Rochester’s Efforts to Prevent and Respond to Childhood Lead Exposure



In Rochester, New York (Monroe County), 87 percent of the housing units were built before 1950 (federal law banned the use of lead in residential paint in 1978), and 60 percent of housing is tenant-occupied, which is more likely to have lead hazards.

In 2000, 1,293 children under age six had blood lead levels of at least 10 µg/dL, which was then the Centers for Disease Control and Prevention’s (CDC) action level— a proportion substantially higher than in high-risk neighborhoods in New York State or in the broader United States. Moreover, there were disparities in both health outcomes (the proportion of children with elevated blood lead levels (EBLs) and risk factors (housing units that were most likely to contain lead hazards from deteriorating paint were home to low-income families).

This led, that year, to the founding of the Coalition to Prevent Childhood Lead Poisoning by a group of individuals and organizations to end childhood lead poisoning in Monroe County.

Rochester’s Lead Ordinance

In December 2005, the Rochester City Council unanimously passed a new lead poisoning prevention ordinance that required regular inspections for lead paint hazards as part of the city’s certificate of occupancy process for most rental properties (Chapter 90, Property Code – Article III Lead-Based Paint Poisoning Prevention). The law took effect on July 1, 2006. Rochester also passed “three accompanying resolutions to the lead law prioritizing inspections in target areas (Resolution 2005-23); encouraging public education and establishing a citizen advisory group to inform implementation (Resolution 2005-24); and requesting that the city establish a voluntary program for owner occupants (Resolution 2005-25).”

While the goal was to inspect nearly all rental properties by 2010, Rochester made initial inspection efforts on properties at highest risk – the areas of highest concentration of EBL cases – its highest priority. The city worked with the Monroe County Department of Public Health to establish the designated areas of “high-risk” within the city.

Under the ordinance:

  • Most pre-1978 rental housing is subject to a visual inspection for deteriorating paint or bare soil at the time of a city housing inspection. Housing inspections may be triggered by a number of factors, including a new or renewed Certificate of Occupancy (C of O), a neighborhood survey, a referral by an outside agency, or a complaint. Some housing units are exempt (for instance, if an EPA-certified risk assessor certifies that the unit does not contain lead paint).
  • All deteriorated paint in pre-1978 housing units is assumed to contain lead unless testing, conducted at the owner’s expense, confirms otherwise.
  • Properties in “high risk” areas – as determined by past blood lead data – that pass the visual inspection (e.g., do not appear to have interior deteriorating paint) also undergo a dust wipe test to make sure that the home is safe.
  • Properties with deteriorated paint above U.S. Department of Housing and Urban Development (HUD)-required levels or bare soil within three feet of the house fail the visual inspection.
  • Lead-safe work practices must be used for all lead hazard control activities, and owners must follow the Renovation, Repair and Painting (RRP) rule.
  • Dust wipe tests (e.g., clearance tests) are required for properties after repairs have been completed.
  • To pass inspection, homes must be lead-safe but not necessarily lead-free.
  • Residents can request a free inspection by the city at any time.

In addition, ongoing monitoring is required—one- and two-family rentals are inspected every six years. Properties in a designated high-risk zone where a lead hazard is identified and the owner opts to use a temporary measure to control it, are inspected every three years, as are multiple dwellings and mixed use occupancies. The city maintains a public database of all residential properties where lead hazards have been identified, reduced, and controlled with federal HUD funds. The city also maintains online accessible databases of all lead safe units and all properties granted a C of O.

To receive a C of O, property owners must correct any identified lead hazard violations. Owners or workers trained in lead-safe work practices are allowed to complete repair work and use less expensive interim controls (e.g., components with paint hazards may be fixed and repainted rather than replaced or permanently encapsulated) to reduce compliance costs.


To implement the ordinance, Rochester initially hired four new inspectors. Since then, due to budgetary constraints, the city consolidated all code enforcement staff and cross-trained building and housing inspectors to assess lead hazards.

According to a recent journal article, the lead law has had a positive impact on children’s health– possibly because nearly every unit was inspected in the first four years of implementation. In addition, the number of units that passed was higher than expected, likely signaling that landlords had made remediation a priority before inspections occurred. Notably, the article also states that the law does not appear to have significantly impacted the housing market in Rochester.

In the decade since the law passed, the City of Rochester Office of Inspection and Compliance Services has inspected 89,935 structures (exterior inspections) 86 percent of which had no lead violation. Of those with a violation, 88 percent were remediated by June 30, 2016. Of the 141,474 interior inspections conducted, 95 percent passed the initial visual inspection. Among those with an interior violation, 86 percent had complied with remediation. Ninety percent of the units subjected to dust wipe testing (over 30,000 units) passed. Also, during the same 10-year period, the city issued 651 vacate orders for situations with severe hazards and 2,715 tickets for noncompliance. In the first five years alone, all target units in high-risk areas were inspected.

Experts describe Rochester’s lead poisoning prevention laws as one of the “smartest” in the nation.

Since the city ordinance was implemented, the number and proportion of children with EBL has decreased countywide. In 2004, 900 children out of the 13,746 tested in Monroe County had blood lead levels above 10 µg/dL, while in 2015, 206 of the 14,283 tested had blood lead results above this level. Between 1997 and 2011, the number of children with blood lead over 10 µg/dL decreased roughly twice as fast in Monroe County as it did in New York State and nationwide.

Despite this significant progress, however, in 2015, 988 of the 14,233 children tested—enough to fill 40 kindergarten classrooms—had blood lead levels above the current CDC reference value of 5 µg/dL, indicating that more effort is needed in Rochester.


In August, 2017, the Health Impact Project, a collaboration between the Robert Wood Johnson Foundation (RWJF) and Pew Charitable Trusts released: Ten Policies to Prevent and Respond to Childhood Lead Exposure. The Trust for America’s Health (TFAH), National Center for Healthy Housing (NCHH), Urban Institute, Altarum Institute, Child Trends and many researchers and partners contributed to the report. TFAH and NCHH worked with Pew, RWJF and local advocates and officials to put together the above case study about lead poisoning and prevention initiatives.

The case study does not attempt to capture everything a location is doing on lead, but aims to highlight some of the important work.

There is also a case study on New York State and another one on New York City.