Flint and Beyond: Lead Poisoning Remains a Critical Public Health Issue

As the lead-in-water crisis in Flint, Michigan, continues to evolve, NCHH joins the nation in supporting the residents of Flint in their time of need. Resources must be marshaled as quickly as possible to ensure a safe water supply and provide follow-up services to address the long-term consequences of lead poisoning. We need to take the lessons from this crisis to improve our public policies so that no other communities have to experience what the residents of Flint are going through.

Due to the media attention generated by the crisis in Flint, NCHH has received many inquiries about lead poisoning and what parents can do to protect their children. Many people are telling us that they thought that the problem of lead was solved decades ago. The sad truth is that industry mined massive quantities of lead over the last century and put that lead into many products that went into our homes, including lead pipes and solder, paints and glazes, and other consumer products. Although lead was banned from new residential paint in 1978 and from new plumbing in 1986, residents may still be exposed to lead from products that remain in older homes. Lead was also added to gasoline for on-road use until 1996, and as vehicles burned the gas, the lead was left behind in the dust and soil in our communities.

After decades of sustained research and action, the percentage of children who have been lead-exposed is much lower than it was in the 1980s. Yet lead exposure remains a threat for far too many people. Here are a few things every parent should know to protect their families from lead exposure:

Young children should be screened for lead exposure.
People exposed to lead don’t usually act or feel sick, so screening for lead exposure is very important, especially for young children who are at highest risk for exposure. Screening often begins in the doctor’s office with a series of questions to determine whether a child is at risk. Screening policies and requirements vary from state to state, but at-risk populations, including Medicaid-enrolled children, should have a blood lead test at or around 12 and/or 24 months. A blood lead test is the only way to confirm whether a child has been exposed to lead. The CDC encourages parents to talk about lead screening with their child’s doctor.

Even very low levels of lead can be harmful to young children.
Over the past 50 years, a growing body of scientific evidence has documented the connection between elevated childhood blood lead levels (EBLLs) and neurological damage, decreased IQ, increased blood pressure, anemia, gastrointestinal issues, stunted growth, seizures, coma, and—at very high levels—death. Recent research has found that even very low levels of lead exposure can have a detrimental impact on a child’s IQ, likelihood of having a learning disability, educational attainment, and reading readiness at kindergarten entry. Compared to adults, children are at greater risk for two main reasons: First, they are more likely to ingest lead and absorb a higher percentage of ingested lead. Secondly, their rapidly growing minds and bodies are more susceptible to lead’s harmful effects. Once a child’s health or cognition has been harmed by lead, the effects are permanent and continue into adulthood. This relationship is detailed in the NCHH Issue Brief: Childhood Lead Exposures and Educational Outcomes.

Lead-based paint is the most common source of lead exposure for young children.
Lead-based paint continues to be the most common source of exposure for young children. Although it was banned for residential use in 1978, up to 35% of houses across the United States still have some amount of lead-based paint. Lead-based paint can be especially problematic on doors and windows, which can scrape microscopic particles of lead dust loose as they open and close. As noted above, even these trace amounts can pose a serious threat to small children. NCHH-led research has also identified floors, porches, and common areas of apartments, as important sources of exposure.

If your home was built before 1978, hire a professional to test for lead-based paint hazards. Then make plans to fix any hazards that are identified. Read the EPA's Renovate Right brochure to understand your options, including hiring a lead abatement contractor, hiring a lead-safe renovator, or safely performing the work yourself. There should be post-work testing to make sure no hazardous dust lead is left behind. NCHH recommends clearance dust sampling that is analyzed by a certified lab and compared to EPA standards to give you the peace of mind that the job was done correctly.

Problems can also arise during renovations of pre-1978 dwellings, which is why the EPA requires that firms performing renovations that disturb lead-based paint use certified renovators trained in the use of lead-safe work practices that prevent exposure.

Water, soil, toys, and other household goods can have lead too.
While deteriorating lead-based paint is the most significant source of exposure, lead can be present in drinking water, soil (which can be tracked indoors), painted toys, jewelry, cosmetics, imported candy, dishes, folk remedies, and other household goods. If you’re concerned about lead in your drinking water, you can review your local water quality report, test your home’s drinking water, and follow these tips to reduce your exposure (e.g., using only cold water from your tap).

You can reduce your child’s exposure to lead.
There are many excellent resources available from CDC, EPA, and others with detailed advice on how to prevent lead exposure. Here are some general tips to reduce your child’s exposure to lead in your home/environment:

  1. Keep your child away from painting and repair work that disturbs paint, and make sure no paint chips or dust remain in the work area before your child enters.
  2. Pay attention to peeling paint: Report it to your landlord if you’re a tenant so that repairs will be made (and call code enforcement or legal aid if there’s no response), and repair it safely if you’re a homeowner.
  3. Wash your child’s hands, toys, bottles, pacifiers, and any other items your child often puts in his or her mouth.
  4. Regularly clean floors, windowsills, and dusty places with wet mops or wet cloths to pick up any dust.
  5. Use only cold tap water for making baby formula, drinking, and cooking. Let the water run for a few minutes first.
  6. Avoid using products from other countries, such as health remedies, eye cosmetics (e.g., kohl, kajal, surma), candies, spices, snack foods, clay pots and dishes, painted toys, and children’s jewelry. These items may contain high levels of lead.
  7. Remove shoes before entering your home.
  8. Any household member who does construction work or other work that may involve lead should remove work clothes before entering; wash them separately.

Visit NCHH’s Lead Links page for additional links and resources.

NCHH and many other federal, state, and local partners are working hard every day to prevent childhood lead poisoning. Here are a few of the ways we do that:

Since our inception in 1992, NCHH has researched and published about lead poisoning extensively, conducting numerous studies relating to lead sources in paint, soil, common areas in multiunit buildings, and on windows and porches and contributing over 50 articles to respected medical journals and books.

In 2014, NCHH and the American Public Health Association published the National Healthy Housing Standard, a comprehensive document designed to impart the latest knowledge of the connections between housing and health to municipalities looking to update their building and maintenance codes, elected officials, property owners, and anyone else seeking more information about housing as a platform to health. One of the stretch provisions included in the standard addresses the testing and remediation of suspected lead-contaminated water.

Through our Housing as Healthcare campaign, NCHH has advocated for increased Medicaid coverage for follow-up services for lead-exposed children. We’ve also collected valuable information about strategies for healthcare reimbursement from all across the nation.

Over the years, we have provided technical assistance and program evaluation to help local lead poisoning prevention programs maximize their impact, including nearly 10 years of working with the innovative New York State Childhood Lead Poisoning Primary Prevention Program, which aims to identify and reduce lead hazards in the home environment before children are poisoned.

Between 2009 and 2014, as one of the nation's top EPA-accredited training providers, NCHH trained over 27,500 renovators across the country in lead-safe work practices.

Finally, NCHH chairs the National Safe and Healthy Housing Coalition, which leads the efforts to increase federal resources for prevention of childhood lead poisoning dramatically. The Coalition is pressing Congress to double funding to the CDC's Healthy Homes and Lead Poisoning Prevention Program, from the current $17 million to $35 million. This program provides critical support to state and local governments to screen children for lead exposure, conduct surveillance to determine the extent of childhood lead poisoning at the state and county levels, educate the public and healthcare providers about lead poisoning, and ensure that lead-exposed children receive necessary medical and environmental follow-up services. Similarly, the Coalition is also calling for doubling the budget from $110 to $230 million for HUD’s Office of Lead Hazard Control and Healthy Homes, which provides grants to identify and control lead-based paint and other home health and safety hazards, and research on how to improve surveillance and control of these hazards. The return on investment of HUD’s lead hazard control grants is more than $17 per dollar spent.

NCHH and the National Safe and Healthy Housing Coalition promote a wide array of actions to be taken by federal, state, and local government, as well as the private sector, to prevent and address lead poisoning in U.S. children, as summarized in our Blueprint for Action. Join NCHH and the Coalition to take action today for lead poisoning prevention!

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