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dc.contributor.authorBoreland, Frances Theressa
dc.date.accessioned2019-08-08
dc.date.available2019-08-08
dc.date.issued2017-07-21
dc.identifier.urihttp://hdl.handle.net/2123/20870
dc.description.abstractThis thesis uses a translational research approach and combines theoretical, empirical and experiential evidence to explore four key issues that provide further direction to current efforts to reduce lead exposure in Broken Hill, and more generally to improve management of environmental health risks in the community setting. A theoretical review argues for an adaptive response to program development, recognising that the solution to the problem is not straightforward. The review indicated the need for multi-pronged strategies including both population-based approaches and strategies focussing on particular risk groups. Unintended negative consequences must be scanned for and managed so as to ensure a positive benefit : harm ratio is maintained. A qualitative, interview based case study of successful lead exposure reduction programs identified the need for an accurate understanding of sources and pathways of exposure, which may need an iterative approach; effective control of those sources and pathways, adequate funding to undertake the work and active cooperation of relevant stakeholders. A qualitative, interview based case study of the Broken Hill Lead Reference Group found there was broad agreement as to what was required to further reduce lead exposure but that lack of recognition of constraints other organisations faced and overall lack of resources (funding and leadership) within the LRG significantly inhibited collaboration across the group and efforts to reduce lead exposure. Improving collaboration and leadership within this Group is necessary in the long term to reduce lead exposure. A before-after study of changes in participation in blood lead screening found that changing from venous to capillary screening and improving convenience both increased screening, and showed that restructuring services in response to community concern can effectively increase participation. A $13 million, five year program to reduce lead exposure in Broken Hill was established in 2015; considerably more funding is likely to be required.en_AU
dc.publisherUniversity of Sydneyen_AU
dc.publisherFaculty of Medicine and Healthen_AU
dc.publisherSchool of Public Healthen_AU
dc.rightsThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
dc.subjectblood lead levelsen_AU
dc.subjectleaden_AU
dc.subjectchildrenen_AU
dc.subjectBroken Hillen_AU
dc.subjectcontaminationen_AU
dc.subjectscreeningen_AU
dc.titlePROTECTING BROKEN HILL CHILDREN FROM LEAD IN THE 21ST CENTURYen_AU
dc.typePhD Doctorateen_AU
dc.type.pubtypeDoctor of Philosophy Ph.D.en_AU
dc.description.disclaimerAccess is restricted to staff and students of the University of Sydney . UniKey credentials are required. Non university access may be obtained by visiting the University of Sydney Library.en_AU


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