Lead report lists ways to protect kids
Because even very low levels of lead in the blood can cause permanent problems, reducing young children’s exposure is critically important, according to a blueprint for action issued Wednesday by a nonprofit collaboration.
The report says that in addition to improving the quality of children’s lives, if interventions begin for children born in 2018, the nation would realize $84 billion in future savings in health and education spending and increased earnings.
The Health Impact Project, led by the Robert Wood Johnson Foundation and The Pew Charitable Trusts, titled the report, released Wednesday, simply “10 Policies to Prevent and Respond to Childhood Lead Exposure.”
Also on Wednesday, Gov. Tom
Wolf called for universal testing of blood-lead levels in all Pennsylvania children under the age of 2 to determine who is at risk for lead poisoning and where children with the highest and lowest levels live.
Researchers in the national project confirmed that even at levels between 3 and 5 micrograms of lead per deciliter of blood, the brain’s ability to function in the areas of impulse control and information processing is affected. Measurements of 5 micrograms and above are considered elevated blood lead levels by the U.S. Centers for Disease Control and Prevention.
A consultant in the report, Dr. Mona Hanna-Attisha, a pediatrician who uncovered the water crisis in Flint, Mich., called for public officials to learn from the Flint crisis. Referring to the new report, she said, “These recommendations provide the playbook.”
Dr. Karen Hacker, director of the Allegheny County Health Department, said the report is a welcome compilation of information and analyses. She is head of the county’s Lead Task Force, which is developing a science- and data-based strategy against childhood lead exposure from paint, soil and water.
“The timing couldn’t be better. We’re in the middle of our lead-testing work,” she said, referring to the county’s new law on universal testing of lead levels in children and its recent hiring of an epidemiologist to collect and analyze lead exposure data. “A lot of things they’re talking about are things we’re discussing.”
Nationally, the report says, despite years of pipeline regulations and leadfree paint and gasoline, lead persists in many places, mostly in drinking water and paint in older homes and related dust and soil contamination.
“We are working with others to build a culture of health,” said Giridhar Mallya, senior policy officer for Robert Wood Johnson Foundation, in an online news conference Wednesday. He said success stories in the report include that of Rochester, N.Y., where efforts have reduced children’s bloodlead levels countywide.
In December 2005, the Rochester City Council passed a law requiring regular inspections of most pre-1978 rental housing for lead paint hazards as part of the occupancy permit process. Property owners must correct identified violations, and the city maintains an online database of lead-safe properties. More than 141,000 homes have been inspected.
“Experts describe Rochester’s law as one of the smartest in the nation,” the report says.
Rebecca Morley, director of the Health Impact Project, noted similar progress in other Rust Belt cities. In Toledo, Ohio, for example, an ordinance passed last year requires most rental properties to be inspected and designated free from lead hazards before they can be rented.
The researchers analyzed these and other policies for their impacts on public health and health equity, guided by experts and advisers and also people directly affected, such as families with children who have been harmed by lead exposure.
For the group of U.S. children who will be born in 2018, the report says the economic benefits would be many: Removing water service lines containing lead from the homes of that group would protect more than 350,000 children and yield $2.7 billion in future benefits, or $1.33 for every $1 invested.
With other actions, the report estimates the number of children protected and future benefits would be: removing lead paint hazards from older homes of children in low-income families, 311,000 children, $3.5 billion; ensuring compliance with contractors’ lead-safe renovation rules, 211,000 children, $4.5 billion; and eliminating lead from airline fuel, 226,000 children who live near airports, $262 million.
By targeting evidencebased academic and behavioral interventions to the 1.8 million children who already have been exposed, the report says their lifetime family incomes would rise, along with chances of graduating high school and college, and their potential for becoming parents as teenagers and being convicted of crimes would go down.
The study team recommends a reduction of lead in drinking water in homes built before 1986 by replacing lead service lines — performed by states and municipalities, with support from federal agencies. It says lead paint should be removed from low-income housing built before 1960 and calls for the EPA and state agencies to hold more investigations to make sure leadsafe rules in training and certification are being followed by contractors.
The report also recommends that federal and state health agencies should remove barriers to blood-lead testing and reporting.
Mr. Wolf, in a news release unrelated to the nonprofits’ report, called on the state Department of Health to work with the Legislature and community partners to draft laws requiring universal testing in Pennsylvania.
“We need to be able to identify all children who have elevated blood-lead levels in order make sure their families have access to the services they need,” he said. “Only with universal testing will we know the true scope of lead poisoning in Pennsylvania and be able to refer affected children for care.”
In a word of caution about universal testing, Ms. Morley of the Health Impact Project said, “Testing only takes us so far. Our goal is to bring babies home to a safe home,” instead of waiting for them to be tested for lead exposure.
To build quality data and research and provide public access to them, the report calls for cooperation among federal, state and local authorities to find sources of lead exposure and identify those at the greatest risk.
Allegheny County’s new lead-related data collection and analysis is moving in that direction, Dr. Hacker said. It will give the county a chance to respond to issues such as a spike in blood-lead levels where immediate intervention is needed or a lead-exposure problem in a specific location, she said, adding that the state has in the past issued reports years after data is collected.
Reviewing recommendations in the report, Dr. Hacker noted many are underway in the county, including the removal of lead water lines and a pilot program under Allegheny County Economic Development to remove lead paint hazards in older homes. Last year, the state lowered to 5 micrograms the lead level that opens up early intervention services for children.
Dr. Hacker said the task force is looking into other areas as well, including the enforcement of regulations concerning remediation work in older homes and the remediation of contaminated soil.
“It makes me feel we’re on the right track.” The report online: www.pewtrusts.org/lead