,037 properties (both backlog and new properties) that housed 1,476 children were remediated, representing a significant increase in remediation capacity.